The Patient Review: A Masterful Psychological Thriller

Dr. Alan Strauss (Steve Carell) starts "The Patient" in a nightmare scenario. He's woken up in a strange new place, on a bed in a room that looks stuck in the 1980s. He gets up and makes his way to the door, but encounters an unexpected and shocking resistance: Strauss' leg is chained to the bed. Unfortunately for him, he isn't dreaming, and he's really trapped in a basement he's never been in. Turns out, the room belongs to Sam Fortner (Domnhall Gleeson), who Strauss has been seeing as a patient in his therapy practice for a number of months.

Sam has been frustrated by the lack of progression in therapy, and he has a new method in mind — to keep Strauss prisoner in his home so he can get the help he needs in order to be a better person. It's a bit more complicated than that though, as Strauss points out that being kept prisoner is not typically an avenue to have healthy, safe conversations in order to genuinely progress as a person. It doesn't matter to Sam — who's previously given the therapist a false name, career, basically an entire existence — as he's desperate. He has an innate drive to kill, he's killed before, and unless Strauss can curb his desire to murder, he's going to do it again. Strauss finds himself in an impossible situation: he must help his patient in order to save his own life.

As Strauss attempts to rehabilitate his patient, his circumstances leave him with seemingly endless swathes of time on his own, which forces Strauss to look inwards at his own personal struggles. This is where "The Patient" feels especially enthralling. Carell delivers what might be the best dramatic performance of his career in a role that requires him to go to some dark, desperate places. Strauss is a dedicated member of the Jewish faith, and his recently deceased wife was the cantor at their synagogue. Strauss' relationship with his wife was incredibly strong, and she passed just a few months before he wound up imprisoned in Sam's basement. 

Strauss also has a complicated relationship with his son, who has become estranged since leaving behind his family's reformed Judaism for Orthodox Judaism, and it's fascinating, as a Jewish person, to watch this divide slowly unfold over the series. While that may seem inconsequential to many people, "The Patient" gives the complex issue the respect and unique insight that the discussion deserves, leading to one of the more surprising and powerful story beats in the series. Faith is so important to so many people, and "The Patient" deals with issues of belief and the way differing beliefs affect a family in incredibly moving ways.

Events unfold slowly and methodically as we get to know more about Dr. Strauss and Sam. That's not to say "The Patient" is boring — far from it, as tension is ratcheted up at every moment. There's an impressive element of unpredictability written into Sam's character that comes from frequently revealing new details about his life that begin to paint a more complete picture of him, but you also never know when he'll suddenly lose his cool and become overwhelmed by a desperate need to kill. Despite being an entirely different show, "The Patient" takes the same method as Strauss, slowly revealing crucial details about his own life — largely through flashbacks, as his circumstances don't exactly allow for information to come many other ways.

Making a show like "The Patient" that largely centers around therapy is a clever way to make the exposition feel natural. Thankfully, Strauss' deep investment in his career and his passion for helping people — and most importantly, his own need for survival — propel him far beyond a stereotypical therapist you regularly see on TV. Strauss doesn't just sit silently while Sam rants for hours on end, interjecting with an occasional, "How does that make you feel?" Strauss plays an equal part in the sessions, and you can feel earnestness in Carell's performance as Strauss, a man not only desperate to make it out of this nightmare scenario alive but reform Sam as a commitment to his life's work. The longer things are drawn out, the more Strauss begins to detach from reality, but he remains incredibly determined to solve the immense problem he's in, and also to solve it the right way.

As Sam, Gleeson is exceptional. A character with an innate desire to kill could so easily come off as hokey, but Gleeson never resorts to easy choices like sudden crazed outbursts that are so common in representations of killers. In fact, most of the time he seems completely normal, especially when we see him outside of the basement conversing with others in day-to-day life. He has certain particularities that make him a unique person, but what's especially chilling about Sam is that he seems like the kind of person who you walk past every day, quiet, and just minding his own business. His mindset can turn, and turn quickly, but it never feels out of character or too much. It's not an easy role to excel in, but Gleeson makes the terrifying feel utterly normal.

After a game-changing moment halfway through the series, you'd expect the drama and tension to exponentially increase. While things certainly remain at a knife edge, "The Patient" instead gives us an opportunity to learn more about who Strauss and Sam really are. It's a similar technique that helped the show creators Joe Weisberg and Joel Fields' previous show, "The Americans" — one of the best, most tightly-wound, character-driven shows of the 21st century. Even when everything was going off the rails, the focus of the show remained on the characters themselves, allowing things to feel grounded and impactful. The same kind of storytelling is found here, albeit in a far more intimate setting, as most of the show takes place in a single room. Characters always come first in "The Patient," which helps keep the show humming.

Speaking of its limited locations, "The Patient" does a fantastic job with its restricted setting. There are occasional breaks from Sam's basement, but the overwhelming majority of the series keeps things to the single location. It's an impressive feat that spending multiple hours in the same unremarkable location never feels boring. Cinematographers Dan Stoloff and Moira Del Pilar Morel do incredible work in "The Patient," maximizing space in unexpected ways and regularly delivering striking visuals that impact the story. There's a shot in episode five that's so incredibly powerful and astonishing and hopefully, Emmy voters will take note of Morel's work.   

Keeping the episodes between 20-30 minutes allows the story to unfold the way it needs to. That might sound like an obvious statement, but consider the way so many limited series are eight or 10 hours long, and feel like there are so many unnecessary moments that bog things down in order to fit into some pre-conceived notion of being long for the sake of it. "The Patient" is far too story-driven to fall into that trap, and its 10 episodes never feel weighed down by the superfluous. 

"The Patient" works because instead of delivering an attempt at a hostage situation show, it does something else entirely, reveling in an intimate and intricate character study of two people in an extremely difficult situation. The writing is extremely sharp, delicately layering in shocks and twists that never feel out of place, and are always firmly in the realm of believability. It's so committed to its characters and everything centers around who they are, which makes everything feel legitimate. It's easy for a show like this to get bogged down by characters making some extremely questionable decisions, but in "The Patient," everything is thought through in meticulous detail. 

For fans of "The Americans," it should be no surprise that Weisberg and Fields can deliver a top-tier prestige drama, but there's every bit as much to enjoy here for those who have never seen their work before. "The Patient" is proof that one doesn't need to get bogged down in an overlong series. Carell and Gleeson are operating on top form, and nearly every moment of the entire show is exceptional. You won't want to miss it.

The Patient debuts August 30, 2022, exclusively on Hulu.