In (Very Extreme) Treatment

The Patient can sneak up on you in many ways.

THE PATIENT IS NOT EPIC. Unlike several of the major shows arriving on TV of late—House of the Dragon, She-Hulk: Attorney at Law, The Lord of the Rings: The Rings of Power—it does not boast dizzying visual effects, take place in a fictional realm, or have any connections to a larger cinematic universe.

While they go big, The Patient remains appropriately, suspensefully intimate and contained. For long stretches, it functions as a two-hander with scenes that involve a pair of actors doing exceptional work opposite each other: Steve Carell as therapist Dr. Alan Strauss and Domhnall Gleeson as Sam, a patient with homicidal tendencies. Much of it is set in a single room, the spare finished basement of Sam’s isolated home in the woods. Most of the ten episodes run 30 minutes or less; the first lasts a mere 20, which is precisely how much time is required to establish the show’s central premise and conflict. It is,

pardon the pun, all killer, no filler, but not in the ways you may imagine.

Sam is a serial murderer who kidnaps Alan, chains him up in said basement, and insists that Alan cure him of his desire to take the lives of people he deems offensive. Yes, we see Sam engage in some rather violent behavior, but The Patient is not a “murder show.” It doesn’t fixate on the grisly nature of Sam’s crimes or a police investigation into them or, refreshingly, any sexual compulsions that may be driving him. Creators Joel Fields and Joe Weisberg, in the follow-up to their masterpiece The Americans, steer all the way around serial-killer tropes to create a limited series that offers surprising twists and thoughtful nuance in equal measure.

Written entirely by Fields and Weisberg and co-directed by Americans veterans Chris Long, Gwyneth Horder-Payton, and Kevin Bray, The Patient emphasizes claustrophobia and isolation in every artistic choice. When Sam returns home from work or an errand, the headlights from his car illuminate the basement as though someone has finally come to Alan’s rescue, a hope extinguished each time his captor walks through the sliding glass doors. Even the scenes outside the basement, which include flashbacks to moments in Alan’s life pre-kidnapping, are often set in compact interior spaces: a crowded dinner table, the deathbed of a loved one, a small office. The Patient does everything it can to put us in a mind-set reflective of the private, sometimes uncomfortable process of seeking therapy.

Sam initially starts sessions in Alan’s office, where he uses an alias and isn’t completely forthcoming about the depth of his problem. He kidnaps Alan on the assumption that more regular therapy in his home, where he can speak freely, will lead to a breakthrough. If Sam doesn’t reach that point, it seems very likely that Alan will become his next victim, a possibility that hangs over the series like the unspoken diagnosis of a terminal disease. Much of the tension in The Patient naturally derives from whether Alan can make it out of that basement alive, an emergency situation at odds with the calm compassion he exudes while counseling Sam.

Alan brings his baggage into the sessions, too, and his issues figure as prominently as Sam’s. Via scenes from the past and some imagined discussions with his own late therapist, Charlie

(David Alan Grier), we learn that Alan’s wife, Beth (Laura

Niemi), recently died of cancer and that Alan is estranged from their son—losses that nag at his soul and become intertwined with the emotions he experiences in the basement. Alan’s feelings about Judaism, a matter directly related to the rift in his family, become more central as the episodes progress, giving the series a sense of gravity. On its surface, The Patient is a thriller about a man held prisoner by someone he’s expected to treat. More deeply, it’s about atonement and forgiveness, finding empathy and recognizing our own blind spots, and seeking justice and realizing it doesn’t always come, at least not in the form we may want.

Fields and Weisberg once again demonstrate a gift for threading multiple needles in tone and theme, then sewing all the pieces together in an impressive finale. As was the case on their Russian-spy drama, they are aided considerably by their star duo. Playing a man whose life is defined by compulsions both dark (murder) and pedestrian (Dunkin’ Donuts coffee), Gleeson never fully relaxes. Through small tics—the clenching of his jaw, the plucking of loose flesh on his hand—he conveys how uncomfortable Sam is in his own skin and how happily he would shed it if he could. Carell gives one of his strongest dramatic performances, communicating panic in moments of genuine distress and, more poignantly, in the undercurrent that runs beneath his seemingly affable attempts to encourage Sam. Alan’s life preserver is his ability to maintain professionalism in an absolutely maddening situation, but that doesn’t mean it keeps him safely afloat. Carell keys us into just how hard he’s kicking beneath the water, briefly signaling desperation in his gaze or making a nerve beneath his right eye twitch when he hears news from Sam he doesn’t like. We see those details only because The

Patient is the kind of show that keeps its focus narrow and purposeful. Because this is an original piece of television—not based on a true story or existing source material, which is beginning to feel like a rarity—there are moments of real discovery and shock. As Alan advises Sam during a therapy session in which he keeps interrupting, “sometimes when we wait, people don’t say what we think they are going to.” The Patient does that throughout its economically constructed season, right up to the very end. It may not be the most uplifting series you’ll watch this year, but it’s certainly one of the most thought-provoking and absorbing. ■