Steve Carell Led Series ‘The Patient’ is a Surprisingly Profound High Concept Thriller

Steve Carell and Domhnall Gleeson star in a darkly emotional new FX on Hulu show from the team behind The Americans, about a serial killer who kidnaps his patient.
The Patient Review Steve Carell

In 2018, The Americans bowed out after six seasons as one of the most critically beloved shows on TV, with four Emmys and a whole host of lifelong fans to show for it. Series creator Joe Weisberg and co-showrunner Joel Fields could have done anything on the heels of The Americans, but four years later, they’ve returned with a project every bit as thorny and thoughtful as the one they’re already known for. The Patient, a ten-episode FX miniseries available soon on Hulu, is a well-acted thrill ride that ultimately challenges the mind, heart, and spirit.

The show follows Dr. Alan Strauss (Steve Carell), a well-known therapist and author whose wife died not long ago. He isn’t the most demonstrative of mental health clinicians, but he’s helpful, professional, and excellent at his job. His troubles begin when he meets Sam (Domhnall Gleeson), an aloof and angry man who refuses to open up in sessions. Then one day, Alan wakes up in a basement, chained to a bed. It turns out Sam is a serial killer who desperately wants help to curb his homicidal urges. Maybe, he thinks, a live-in therapist is the answer.

As with The Americans, the premise of The Patient is extremely cool on the surface, but the execution is more nuanced and heartfelt than viewers could ever anticipate. For much of the series, Alan holds sessions – or as close as one to get to a therapy session while in chains – with Sam and attempts to peel back the layers of his psychology while reflecting on his own life’s regrets. Alan is Jewish, and The Patient is a show about Jewish tradition and resilience as much as murder and therapy. Its surprising strength is in Alan’s solemn reflectiveness as he undergoes an internal change that’s as vital as the one Sam hopes to accomplish.

The Patient is a series full of meaningful and unexpected contradictions – choices that zig instead of zagging. It’s essentially a bottle series. Its action mostly contained to the mundane lower level of Sam’s house. Its very intentionally rendered setting doesn’t feature a design setup that evokes inhuman evil. There’s a sliding glass door to the outside world, a bathroom with thin walls, and a rudimentary dining table where Sam brings Alan high-quality takeout meals.

The basement design isn’t inherently dangerous, which is pretty much how Sam seems as well. Gleeson plays him compellingly as a slack-jawed, over-reactionary man with the emotional maturity of a teenager. An American one replaces his own Irish accent, and Sam hides his penetrating stare under a fringe of black hair. Sometimes, the killer is darkly funny. More often, he’s volatile and frustrating. Yet the show never seems interested in characterizing him as irredeemable, taking both its wild premise and the clinical lens of its therapist protagonist seriously.

Carell’s performance is equally explosive, though in a highly internal way. The actor best known for The Office has repeatedly proven that he can do drama with the best of them. Still, the claustrophobic, pressure-cooker setting of The Patient allows him to put in one of the best performances of his career. Alan is more intellectual than emotional, a refreshing change of pace for someone in a horror movie situation. Yet as the show continues on, it takes a sharp turn into a level of heavy emotional profundity with Alan at its center.

Far from a sensationalized crime drama, The Patient understands the weight of its story every second of the way. As it shifts to center Alan’s Judaism and the ways his family’s traditions have fundamentally connected and disconnected them from one another, the series gains an unexpected gravity. Its emotional honesty and increasingly raw emotion lay plain the fact that so many other shows that are ostensibly about murder are actually about viewers’ entertainment. Not this one. Here, Weisberg and Fields craft a story that grapples with the burden of death and pain in a genuine and unshakeable way.

The Patient surely won’t be for everyone. It’s more of a slow burn than a heart-pounding thriller, though it certainly includes several twists and moments of high tension. Viewers have also unfortunately been conditioned to expect something different from our crime shows, something The Patient isn’t willing to deliver. It’s a noble-hearted yet unblinkingly grim show that cares less about viewers’ satisfaction than it does about their emotional investment and care. None of these are bad things, but all of them make this limited series a tougher watch than most of its contemporaries, especially as it shifts into darker and darker territory as it unfolds.

Ultimately, The Patient succeeds not just on the strength of its two considerably talented leads but thanks to its willingness to subvert genre cliches and tell an even bolder story than its premise would indicate. It’s about a serial killer in therapy, yes, but it’s also about the profound experience of enduring the unendurable. That The Patient never closes its eyes to the most difficult parts of its story makes it not just a bold and impressive show but perhaps even a necessary one.

The Patient premieres on Hulu on August 30th. Watch the limited series’ trailer here.

Valerie Ettenhofer: Valerie Ettenhofer is a Los Angeles-based freelance writer, TV-lover, and mac and cheese enthusiast. As a Senior Contributor at Film School Rejects, she covers television through regular reviews and her recurring column, Episodes. She is also a voting member of the Critics Choice Association's television and documentary branches. Twitter: @aandeandval (She/her)