The Patient Recap: Can’t We All Get Along?

The Patient

Season 1 Episode 5
Editor’s Rating 4 stars

The Patient

Season 1 Episode 5
Editor’s Rating 4 stars
Photo: Suzanne Tenner/FX/Copyright 2022, FX Networks. All Rights Reserved.

It has been less than one week since Sam Fortner kidnapped Alan Strauss. And there’s already a body count.

At this point, we’re halfway through the season, and Sam’s dark passenger has finally made an appearance. The repercussions of Elias’s death will surely be felt throughout the remainder of Alan’s stay at Chez Fortner, but now the odds have suddenly and violently been stacked against the good therapist leaving the basement alive.

It’s clear that Alan once believed he could use his considerable skill as a therapist to appeal to Sam’s humanity. Yet throughout this episode — which takes place over mere hours — Alan is beginning to panic. He begins to talk more than his patient, offering painful (and accurate) insights that Sam isn’t ready to hear or accept yet. And Sam is trying. But despite the presence of a trained, talented therapist, he’s white-knuckling the whole experience.

Shame on me for not talking much about Domhnall Gleeson’s clever and nuanced portrayal of Sam yet in these recaps, but this particular episode is a wonderful showcase for what he’s done with this character. Sam doesn’t talk much in this episode — to be fair, he’s a man of few words in general — but we get the strong sense he’s fighting with everything he’s got against this horrific impulse that plagues him.

Gleeson seems to know that individuals who have gone through severe childhood trauma often build impenetrable emotional walls around themselves, refusing to let most people in for fear they will be harmed again. While Gleeson often portrays Sam with a pancake-flat effect, this episode allows him to showcase moments of fleeting emotion that reveal the person he is, or could be, behind all his interpersonal barriers. Occasionally, Gleeson will let a flutter of a smile escape Sam’s lips or allow tortured tears to broach his eyes, and these brief reveals are heartbreaking. The man feels as though he has to use murder as an emotional outlet because it’s all he knows; it provides a cathartic release he can’t get anywhere else.

This is the first episode that opens on Sam and not Alan. Sam visits his ex-wife and blasts Kenny Chesney’s “Get Along” to shake off his stress as he drives. Serial killers! They’re just like us! But Sam’s jaw is tight and he’s pointedly not singing along with the song, so maybe not so much like us.

Sam arrives at Mary’s (Emily Davis) house, and the two have a very awkward conversation. Mary seems pleased Sam has visited her, but she’s also interested in getting to the root of the visit. They briefly catch each other up, nervously clutching coffee mugs at two distant ends of the dining table. As they talk about Mary’s adopted children from Bangladesh, Sam’s initial concern focuses on himself: Has she told the little girl they were fostering about their divorce yet? Nope. Oh, well. Mary tries to engage her foodie ex with talk of the delicious Bengali dishes her adopted kids like to eat, but Sam doesn’t take the bait. The conversation continues, uncomfortable and stilted. However, it does become clear that, unlike Candace, Mary doesn’t quite know that the man in front of her is a serial killer.

When Sam returns to the basement, divorced-dude La-Z-Boy in tow, Alan is ready to engage. He starts to ask some questions about his meeting with Mary, but Sam is still yearning to find an outlet for all the feels roiling around in his body. He jumps up, ready to unleash his anger on Elias, and Alan has no recourse other than to shout for Sam’s mommy like a little kid. But the tactic (temporarily) works. Candace flies down the stairs, admonishing her son and basically treating him like a dog that’s shit on the carpet. When he seems to be under the spell of his violent impulse, she claps sharply and brings him back to the present. He swings around and looks at her, angry tears suspended in his eyes. And then? He actually listens to her. She shifts her tone and starts talking to him as she might talk to a child, telling him to go to his room and get a good night’s sleep. Without a word, he turns and walks into his room.

Alan is grateful and dumbfounded but knows this is only a brief reprieve. Throughout the episode, he’s been gearing up for the worst. Thinking that Elias might just make it out, he’s given him a message for his own family. The morale of the basement captives is sinking ever lower as Alan’s therapeutic techniques do not seem to produce lasting results.

But behind closed doors, Sam is at least attempting to practice what his therapist is preaching. He works to distract himself by listening to more Kenny Chesney (seriously, how did this man sign off on this show?), connecting with other fans on the No Shoes Nation chat boards, and briefly browsing some porn options. He contemplates a few top videos featuring stepmothers and neighbor’s wives before typing “big tits” into the search bar. That’s his kink?

For all of Sam’s efforts, nothing works, and Alan is forced to play his last card. Alan hasn’t been sleeping; he’s been on Elias watch. So when Sam comes out of his bedroom, Alan is waiting for him. He dutifully scoots off the bed and into his therapist’s chair. “Come. Sit down,” he says solemnly.

Alan then proceeds to drop some truth bombs on Sam. Alan dares to counter Sam’s position that every one of his victims deserved to die. They didn’t. They just happened to meet Sam at the wrong place and the wrong time. Alan reflects back to Sam that he is acting out the abuse he suffered as a child by punishing random people for doing nothing wrong, just as his father did to him when he was young. And this violent outlet is Sam’s way of discharging all those pent-up feelings he keeps bottled inside because of his unresolved childhood trauma. It’s a solid analysis, and Alan even caps it with a classic Good Will Hunting–esque “It’s not your fault” moment for good measure, but Sam isn’t ready to hear it.

So Alan switches tactics and attempts to engage Elias in the therapeutic process. Sam’s egocentric mind initially won’t allow this to happen because this is his therapy, his time, his pet therapist, but Alan gently reminds him this interaction might just serve to help him … until it very much doesn’t.

Sam drags Elias out into the room, and Elias barely has time to start talking about his parents and his Asian-fusion recipe for pastitsio before Sam hurls his body at him. As Sam strangles the life out of his captive, director Kevin Bray chooses to really focus on Alan. For better or worse, this choice mutes any menace or evil that might be interpreted from Sam’s heinous act. Instead, it centers on the appalling trauma Alan is experiencing by bearing witness to this event.

For his part, Carell truly makes Alan’s experience come alive. The doctor has failed in his task. He was unable to save this man and stop his patient from committing a violent crime. Helpless and left with no other options, he uncontrollably screeches, “No! No, no, no!” and calls for Candace to intervene. But Candace doesn’t come, and Alan is left to watch this atrocity firsthand. In shock, he seems unable to look away from what’s happening mere feet in front of him.

Sam exits the scene, leaving Alan in the room with Elias’s body. He discharges some frustrated energy into the air and then grabs his murder trophy box full of wallets and watches. Curiously, he takes three wallets out of the box and carefully lays them on his bed. It looks as if he might start counting them, but instead, he just cuddles up to the box. The intent behind this scene seems purposefully ambiguous. Sam is expressing a measure of relief, but there seem to be strands of regret and confusion woven into the mix. Gleeson’s performance in this moment invites us to analyze Sam in a moment of utter vulnerability, but he continues to preserve the mystery of his character as he serves up a tangle of emotions that are too inscrutable and contradictory to provide any concrete conclusions.

The last moment of the episode brings us back to a wide-eyed Alan, clutching the ancient floral comforter on his bed like a life raft. He couldn’t save Elias. Will he be able to save himself?

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

Progress Notes

• When Alan talks to Elias about his complicated relationship with Ezra, he notes that he really hated when Ezra’s family brought their own food when they visited. This anecdote feels like it’s in keeping with the overarching theme of sharing food as a connective tissue of the human experience. Sharing a meal with family or friends can be an intimate ritual, and while Alan is getting that experience with his captor, Sam, he is mourning the loss of that experience with his own son.

• Alan also has a fleeting memory of Ezra joining Beth in song at temple when he was a kid. For once, it’s a happy memory.

• No food at all in this episode or the previous episode. Has Sam tired of playing DoorDash with his captive?

• It’s interesting to note that, as the episode run times are getting longer, the time unfolding onscreen within each episode is getting shorter. While this week didn’t play out in real time, it covered only a few harrowing hours. Will we possibly get a real-time episode in the future?

The Patient Recap: Can’t We All Get Along?