Alan has reached a breaking point. In the aftermath of witnessing Sam murder Elias, he’s beginning to retreat into the recesses of his own mind. He is alone, scared, and scrambling for answers, and he can’t possibly keep this up for much longer. But he knows if he lets his professional façade falter, Sam will no longer consider him useful … and then what?
Two significant things happen in this episode of The Patient. First, we meet Charlie, Alan’s old mentor and therapist. Second, Sam actually listens to some of Alan’s advice and guidance in an effort to change. These developments are connected.
Well, we kind of meet Charlie. The real Charlie is dead. The Charlie we see — played by an excellently droll David Alan Grier — is an amalgam of Alan’s fond memories of his friend, his own therapeutic experience, and a deep, desperate, abiding hope that his knowledge will get him out of this jam.
All the best therapists have therapists. And as Alan finds himself in Charlie’s gorgeously appointed dream office, he begins to relax and reframe the reality of his situation. He starts to ask himself tough questions that, so far, we’ve only seen manifest in the form of meaningful glances and microexpressions on Alan’s face. While Carell’s performance has certainly left no stone unturned in delivering cathartic, urgent emotion to Alan’s experience, the imaginary therapy device allows him to reveal all of these thoughts out loud. It works.
Alan realizes he’s dissociating, but he’s glad to have someone to commiserate with. As Sam forces Alan to help dig Elias’s grave in the basement, Alan’s mind wanders to all sorts of different memories. He experiences flashes of his son, Ezra; memories of reframing his own grief for his patients; discussions with a colleague; and, curiously, images of the gas chambers at Auschwitz — but he keeps coming back to sessions with Charlie. Here, he gets an opportunity to just be himself and unload on a third party. (Therapy!) He also gains a confidant who keeps him accountable for his actions. When Charlie asks why Alan has been eyeing the heavy white pitcher that conspicuously ended up in the dream office, Alan insists that he’s been “fighting back with everything I have.â€
We, like Charlie, know this isn’t the truth because Alan hasn’t actually tried to use the pitcher, which is a powerful tool in his arsenal. (He’s also wearing wire-rimmed glasses that might be just perfect for picking a lock, but that’s another story.) Due to an overwhelming sense of fear, Alan is underestimating his physical abilities, and when it’s clear that Charlie isn’t buying what he’s selling, he quickly admits to this. He says, “I don’t want to die any sooner than I need to.†Perhaps, he muses, he’ll run out of either his pills or his foot cream and die of a heart attack or foot fungus instead, sparing Sam the trouble.
Along with providing a sort of emergency therapy, Charlie and Alan discuss Sam and his myriad problems. Charlie seems loath to give direct clinical advice (he is imaginary after all), but Alan uses him as a sounding board for his own thought process. Alan knows that if he can’t untangle Sam’s knotty psyche — and fast — he’s going to die.
As Alan chats with Charlie, he realizes that Sam’s complete and total lack of empathy has been an ongoing barrier to providing effective treatment. It’s clear that the abuse Sam suffered as a child has prevented him from progressing past the egocentric stage of development (what up, Piaget!), and therefore he cannot empathize with others. This trait notably reveals itself during Sam’s agonizingly awkward conversation with his ex-wife, in which he seems chronically incapable of talking about anything but himself. Oh, also leaving Elias’s rotting body in Alan’s room for an entire night without considering how he would be affected by that experience is a telling sign. Also, kidnapping Alan. Also … pretty much everything Sam has done up until this point.
But as Alan himself says in the very first episode, if a person shows up to therapy and is willing to change, the work can be done, so Alan refuses to fall apart. Instead, he rededicates himself to the work of healing Sam, mostly because it’s his only possible ticket to freedom but also because he’s a therapist who believes everyone is capable of change.
After a few sessions with Charlie, Alan starts to shift his approach with Sam. While he knows he’s starting at “absolute zero†with Sam’s empathy meter, Alan is determined to try to move that number in a positive direction, even if it’s just a small change. He tries to take the lemon of Elias’s rotting corpse and turn it into therapeutic lemonade.
It’s of note that Charlie and Alan aren’t trying to diagnose Sam. Instead, they’re working off his behaviors alone. And Sam’s behavior the morning after he kills Elias is completely atrocious. It’s clear he blames Alan for this turn of events. In a chilling scene, Sam chains his pet therapist up to dig Elias’s grave and then leaves. When Sam comes back, he offers up gourmet doughuts, and the two sit in silence for a moment. In an attempt to activate Sam’s empathy center, Alan proposes that Sam engage with his victim and consider him a person.
Initially, Alan tries to get Sam to feel something deeper by looking directly at Elias’s face. As Sam removes the duct tape, dead skin peels away from Elias’s forehead in a gummy ribbon of gore. It’s a grotesque scene that activated my gag reflex hard, but Sam doesn’t seem to care. It’s a swing and a miss from Alan.
Yet Alan has another trick up his sleeve. He continues on his quest for empathy, encouraging his patient to consider Elias a whole person. Elias didn’t just exist in the confines of the interactions he had with Sam; he was a member of society with hopes and dreams and wants. He had a family who loved him, and families need to grieve when they lose a loved one. Miraculously, this seems to connect with Sam. He has a lot of follow-up questions about the Jewish grieving process, and Alan handles these with aplomb. There’s a funny beat when Sam asks if he should recite the Kaddish for Elias and Alan is barely able to stifle his horrified reaction to this misguided thought. Ultimately, Alan is successful in temporarily shifting Sam’s perspective to think about others instead of himself, and Sam agrees to dump the body where it can be found.
Before dragging Elias’s corpse away, Sam needs to take one of his signature Dunkin’ piss interludes, giving Alan just enough time to hastily scribble a message and squirrel it away inside Elias’s mouth. It’s a tense sequence that illustrates how Alan truly is trying to fight back with everything he has. While the contents of his note are somewhat incoherent, prioritizing a message to his kids instead of providing more details about who he is and how he’s being held captive, the part about “Sam Rest Insp†may just be enough for the authorities to find him.
The conclusion of the episode sees Alan watching Sam drag Elias’s body away. With every rough bump and tumble of the corpse, Alan fears his message will pop out, but it doesn’t. When Sam is out of sight, Alan retreats into his mind again, recalling a time when he watched his wife sing at their temple. Is this a moment of hope? Or is it a foreshadowing that he’ll soon be reunited with his beloved in the afterlife?
That’s all the time we have for today, but I’ll see you at our next session.
Progress Notes
• We don’t see much of Sam outside of the basement this week, but a chilling interaction with his mother tops the episode. She comes out and chastises her son, saying she’s at her wit’s end with his behavior. Her tone is serious but not quite on the level of someone who witnesses her son murdering a man in her basement the previous evening. Candace Fortner’s penchant for inaction in the face of severe violence is certainly one piece in this puzzle, and even Charlie knows it. At one point, he mentions to Alan that he needs to shift the narrative and help Sam see that his mother is partially culpable for the abuse he suffered as a child. This is something a therapist might bring up slowly over time with a patient, but Alan doesn’t have that luxury.
• A+ acting job from Alex Rich as dead Elias. It can’t be easy playing a manhandled dead body, but this guy pulls it off.
• I’m really and truly loving the chemistry between Grier and Carell, both comedy legends with a gift for the dramatic. Their rapport reminds me of the fantastic interactions between Chuck (Michael McKean) and Jimmy (Bob Odenkirk) in Better Call Saul. The comedic-actor-to-serious-actor pipeline is often underutilized but always a delight to see in action.
• Sam’s insistence that the carpet fibers from his home may incriminate him in Elias’s murder is completely laughable considering he had to go to the store to buy lime, a jackhammer, and other super-murder-y items to bury the body in his basement. Decades-old carpet fibers won’t take Sam down, but maybe his credit-card statement will?