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Book Reviews   |    
Reviewed by Eben L. McClenahan, M.D., M.S.
Psychiatric Services 2005; doi: 10.1176/appi.ps.56.12.1630-a
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by Stephen Spignesi; New York, Bantam, 2005, 368 pages, $23

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With Dialogues, Stephen Spignesi makes his novel debut. Spignesi has authored more than three dozen nonfiction anthologies with such varied topics as Stephen King, the Beatles, the Titanic, J.F.K., UFOs, Robin Williams, jewelry, and films. He stated that he felt a strong impetus to write this psychological mystery over a period of six weeks, during which he suspended his usual work.

The story begins with the first of several dialogues between the protagonist, Tory Troy, and her psychiatrist, Dr. Bexley, hired by the court system to evaluate her competence to stand trial. She has been accused of murdering six coworkers at an animal shelter, where she was a euthanasia technician. The plot continues through a series of dialogues, including those between Bexley and each of Troy's parents, Bexley and the defense attorney, Troy and a priest, jury members among themselves, Troy and a psychiatric nurse whom she befriends, and two corrections officers inspecting pancuronium bromide and other chemicals held in stock for lethal injection. By means of these dialogues, Spignesi quickly engrosses the reader. He leaves one grappling with confounding intertwined uncertainties ensuing toward a climax that possesses a quality of legerdemain, a literary trompe l'oeil. Of course, I may not divulge the conclusion. I can, however, guarantee that, until the final 15 pages have been read, the reader will be altogether unable to discern the outcome.

I would be interested to know what my colleagues in forensic neuropsychiatry would think about this book. Troy, a college graduate with a Mensa IQ, reads James Joyce's Ulysses while confined to the psychiatric facility. She had lost her job in pharmaceutical sales because the company switched to marketing via the Internet. She thought working at the shelter would be rewarding because of her love of animals. We also learn that she has a history of childhood sexual and physical abuse. One gains a few additional glimpses into her psyche by way of some of her poems and short stories. Spignesi depicts Bexley as a deft psychiatrist who maintains good reflective listening and appropriate therapeutic neutrality throughout his encounters with Troy, notwithstanding her frequent sarcasm. Up until the very last few pages, the reader continues puzzling as to why indeed Troy might commit such a ghastly crime. I quite readily recommend this thriller and look forward to other fictional works by Spignesi in this genre.

Dr. McClenahan is assistant professor of clinical psychiatry at Tulane University School of Medicine in New Orleans and medical director of region 3 of the office of mental health, Louisiana State Department of Health and Hospitals.




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