The Patient Recap: The Main Point

The Patient

Season 1 Episode 4
Editor’s Rating 5 stars

The Patient

Season 1 Episode 4
Editor’s Rating 5 stars
Photo: Suzanne Tenner/FX

Oddly enough, love is in the air in the latest episode of The Patient.

The love referenced in the show certainly isn’t a romantic type of love; it’s love in a more general sense. As Alan gets to know Sam and Sam’s captive Elias (Alex Rich), both men talk about how love is incredibly important to them. Alan also gets an opportunity to speak about his deep — and complicated — love for his family. I guess the Beatles were (mostly) right. In the context of The Patient, all you need is love … and a rescue party.

The love that Sam speaks about is a more nebulous, communal concept of love. At the top of the episode, Alan’s increasingly panicked state is interspersed with snippets of previous sessions he’s had with Sam. Sam shares that he was once married and that it was nice, but what he really appreciated was when his ex-wife attended two Kenny Chesney concerts with him as he’s a huge Chesney fan. (How they got Chesney to sign off on this particular show and this particular fictional fan is pretty amazing. A sign he’s a pretty chill dude in real life.)

Sam says the concerts bring him a sense of community, togetherness, and peace. The central concept of Chesney’s “No Shoes Nation” is love. Since Sam’s childhood upbringing appears to have been short on secure familial love, it makes sense he would begin seeking it out in other, broader ways.

I believe I’ve mentioned this before, but I truly appreciate how Sam is becoming a more three-dimensional person as the episodes progress. Not only do we hear more about his affinity for country music and his desire to be part of something larger than himself, but we also get to see him interact with co-workers outside the basement’s confines. In fact, for most of the episode, Alan actively tries to push Sam into the outside world, desperate for his patient to distract his mind from his captive and make human connections in the hopes he will make a different choice than the one nagging at his mind.

Finding himself responsible for a life other than his own, Alan frantically begins to pull out every tool in his therapist’s toolbox. In one of his memories, Sam asks, “Is this how therapy works?” And Alan responds with a layered chuckle that’s two parts nervousness, one part panic, and one part genuine. The answer is just as layered as that laugh. Yes, therapy is a complex process involving a lot of talking, mining of memories and experiences, and trying new tactics to change ingrained behaviors. But therapy does not occur in a vacuum. In addition to what unfolds in session, a good therapist often uses referrals to connect patients with community resources or to connect themselves with a colleague or supervisor who can provide another perspective. And they can also call upon the authorities when something goes horribly wrong in a crisis situation.

Alan has no such luxury. He is completely on his own with only wits, instinct, and decades of experience to guide him. As he tells Elias at one point, he believes he can save both of their lives — and we get the sense he feels pretty confident this is true— but he’s also desperate and tired. As Alan begins to converse with the mystery captive behind the door, he often slumps onto the ground, chain winding beneath his legs, exhausted from the effort of keeping it together.

This episode establishes Alan as the fulcrum between the two men. Being the healer he is, he effectively endears himself as both therapist and friend to the suffering Elias. Except for a fleeting glimpse of his duct-taped face at the end of the episode, we don’t actually see Elias at all. Carell is tasked with speaking to a disembodied voice and making every emotional note sing. I’m a person who’s quick to praise actors for making interactions with CGI characters feel realistic and whole (Christopher Meloni, MVP), but much of this chapter involves Carell speaking in the direction of a closed door, and he manages to bring that situation to life in a compelling way.

Throughout the course of a single, fraught day, Alan keeps volleying Sam back out into the world to prevent him from killing Elias. Colloquially, in the recovery community, this tactic is referred to as “Move a muscle, change a thought.” First, Alan summons all the therapist authority he can muster and demands that Sam go to work for the day. He does, which gives Alan time to learn more about Elias.

Alan doesn’t get much time with Elias before Candace storms down the stairs, brandishing her fireplace poker and holding out a battery-deficient phone. The robotic voice demanding that the phone be charged is a touch that is both hilarious and horrifying. Alan orders Sam to stay at work for the rest of the day, then suggests he go to a “No Shoes Nation” concert, to which Sam scoffs. Chesney is touring in California, and he’s not going to California.

Thankfully, Sam does as Alan says and stays at work for the rest of the day. This gives Alan time to chat with Elias. The two men, desperate and fearing for their lives, begin talking about the people they love. Elias recalls coming home to care for his mother when she had cancer. When he learned that his mom was sick, he returned home from travels in Asia and created a recipe for her that incorporated Udon noodles into pastitsio, a traditional Greek baked pasta. It was a dish born out of creativity but also a deep desire to bring comfort to his ailing mother.

Elias wants Alan to write down a message to his parents just in case he doesn’t make it. Alan dutifully grabs his paper and pen, but Elias has a very brief message he’d like to convey: “Mom and Dad, I love you,” he says. Love. A short, simple word that speaks volumes. It’s a universal human emotion that comes to the forefront even in times of despair. Alan is moved by this sentiment, and when Elias asks if it’s enough, Alan’s breath catches with emotion as he responds, “I think it’s the main point.”

Alan relates to Elias’s family situation as his wife, Beth (Laura Niemi), just died of cancer a few months prior. This is the most we’ve heard Alan talk about Beth, and the information is accompanied by a flashback to a time when she served huge ice-cream sundaes to two of her grandchildren right in front of her three other grandchildren, who could not partake. While it’s understandable that Beth might have been upset about her son Ezra’s conversion to Orthodox Judaism, this move seems unnecessarily cruel to the other children at the table. Alan reflects upon this memory as he waits for Sam.

Sam returns home with a sound machine and places it just inside the door where Elias is being held. This gesture provides a glimmer of hope as Sam clearly doesn’t want Elias to hear what he has to say, indicating that he’s still considering the possibility of letting him go free. It seems important to note that Alan has given no identifying information away about Sam to Elias either.

Alan reminds Sam that his four-month gap of murder abstinence is impressive. Alan compares it to his battle to give up smoking, but then he immediately backpedals on that statement, though he’s not entirely off base. Sam is using violence against others to escape from his own psychic pain, much as many people with substance addictions use substances to escape from their own psychic pain even when continued use hurts themselves or others. (Okay, it’s not completely the same, but there are similarities!)

Realizing that continuing to talk about the situation isn’t working, Alan encourages Sam to visit his ex-wife. In a moment of bold confidence, Alan asks that Sam unplug the sound machine. As Sam rounds on Alan, Alan’s face morphs from a look of fear to one of stoic insistence. Alan is refusing to give up his position of power in this therapeutic relationship, and I’m living for it.

After Sam storms out, Alan and Elias are left to chat once more. Elias is scared. So is Alan. Alan looks to comfort his fellow captive, so he begins singing the chorus of John Denver’s “Take Me Home, Country Roads” to soothe both of them. Elias joins in, and then the two exchange names, identifying themselves as something more than just terrified prisoners. The moment provides a sweet beat of connection in a sea of despair.

That’s all the time we have for today, but I’ll see you at our next session.

Progress Notes

• By the end of this episode, Elias has gone a full day without food or water. Alan’s tactic to keep Sam out of the house can’t possibly work forever because Elias could potentially die from dehydration. So what will his next move be?

• When Alan asks Candace to shed a bit more light on Sam’s childhood, Candace says, “I can tell you all about it, but I don’t think it’s going to give you the answer to why he does what he does. He was always … just … Sam.” Here, it feels as if Candace is saying that Sam’s violent compulsions weren’t learned or shaped by his environment but instead that he was born this way (no shade, Lady Gaga).

• I love the touches of dark humor in this series. Sam gets a funny moment early on in the episode where he makes the “cuckoo” motion when referencing a friend who’s been to more than 70 Chesney concerts, and Carell finally gets to deliver a moment of levity when he tells Elias that Sam “doesn’t seem to fully respect the patient-doctor relationship.”

The Patient Recap: The Main Point