Summary: Part 1, Chapters 4-7

Chapter 4

Theo leaves his job at Broadmoor, a mental hospital, to work at The Grove and get closer to Alicia. Before leaving, he speaks with his supervisor who warns him that he is making a poor career choice. He claims that Lazarus Diomedes, who testified at Alicia’s trial and directs psychiatric care at The Grove, is somewhat unconventional. Further, The Grove is struggling financially and might not be open for very long. Theo remains committed to his decision, and shortly after he begins work at The Grove, the psychiatric wing of Edgeware Hospital. He describes the hospital as a large Victorian building surrounded by ugly, modern additions. First, he meets Yuri, a thirty-something year old Latvian immigrant who serves as the head nurse at the facility. While Yuri offers him a warm welcome, Theo is treated more coldly by Stephanie, the manager of The Grove, who wastes little time with niceties and instead prioritizes safety for patients and staff. Yuri recommends that Theo spend some time settling in, but Theo wants to dive right into his work, and offers to participate in the daily group therapy session called Community.  

Chapter 5 

The Community meeting, a mix of a group therapy session and an administrative meeting, is held once or twice daily. Diomedes, a handsome Greek therapist in his sixties, runs these Community meetings because his principal background is in group therapy. He considers Community an important way of getting patients involved in their own care by allowing them time and space to provide feedback for the staff. Theo also meets some of the other staff at the meeting, including the friendly Indira, who was present at his job interview, and Christian, who Theo previously worked with at Broadmoor. In addition, Theo meets some of the patients at The Grove, including Elif, an intimidating Turkish woman in her mid 40s who interrupts the meeting to complain about a broken pool cue, angrily demanding a replacement. Theo scans the room for Alicia and realizes that she has been sitting right in front of him. The lively and energetic young woman shown on the news is now barely recognizable, heavily sedated and drooling as a side-effect of her medication. Though Theo does not interact directly with Alicia, seeing her confirms for him that he made the right decision in coming to The Grove.  

Chapter 6 

After the Community meeting, Theo finds Diomedes in his office, which is full of musical instruments, including a piano, violins, and a harp. Diomedes confesses that music is his “passion,” and would have been his career path if he had not become a psychotherapist instead. He asks Theo if he has any interest in music, and Theo admits that he hasn’t played an instrument since learning the recorder as a child. Diomedes explains that he cast the deciding vote to hire Theo, who reminds Diomedes of himself. The Grove, Diomedes notes, has fallen on difficult times financially. The Trust that funds the facility has been closely monitoring and assessing their work, and he fears that the Trust is looking for any excuse to shut down The Grove. Further, Diomedes believes that Stephanie, the manager, is in league with the trust and has been placed there as an “insider.” Theo shifts the conversation towards Alicia, and he asks whether she has been treated with individual therapy. Diomedes states that he attempted to treat Alicia, but she was entirely unresponsive to him. Theo suggests that she might not respond well to an older male figure if she had a difficult relationship to her own father and offers to work with her himself. Diomedes accepts Theo’s offer to treat Alicia.  

Chapter 7  

Theo has his first one-on-one meeting with Alicia, requesting that Yuri leave the room despite safety protocols that require two members of staff to be present. Still heavily medicated, Alicia shows little response. Theo imagines how Ruth would respond to this challenge, and he concludes that if Alicia won’t speak, he’ll have to focus on nonverbal cues and examine his “countertransference,” or his own emotional response as a therapist to their therapy sessions.  


Theo’s decision to transfer to The Grove is surprising to his colleagues at Broadmoor. His supervisor even suggests that he is committing career suicide by moving to a facility with such an uncertain future. Their discussion underscores the differences between Theo and his more career-focused colleagues. Theo wonders how to explain his choice in a way that others might understand, and even considers telling his supervisor that he intends to write a book after treating Alicia, which would surely attract a good deal of attention given the high-profile nature of the murder trial. To his colleagues at Broadmoor, working as a psychotherapist is just like any other job. While they value job security and celebrity, Theo thinks of his work as his calling. He makes it his personal mission to treat Alicia Berenson, though the source of his obsession with her is still unclear at this point in the story. He claims that he feels sympathy for Alicia because he too might have suffered from a mental health crisis if he hadn’t received therapy early in life.  

At The Grove, Theo meets a wide cast of characters with very different backgrounds and motivations. Some of the staff there are friendly, like Yuri, who has worked hard to teach himself English and wants to be liked by others, and Indira, who brings a maternal touch to the otherwise clinical psychiatric ward. However, other members of the staff are unfriendly or hostile to Theo. Stephanie is obsessed with safety protocols, which have become more stringent under her management, and Christian, a former colleague of Theo at Broadmoor, attempts to embarrass him in front of patients and staff at the community meeting. Though the staff of The Grove work together to treat their patients, they are by no means united in their personal values and philosophies. Their work is important, but petty jealousy, miscommunication, and the financial strains of the facility all hamper their ability to work effectively as a team.  

The most important member of staff who Theo meets at The Grove is Prof. Diomedes, who is somewhat eccentric. Theo notes that he seems more like an irreverent uncle than the director of a psychiatric facility, though it is also clear that Diomedes cares greatly for the patients under his care, arriving early in the mornings and leaving late in the evenings. He sees some of his own passion in Theo, though he is somewhat reluctant to assign Theo to work with Alicia, whom he describes as a “silent siren” due to her tendency to “lure in” others with the mystery of her silence.  

Theo is ultimately far more interested in Alicia than he is in the other patients or staff at The Grove. During the Community meeting, he is so absorbed in his observation of Alicia that he struggles to follow the group conversation. He is surprised by how little progress has been made in treating her, and resolves to stop at nothing to reach her despite her unresponsive nature. In their first meeting together, he disregards the facility’s safety protocols by meeting with her one-on-one, the first of many times that Theo will bend or break hospital rules. This first session highlights Theo’s passion and resolve, but also the reckless nature of his determination.