In the world of various takes on “crime” media, The Patient seemed like a unique take on the fictionalized story of a serial killer. The show is a short one-shot series on FX with 10 episodes ranging from half an hour to 45 minutes. It has a lot happening, both in terms of Dr. Strauss’ sessions with his patient, but also his own struggles with his family, as well as a lot to do with his Jewish faith. It’s a complex and solid show, although with a few misses for me here or there.

I will also say there is a lot about the Jewish faith and references to the Holocaust. I get the themes that the show is trying to present, but I don’t feel qualified to speak on them overall. I am not completely divorcing my opinion from those aspects of the show; I just don’t feel like I can do an in-depth dive on Dr. Strauss having dreams about being in Auschwitz and the like while being held captive.

With that –

The show opens with Dr. Strauss (Steve Carell) waking up in an unknown place and realizing he is chained up. He is panicked, and after we see him freak out, we flash back a bit. We get a look at his regular routine, including meeting with a new patient. During a session with that patient, without realizing it, Dr. Strauss seals his fate. He confronts the patient about not being fully honest, and that therapy can’t work without that honesty. Sam, who is a serial killer attempting to control his compulsion, realizes he agrees but that he can’t tell his Dr what he is without full control over the situation. He kidnaps Dr. Strauss so that they can do therapy sessions.

Dr. Strauss goes through a few phases and, at first, is completely unwilling to work with Sam. However, Sam essentially spells out that Dr. Strauss is only there to help him, and if he refuses, then… what’s the point? Dr. Strauss knows he must play along at least for a while in order to buy himself some time and possibly even convince Sam to let him go.

The show takes place over a fairly short period of time, with Sam opening up about his feelings about being a serial killer, the fact that he has his next victim picked out and is driven to kill him, and the general fear and intensity of the situation. Sam is obviously unbalanced and keeps putting Dr. Strauss in extreme situations that are out of his element and area of knowledge. Dr. Strauss is also struggling with his own visions of how this might end, including fantasies of overpowering and killing Sam.

While not focused on Sam, Dr. Strauss begins to reflect on his life. His wife passed away from cancer, and Dr. Strauss’ relationship with his son is strained to the point of almost no contact. Ezra, his son, converted to Orthodox Judaism, something that Dr. Strauss and Beth (his wife) did not support. While at first, Dr. Strauss was willing to let the strain of their relationship be the responsibility of his late wife, he is forced to confront his own part in it, and his own contempt for the choices his son made and how that made him behave.

The show is fairly interesting in how it plays out. Despite the way the previews show it, a lot of it is not actually their therapy sessions. While those do happen a lot and are important, it’s not as present in some episodes as you might expect. There is also some juxtaposition as Dr. Strauss starts having “pretend” therapy sessions in his own mind. They are both “the patient,” and in many ways, Dr. Strauss is more so.

Steve Carell does a masterful job, and he really is the central feature of the show. While that doesn’t mean Sam is entirely forgotten, the growth he goes through in helping Sam – or occasionally with his own struggles with how to plot against him – is compelling and a main driver of the experience. Sam is always present, and the threat of how this will all end is always looming and lingering. However, it drives Dr. Strauss to confront his problems with his family, his grief, anger, and even, to an extent, his faith. It’s interesting how the script is really flipped for the audience about halfway through, so we see Dr. Strauss as more of the main character. And I liked this, by the way. Too much focus on Sam and the “diving into the mind of the killer” would have been pretty paint by numbers and expected. Putting the focus on how Dr. Strauss deals with him, as well as his own struggles, makes this show fairly unique.

That doesn’t mean Sam or his story is absent, not at all. Several episodes are focused on him, and even some that seem more focused on Dr. Strauss still have important moments for Sam. Sam was abused as a child and is an angry person who allows his anger to drive him to the unspeakable. Sam is not painted as the intelligent “Hannibal,” something the show itself points out. There are times the picture is painted of him being the controlling and smart killer. More and more as the show goes on, though, he is simply… childish and selfish.

At one point, he nearly breaks and wants to kill Dr. Strauss because he had a bad date essentially, and processing the idea of “feeling bad” is too much for him. Domhnall Gleeson does a great job as well and really dials in to all aspects of Sam. Angry, aggressive, immature, and the facade of control.

The show is also pretty solidly thrilling. It can be intense and exceedingly heavy and emotional. It can also be brutal and violent. While fairly bloodless, that does not take away from how intense some of Sam’s moments can be. The show is also complicated too, and some of my emotions changed as things developed. For example, with Candace, you will have to watch to know who she is. It also has a wicked and dark sense of humor that pops up fairly rarely, but when it does, it lands that “I shouldn’t have laughed at that” feeling perfectly.

Yet, despite all it does right, I still… am not entirely sold. Some of the pacing is a bit off and sometimes loses that “thriller” edge to it. I also think for all I appreciate the focus on Dr. Strauss and his family; some of my least favorite moments were with that aspect. They effectively establish what they are meant to, Dr. Strauss looking on while his wife is being blamed for the divide with Ezra, but they didn’t always land for me or sometimes (not always) felt weirdly placed.

Still, with those issues, I would still recommend this show. I don’t think it lived up to being as good as I wanted, but it was still pretty well done. It’s good. I will say as far as the ending, I liked it and felt it was what it meant to be. Although there is one particular aspect of it, I am guessing I am less positive about it than some people. – see end of piece note only if you don’t mind spoilers –

So bottom line? If the premise appeals to you, the show is solidly done and worth the watch. If I were the type to give scores, it wouldn’t be a perfect 10 for me, but it’s above average and something I am glad I checked out. It can be intense though, so if you don’t tend to like these types of things, it might not be where you want to start.

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So a Quick Note!


SPOILER – thoughts on a specific part of the ending, please avoid if you want to watch this show without knowledge of the end, which you should!

– I wanted to mention what I was vaguely hinting at above.

I think most people will probably finish the show with the feeling that Sam has changed, and he has… somewhat. It was good that he made sure the family could find Dr. Strauss’ body and gave them the letter. Also, the fact that he chained himself up is for sure a step above “free to do this whenever I want.” It’s still not turning himself in, however. His mother’s guilt is painted in such a way that we know Sam will be able to get the key from her, probably not easily, but he would be able to. Sam has taken a step in the right direction, but he’s left himself the option of having access to victims again. His chaining himself, I think, is only vaguely positive. I haven’t read others’ reactions, but I am guessing some people will be more moved by that action than I was.