The Patient Recap: Breakthrough

While Sam backslides, Alan confronts the hard truths of his past, as well as his uncertain future. A recap of “Ezra,” episode 8 of the FX on Hulu miniseries ‘The Patient,’ starring Steve Carell, Domhnall Gleeson, David Alan Grier, and Andrew Leeds.

Season 1 Episode 8 Editor’s Rating5 stars *****

Photo: Suzanne Tenner/FX

Oops, Sam did it again. On what seems like a whim, Sam decides to follow his boss, Kyle, after work, corners him in a diner alleyway, and then strangles him to death. All for basically no reason at all.

Sam does not follow through on his contract with Alan. He doesn’t go home or even attempt to process his murder-y impulses with the psychiatrist he has chained in his basement for this exact reason. He doesn’t even tell him he did it until they get through 37 (!) points in a game of table tennis. And then he has the audacity to tell Alan therapy isn’t working.

As Alan has discussed with both Sam and Charlie, therapy is not magic. Hell, even I feel as though I’ve been a broken record talking about that concept throughout these recaps. Effective therapy involves good-faith engagement, a willingness to explore hard things, and the ability to listen and be humbled. At this point in time, Sam doesn’t seem to be doing any of these things. Instead of trying to grapple with the difficult feelings that have arisen in his treatment with Dr. Strauss, he’s bailing on him and looking for another pet therapist. It looks as though Alan’s time is up. This doctor is out.

However, Alan isn’t going down without a fight. And it’s because he’s starting to come to the realization that he has been blind to the part he played in the family’s frayed relationship with Ezra. This episode is very much a silent showcase for actor Andrew Leeds, who moves through this episode with pained eyes and a heavy burden of regret weighing on his shoulders. At times — especially when Ezra’s desperate search for his father is interspersed with quick cuts of Sam indulging his worst impulses— it feels as if there’s some sort of connection between these two men as lost souls because of the failures of their respective fathers. But that comparison is too simple and pat, and the show knows it.

Instead, the connection between Ezra and Sam is revealed during Alan’s glorious breakthrough with Charlie. Left alone for another day, Alan contemplates his empty tube of foot cream. Foot fungus (probably) won’t kill him, but Alan knows the empty tube is an indicator his time has run out; he needs to figure out what he wants to do with the time he has left. In this moment of despair and hopelessness, Alan decides to get real with himself. And his journey in this particular session with Charlie is admirable and astonishing.

Alan’s breakthrough session with Charlie takes place over the course of a day. As Alan begins to wrestle with some hard truths, he also begins to fashion a weapon from his empty tube of foot cream. With each scrape of metal against metal, Alan examines the hard truths of how his own actions served to alienate his son.

Charlie isn’t playing nice anymore. As Alan tries to justify some of his actions, his imaginary friend keeps volleying each excuse back to him. Ezra was offended by his comment about the kosher steak? Well, okay, maybe Alan shouldn’t have qualified it with “kosher.” Ezra was frustrated about the size of the donation he gave to his Orthodox yeshiva? This one is a harder pill to swallow given that Alan felt cornered by an organization that repulsed him to his very core, but eventually Alan realizes he treated Ezra differently (to the tune of hundreds of thousands of dollars) because he refused to support his son’s goals.

Charlie’s reaction to this reveal is fantastic. For the first time, he lets his professional, even-keel demeanor drop for a moment, widens his eyes in disapproval, and gives Alan a subtle “WTF” face. He comes back with an emotionally charged question: “If you could talk to Ezra right now, what would you say?” Alan unloads in a tirade of anger, claiming Ezra thinks his way was the only way. Yet it turns out Alan is guilty of that line of obstinate thinking, too. In fact, he’s the one who passed down those behaviors to his son in the first place.

Realizing there’s been a shift, Charlie encourages Alan to consider what he’d like to say to Ezra for a second time, and Alan fumbles. He’s finally able to shuffle past his feelings of anger and grief, contempt and blame and decides what he really wants to do is apologize to his child for the pain he’s caused him. When Alan says, “He must have felt it. All of it,” I fully broke down in sobs. It’s a cathartic moment that feels triumphant for Alan, but it’s colored by the knowledge he may never get the opportunity to resolve this issue in real life. The capper to this conversation sees Alan realize he’s had more compassion for Sam, a serial killer, than he’s had for his own son. It’s a devastating realization that powers Alan’s survival instinct.

Over much of this ephemeral exchange, we hear the sound of Alan worrying his little tube into a makeshift weapon. Even within the confines of his imprisonment, Alan is gearing up for something big. He’s ready to face the consequences of what he’s done, and he’s finally ready to fight so he can actively make amends for the damage he’s caused to his family.

In the outside world, we get the opportunity to live in Ezra’s skin. As he moves through his day, we see that the men in his community seem to be very supportive of his situation. At one point, his father-in-law gives him a knowing pat on the back as they head to prayer services, and later, a shopkeeper compassionately asks him if there’s any news.

Even though Ezra doesn’t say much — and we don’t have access to the inner workings of his mind, as we do with Alan — we can tell he’s wrestling with his own part in his relationship with his father. He dutifully hangs “Missing” posters on every available surface. When his stapler craps out and his sister offers to take over, he isn’t too sure what to do with himself. He circles back to the comforts of his youth, buying a bunch of forbidden sugary candy for his kids, then heads to his childhood home, where he picks up his mother’s old guitar and sings the same song Alan sang to comfort Elias in Sam’s basement.

Leeds brings us along on Ezra’s internal journey, evoking the feelings of a lost little boy who doesn’t quite know how to make his way home. As he prepares to sing the first few lines of the song, the camera considers the scene from an adjacent darkened room, preserving the intimate and vulnerable nature of this moment as we take him in from his perch on the stairway. His position in the foyer indicates he’s not fully comfortable in this house, but the song tells another story. As he sings, his beautiful voice swells with so many mixed emotions — nostalgia, loss, hope, regret — conveying that he’s also beginning to come to terms with his part in the family conflict. Ezra heads home that night and says as much to his wife, lamenting that he might never get a chance to make it right.

The coda to the episode sees Sam coming home to a changed Alan. Sam wakes Alan up so they can play a game of table tennis. This seems a bit twisted because he followed his latest victim to a table-tennis venue before mercilessly killing him, but whatever. The back-and-forth between Alan and Sam illustrates that the two men are pretty evenly matched and that Alan isn’t willing to give up the fight anymore. As they ping and pong, there seems to be more than just a game at stake. Sam is not only working up the courage to tell Alan about his most recent murder but also about the new therapist he’s lined up. And it becomes clearer than ever that Alan is fighting for his life.

Sam isn’t too sure how he’s going to handle the situation with Alan once he’s started with another therapist. It’s clear he doesn’t want to kill him, but what choice does he have? Sam exercises a weird bit of empathy when he asks Alan how he’d like to die, and Alan responds with a joke. The punch line involves a clever Jewish man asking to die of old age. Unfortunately, we don’t get to see Sam’s reaction to this joke, but within the confines of the basement, it’s not funny; it’s deadly serious.

That’s all the time we have for today. I’ll see you at our next session.

Progress Notes

• Sam’s co-worker Jeanette is certainly the workplace gossip, but there was absolutely no way for her to know that complaining about the boss would end in his imminent demise.

• Speaking of, okay, so who hasn’t wanted to strangle their boss on one occasion or another? Of course, we’re not serial killers, so we don’t do it. But in Sam’s case, strangling where he eats seems to be a very risky and dangerous proposition, and this decision illustrates he’s in a very precarious mental state. Will Sam’s careless misstep lead to the SWAT team of Alan’s dreams coming to rescue him?

• I’m not sure if anyone has pinpointed the state in which Sam and Alan live, but Sam mentions Lincoln County at one point. There are many Lincoln Counties in the U.S., so my speculation on where in the world they are continues.

• Sure, Alan is starting to show some fight by whittling away his foot cream tube, but what about that giant porcelain pitcher that’s just begging to be used as a weapon? Alan has fantasized about using it so much and even talked about it with Charlie on occasion, so it must come into play at some point, right?

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