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In ‘The Patient,’ it’s heal or be killed

Steve Carell (left) and Domhnall Gleeson in "The Patient."Suzanne Tenner/FX

In the opening of “The Patient,” therapist Dr. Alan Strauss wakes up in a strange paneled basement equipped with a bed, a bedpan, and a roll of toilet paper. Just looking at the carpeted, ugly space, you can smell the mustiness. Alan, played by Steve Carell, quickly realizes he’s chained to the floor and can’t move more than a few feet from the bed. He lets out screams for help that no one will hear.

It’s in this humdrum space that much of the 10-episode, half-hour drama takes place. But the basement, with its sliding glass door and, eventually, BarcaLounger, has more facets than you might expect. Thanks to direction and camerawork that make use of every sector of Alan’s prison, our time spent there is not nearly as monotonous as it could be. Like the therapist’s office in “In Treatment,” a show that also largely took place in a single room, the basement becomes a world, as the script digs into notions about forgiveness, the power and the weakness of words, the conflict between fathers and sons, and, most unexpectedly, and unnecessarily, the Holocaust.


And the same goes for the concept of this flawed but original limited series from the creators of “The Americans,” Joe Weisberg and Joel Fields. It’s an uneven narrative, with a few tonal mistakes and excesses along the way — but there’s a lot more to the story line than you might expect from the basic plot description, which is: A serial killer kidnaps his therapist and insists on being cured of his murderous impulses. “The Patient” — a pun on both someone receiving treatment and the quality of waiting — takes the premise and, with flashbacks and surrealistic flourishes, makes it into a full life story with a spiritual undercurrent.

Domhnall Gleeson (left) and Steve Carell in Hulu's "The Patient."Suzanne Tenner/FX

The “In Treatment” comparison with “The Patient” is clear when Alan and killer Sam (Domhnall Gleeson) have their therapy sessions in the basement. Alan had been treating Sam — then going by Gene, and not open about his violent side — in his office. After the initial shock of having been kidnapped by Sam, Alan realizes he must work on all cylinders in order to help Sam resist his impulses — or else he will likely be killed, like Sam’s other victims. Either he succeeds brilliantly at his job, or he dies. The early episodes, in particular, can feel like one-act plays for two characters, with Alan and Sam’s kinetic back-and-forth. Alan is in a position similar to that of Tony Soprano’s therapist — challenged to heal a psychopath despite the high odds against that.


As he works to get Sam to talk more about his abusive father, Alan thinks about his own son, Ezra (Andrew Leeds), and his late wife, Beth (Laura Niemi), whom we see in flashbacks. We learn that Ezra’s decision to become an Orthodox Jew did not sit well with Alan and Beth, even while Beth was the cantor at a liberal synagogue. We also learn about the falling out between Alan and Ezra, as well as Alan’s treatment plans for Sam, through the at times wearying imaginary conversations Alan has with his late therapist, played by David Alan Grier.

As he feels increasingly doomed, Alan also has dreams that find him lurking alongside Holocaust victims in Auschwitz — a layer of reference in “The Patient” that feels unearned. Some recent series, including “Transparent” and “Russian Doll,” have managed to usher themes of generational trauma and the Holocaust into the story naturally and pursue them fully. Here, the themes strain to fit in and don’t go very deep.


The talk and flashbacks are cut with action, too, which I won’t detail here, except to say that there are times when the “In Treatment” vibe morphs into something more akin to “Mindhunter,” and we see just how dangerous the situation is for Alan. Among other things, “The Patient” is a portrait of a serial killer, and, while it contains a bit of black comedy along the way, it is a hard drama. Sam is as creepy as can be, despite his “normal” qualities, which include a love of Kenny Chesney, a taste for good takeout food, and, most of all, his desperate desire to fix his problem. Gleeson is chilling, with his piercing eyes and expressionlessness, but the character isn’t written strongly enough to take us inside his thinking. At moments, I wondered if Sam was meant to be more of a symbol in Alan’s life than a real character.

Alan, on the other hand, brings us into his logic and his past enough to form an intimacy with the viewer. We get to see what he’s really contemplating, before he carefully selects what to show Sam. There are moments when you sense Carell might be trying a little too hard to project terror. Ultimately, though, he is effective, especially in the later episodes. He’s the human to Sam’s zombie, a healer hoping to install a real heart where there is only an empty chamber.



Starring: Steve Carell, Domhnall Gleeson, Linda Emond, David Alan Grier, Andrew Leeds, Laura Niemi. On: Hulu. Premieres Aug. 30

Matthew Gilbert can be reached at Follow him @MatthewGilbert.