The Lost Patient (2022) Ending Explained – What was the identity of the person in black?

The Lost Patient Plot Synopsis

In a similar fashion to Lucy, The Lost Patient’s protagonist Thomas Grimaud finds himself looking for answers and dealing with a ticking time bomb. In showcasing him spiraling into a dark world of truths about his mother and regrets about his past, Christophe Charrier carves palpable tension. The film was released on Netflix a couple of days ago and has left viewers reeling for answers. The trickery in plotting and pacing raises doubts about what actually happened to Thomas’ family and how he ended up in the hospital.

The conspiracy against him has a morbid truth and The Lost Patient does a decent job of preserving the central mystery until the very end. Read our ending explainer of The Lost Patient on Netflix below, and a detailed review of important plot points.

Okay, so to understand The Lost Patient, you need to see the plot as two halves. One includes the flashbacks that Thomas has while in the hospital and the other is the present day where Anna tries to treat Thomas. She is a therapist and is attending to him as he tries to recover from the trauma of losing his family in a single night. Someone in “a black coat” murdered all of them and he sees visions of that person visiting him in the hospital room coming for him.

He sees various signs that there is a conspiracy against him. A male nurse takes a special position in his perceived truth and he even theorizes him as the killer. Thomas is also desperate to find out the whereabouts of his sister, Laura, who was perhaps his closest ally and the only one who understood him. Both timelines are intertwined in such a way that on most occasions, you do not know what is the truth and what a lie.

Who is Bastien?

As it turns out, Bastien is just another patient in the hospital where Thomas is getting his treatment. The narrative did indeed build him up as someone significant who had some connection to Thomas. Even as he discovered the truth about his life, Thomas tried to hang on to that last glimmer of normalcy and innocence by going into Bastien’s room.

That room no. 307 was the one with Bastien and Thomas tried to get him to run away from the facility. But Bastien knew the reality of the situation and called the doctor just in time to avoid any fatal damage.

It has to be said that Bastien was used well in the narrative. He was yet another red herring, albeit not a critical one, to move us as far away from the truth as possible.

Who was the killer of the Grimaud family?

As it turns out, Thomas was the one who killed his family. In the flashback that we see from a neutral standpoint, not from Thomas’ perspective, we learn the dark and tragic truth about his life. Anna was right in her diagnosis that Thomas suffered from frequent and sudden episodes of outbursts of violence. It was all due to how the family treated him. They were too broken over Laura’s death at such an early age and failed to “forge a bond” with Thomas. As Anna explained with the analogy of Frederick II, if a baby is not given love and attention and does not form a bond with the parents, “he dies”.

That part of Thomas which was supposed to love the family and become a warm man, died with the lack of attention. Matt and Betty were almost repulsed by Thomas’ birth and hence, he grew up a very lonely and depressed child. In another one of those outbursts, Thomas took the gun from his parent’s room and started with Matt. The event that triggered this episode was Betty berating Thomas for killing the neighbor’s dog and Dylan moving into the bedroom upstairs, which was supposed to be Laura’s.

Thomas felt as if he was getting replaced. He also felt betrayed that his parents were loving a child of another when neglecting him. He craved their love for years but did not get it. Dylan, who came in just a few weeks back, had already won their favor. That was ultimately the trigger that compelled him to take the gun from the parents’ room and kill them all.

Where and how did Laura Grimaud disappear?

Laura had actually not disappeared. She died before Thomas was born, being hit by a car on the road. The adult version of Laura that we see in Thomas’ recalls is actually an apparition in his mind created from the image of an actress he saw on television while supposedly breathing his last.

Thomas grew up a neglected child and felt an emotional vacuum in his life. That made him violent and imagined things to create an illusory reality to find comfort. Laura’s projections were part of it and Anna wanted to steer him into the actual reality through treatment in the hospital.

What was the identity of the person in black?

The person in black is actually Thomas himself. In the final flashback of the story, when the night’s contents become apparent in his head, he remembers it all. After killing all the members of his family, he realizes what he actually did. The horror of murdering them in cold blood took over him and he retrieved a knife from the kitchen, intending to commit suicide.

As he stabs himself and starts to fall unconscious at the base of the couch, he sees a song playing on the television. It is the same song he listened to “with Laura” in the car when they were bringing Dylan home.

The reality of Laura was that he had imagined her as the actress in that video. In quite a striking revelation, we see that every memory of an adult Laura that Thomas had was of that actress. Sure enough, she wore the same clothes throughout the movie as the girl in the video. To combat the trauma of growing up alone and without a sister, he dreamt up the details of that actress as Laura and believed his delusions to be true.

But who was the “person in the black” then? It was Thomas himself. A part of him, that killed the family, became a monster in his head. To process his guilt and recover from the smear of killing them all, he found someone else to blame. That often happens when you try to run away from what you did.

It scarred him for life and we see in the final scene, he was indeed wearing that black coat and went out after killing them. Still, in a daze, he suddenly saw that part of him in the shadows and went back inside to stab himself.

The Lost Patient remained true to its psychological thriller DNA with that ending and made sure to give us some crucial answers. However, the makers failed to explain many things in the plot and that does leave us unsatisfied. What did you think of the movie? Leave your comments down below!


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11 thoughts on “The Lost Patient (2022) Ending Explained – What was the identity of the person in black?”

  1. Thank you for clearing up a lot of questions in this movie. I like trying to come up with who did what to whom or who is the murderer and this one kept my interest to the end. I liked it.

  2. Remember when it was explained how the six infants died because of a lack of love and communication, even though they were fed?
    That is the key to Thomas’s motivation for killing. He was never good enough. He never replaced his sister. He never was loved.

  3. Thanks for explaining! When I child dies at a young age, like Laura, the parents may feel cold toward the next child, subconsciously afraid that he/she might die too, or feeling that the child they have alive is not as good as the one who died. Things can quickly spiral downhill from there. I saw this in my family.

  4. Long winded, badly dubbed, why oh why did I watch it. Maybe hoping for more of an explanation at the end,.

  5. What is the significance of the bracelet that was gifted to Betty by Laura/Thomas? Why did Betty get upset?

  6. I liked the movie just a couple of things I don’t understand. I know Laura died at an early age and that would be devastating but why did they not love Thomas even more why did they have another child if they were going to neglect him if they couldn’t overcome the loss of their daughter.

  7. Thank you for explaining. Though, presumed who the gruesome murderer was, was unable to get the plot.
    Good. Liked it.

  8. Too soon I figured out that Thomas was the killer which kind of spoiled it for me.. Not a movie I would watch again or recommend to anyone.

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