The Euripedes play Alcestis is the dominant symbol in The Silent Patient and takes many forms. The figure of Alcestis itself is a clear representation of Alicia. Both women face betrayals by their husbands when their husbands favor their own lives over their wives’. Alicia’s choice to sign her self-portrait with “ALCESTIS” highlights her recognition of this symbolic relevance. Alcestis represents “the silent patient,” the woman scorned, the person betrayed. She is voiceless, but her silence alone is a message, expressing disappointment, hurt, and rage. In this sense, she also speaks to the power of non-verbal communication, embodying the adage that sometimes a person speaks loudest when they say nothing at all.

Alcestis is not just the character but also the name of the play, which Alicia sees with Jean-Felix, and Theo reads. The Silent Patient begins with an epigraph, a quote from the play: “But why does she not speak?” The tragedy itself is symbolically relevant in light of the theme of betrayal. By building a narrative around Alcestis—the woman, the self-portrait, and the story itself—the novel strongly aligns itself with the tradition of tragedy, full of murders, suicides, and mistaken identities—all cornerstones of many a tragic work.