In episode 5 of The Patient, Sam goes on a drive to get away from his potential victim and pay a visit to his ex-wife, Mary. He tells her he’s in therapy, that he was told to come see her. She’s surprised, but not exactly unhappy to see him.
He asks Mary how Hara–their adopted daughter from Bangladesh–is doing, and if she told her about him. “That’s against the rules,” she answers. She’s not allowed to tell her children (she’s adopted a second child, Muntaha) about anything upsetting, like divorce.
Their awkward conversation doesn’t last long, and Sam eventually gets into his truck to return home.
Meanwhile, Elias plans on what to do when Sam returns. He asks Alan to convince Sam to bring Elias into their next session. Then, they can attack him together.
Alan gives Elias a message for his family in case he’s the one who doesn’t make it out. “Tell my daughter Shosanna that I love her and that I treasured our life together, and that I want her to find a way to move on.” He also wants him to tell Ezra that he and Beth always loved him, even when it was difficult.
Elias is crying. He asks Alan to keep talking, so Alan tells a story about Ezra and how he became an Orthodox Jew. He tried to help Beth through the difficult period, but Ezra didn’t make it easy for her.
Sam returns before he can finish his story. Alan asks about his encounter with his ex-wife. He tells him that she has kids, one of whom they adopted together. He liked seeing her. “But I don’t think it accomplished what you were hoping.”
Sam can’t stand waiting any more. He goes to Elias’ room. Alan screams for Candace, who comes down and yells at Sam. “You are supposed to be protecting me,” she says. “Get back here!”
Sam pauses. Candace then tells him to go to his room, and encourages him to get some sleep. He leaves for his room, cursing, then listens to Kenny Chesney to calm down.
Alan tries to relax and zones in on a memory of Beth singing at synagogue. A young Ezra runs up to her during the service, and they sing a song together.
But that night, Sam can’t stop thinking about Elias. He gets up in the middle of the night and comes into the basement. Alan gets up to greet him and invites him for a session.
Alan says he’s starting to think Sam is wrong about how his disease works. After what he went through as a child, he’s angry. That anger has made him violent. So, he’s just looking for people who can serve as excuses for him to act out those feelings. And it’s almost random the people he chooses. In reality, he can always find a way to be offended by people.
Sam disagrees. He thinks all the people he has killed are worthless, that they deserved it. But Alan tries to convince him to search more deeply.
He thinks he’s angry because his father would beat him if he didn’t do exactly what he said. That got into Sam’s mind too. He thinks there’s a reason that all these people are behaving rudely to him, but they really haven’t done anything to provoke him any more than Sam did anything to provoke his father. Elias doesn’t deserve to die any more than Sam deserved to be beaten.
Sam can’t digest this, so Alan interjects, asking him to bring Elias out so the three of them can talk. Sam goes and gets him, but is clearly agitated by his presence.
Alan remarks that if he gets to know Elias, he will feel differently about him. He invites Elias to share things about himself.
Elias takes a while, but he eventually tells the story of his parents’ restaurant. But Sam can’t take it. He jumps onto Elias and goes to strangle him. Alan screams, unable to do anything, as Sam finally kills his victim.
The Episode Review
A therapist wouldn’t usually expect his patient to apply his advice immediately–understanding, rather, the time it takes to unpack one’s trauma, forge new mental pathways, and change one’s behaviour.
But Dr. Alan Strauss doesn’t have the luxury of time.
The Patient ramps up the suspense with this dark episode, along with the intense consequences of this captive therapist’s failed attempts to get through to Sam–driving home all the more the pressure we put on psychiatrists as well as the relatable drive to dismiss advice that doesn’t see immediate rewards.