The Patient – Episode 10 Recap, Review & Ending Explained

The Cantor’s Husband

Does Sam kill his father?

In episode 10 of The Patient, Alan frantically calls for Candace. Sam has just left to go kill his dad, in hopes of breaking the cycle of his murders. But Candace still won’t call the police on her son.

When Sam makes it to his father’s place, the man offers to make him a sandwich. He apparently shares his son’s language of food.

Sam doesn’t kill him right away. First, he asks him why he used to hit him and how it made him feel. Sam’s dad replies that he doesn’t know. He was a weird kid, and Candace was always telling him it was his fault. “Sorry,” he say half-heartedly.

Sam jumps on him suddenly and starts suffocating him. But he stops himself before his dad dies. “My therapist told me not to kill you,” he says.

The next thing we know, Sam is back at home and talking with Alan.

Does Dr. Strauss convince Sam to let him go?

Back in his mother’s basement, Sam tells Alan how he stopped himself from killing his father. He’s never been able to do that before, and he doesn’t know why. After all, he hates him so much.

Alan tells him this is a major breakthrough. It shows that he’s trying to change. And Sam didn’t need to kill his father to break the cycle; he needed to not kill him. And by not killing his father, he’s showing that he’s not like his father.

Sam smiles slightly, enjoying the praise. “Thanks,” he says.

Alan then gently changes gears. He says it’s time to let him go home. Like Sam had to work things out with his father, Alan needs to work things out with his own son. He promises to not turn Sam in (as long as he doesn’t kill again) and wants to see him every day in his office for regular therapy sessions.

Sam doesn’t respond, but processes the information. The next morning, he leaves in his truck and brings back a couch and a mini fridge.

He tells Alan he knows he’s been rushing him. But like he said earlier, therapy takes time, even years. He’s going to keep him here–but he’s going to make him more comfortable.

Does Sam turn himself in to the police?

Alan now has to reevaluate. He talks to Charlie in his mind. Alan says he has sympathy for Sam and marvels that the therapy is working to some degree.

Charlie tells him Sam is looking for a replacement father. But Alan and Charlie agree: Alan isn’t going to spend the next 10 years of his life chained up here.

So, he takes a risk and tells Sam he can’t treat him anymore. In his professional opinion, Sam needs to be physically stopped from acting out his urges. Only then can he have the freedom to heal.

He tries to convince Sam it’s time to go to the police. Sam goes to sit outside the police station, but he doesn’t go inside.

Does Alan kill Candace?

Later, Candace argues with Alan. She claims her son isn’t ready. Alan turns his focus to Candace now. He tells her that she didn’t protect Sam from his dad. It wasn’t her fault, but she still didn’t protect him.

When Alan hands her a tissue, he also takes the opportunity to grab her and pull her close to him. With the sharp tube of foot cream pressed against her throat, he calls for Sam.

He tells him to call 911. Either that, or Alan will kill Candace. But Sam doesn’t want to make the choice. He thinks Alan is bluffing.

So Alan presses the weapon deeper into her neck.

Does Dr. Strauss die?

Alan dreams again of a gas chamber. Beth stands close beside him.

When he comes to, he’s with Ezra’s family. His grandson asks if he was thinking about when he was “away.” Alan says he was. He’ll tell him about that time in a few years.

He then sits with his family all around the table. They sing, and Alan is happy. That is, until he sees Charlie.

Suddenly, Alan’s family fades away. Sam is above Alan, choking him while Candace screams at him to stop.

But Sam doesn’t stop. He kills Alan, unchains, then brings him to the other room. He puts his body in the grave Alan himself dug, but he doesn’t bury him.

At Alan’s bedside, he finds a note he wrote before his death.

Did Alan make peace with Ezra?

The scene cuts to Shoshana picking up her mail. In the stack of mail is a typed letter from Sam. He wrote it anonymously and addressed it to both of Alan’s children.

Sam says in the letter that he knows how important it is for Jews to have a body after someone has died. He tells them Alan is dead and where he is buried. Enclosed is also Alan’s note.

Shoshana shares the note with Ezra. Alan tells them how much he loves them both and how much comfort thoughts of them and their families have given him. He apologizes to Ezra for being judgmental and for allowing Beth to take so much blame. He was in the wrong, and he’s so sorry.

Back at Candace’s house, Sam now has his own dead therapist inside his head. The Alan in his head tells him he’s going to kill again.

Sam goes to sit on the bed and chains himself to the floor. He calls for his mother, and hands her the key. It seems like he’s accepted that Dr. Strauss was right. He needs to be physically stopped.

How does ‘The Patient’ end?

Hulu’s The Patient ends on a bittersweet note. Ezra sits with his own therapists. He’s gone through so much, but he’s in a place where he can find healing as well.

Ezra tells his therapist he’s more concerned for his family than for himself. The therapist encourages him to talk about himself, but he’s not sure to start.

“I–” he begins. And that’s where the series ends.


The Episode Review

Joe Weisberg and Joel Fields have done something unique with this limited series. It set up a premise with a lot to unpack about the nature of therapy and generational trauma. Overall, the finale does a satisfying job bringing these compelling themes to a close.

Alan may have died in the end, but he at least completed his search for meaning through a lot of hard self-reflection (something he found, as his note reveals, in his relationships). 

Ezra’s and Sam’s journeys focused more on generational trauma, and the finale doesn’t lose sight of that theme. Sam and Candace each had to learn a difficult lesson through Alan’s death. Each is now doing the hard thing by accepting Alan’s advice. Sam, by physically stopping himself from killing. And Candace, by letting her son heal the difficult way.

But I’m glad the series ended with Ezra. The psychological thriller is about breaking cycles, after all. The scene with Ezra’s therapist is hopeful–suggesting that generational trauma can come to an end.

Although dark and brutal, The Patient closes with an ultimately sympathetic message and encouragement for audiences to self-reflect–and know that change is difficult, but possible.

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You can read our full season review for The Patient Season 1 here!

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5 thoughts on “The Patient – Episode 10 Recap, Review & Ending Explained”

  1. I agree with the previous writer. No accountability for Sam or Cadence. Terrible ending to an otherwise thoughtful series. Toying with the audience isn’t cool. No more.

  2. I thought immediately that at the end, Ezra has been Sam all along, and Sam was one of his personalities.? Just me then? Ok. Lol.. Seriously though, that’s why he was with the Therapist, and he never finished the sentence “I…) because Sam is one of Ezra’s personality’. I thought it was clear as day. Hmmm?

  3. The dumbest most unsatisfactory and unsatisfying ending to a show I’ve seen in recent years. I regret watching it to the finale.
    I love and respect Steve Carell as an actor and filmmaker, but he missed the boat with this one. If there’s a season 2 I won’t be watching.

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