(Note: Spoilers follow for the finale of The Patient.)
How will Alan get out? That question has hovered over every episode of FX's limited series The Patient, which follows therapist Alan Strauss (Steve Carell), who is kidnapped by his serial killer patient, Sam (Domnhall Gleeson), and kept in his basem*nt, forced to conduct therapy to cure Sam’s murderous compulsions. As TV viewers, we are trained to expect the grand escape and a poignant but triumphant ending. Creators Joe Weisberg and Joel Fields, best known for their work on The Americans, declined to give us that. In the finale, Alan, attempting a last chance at freedom, is strangled by Sam.
Sam, having at least absorbed some of Alan's lessons, places the doctor's corpse in a place where his family can find it, recognizing the importance the Jewish religion places on having a body to bury. He anonymously delivers the news to Alan's daughter Shoshana (Renata Friedman) and estranged son Ezra (Andrew Leeds), the latter of whom turned to Orthodoxy to his dad's frustration, along with a letter that Alan wrote in his final moments alive. Weisberg and Fields end with two images: Sam deciding to lock himself up in the basem*nt where he held Alan to prevent any further murders, and Ezra in therapy, about to open up about his experience.
It's a poetically grim conclusion to a show that wrestled with questions of faith and empathy in a serial-killer framework. But ask Weisberg and Fields to explain their methodology and they will demure. Like good therapists they want audiences to do the work themselves.
Did you always know from the start of writing that Alan was going to die?
Joe Weisberg: I would say we pretty much did. It was our initial idea. It sort of happened somewhat differently. But it always seemed like there was no real way out. But, by the way, we second-guessed ourselves. We constructed other scenarios and other endings. We thought about every way he might get out and whether or not it would be good and if we'd believe it. But we kind of ended up back where we started, that sadly for Alan Strauss, this is going to be it.
What didn't work about the ideas of him possibly living, and why did it make sense for the story that you wanted to tell that Sam would kill him?
Joel Fields: I would say it wasn't so much a question of what didn't work, but what did work and what felt most authentic and most emotionally impactful. So as we experimented with all the possibilities, when we landed on the specifics of these particular moves, they just felt true to this story. They felt like the inevitable place that these characters were going.
How did the ending get at what you initially wanted to accomplish within this scenario?
Weisberg: That's a hard question to answer both because it's literally hard to answer and because I think we want to be careful not to foist our own interpretations of things on the watcher, but let them go where they're going to go. But I guess I'll just say that knowing he was going to die got us about a fifth of the way there.
