The Patient review – Steve Carell offers killer therapy in intriguing series

<span>Photograph: FX</span>
Photograph: FX

With less commercially mandated restrictions to the length of most TV episodes thanks to the streaming swell, writers have taken full advantage, going rogue for better or worse. It’s led to seasons that expand and constrict by the episode, less pressure to streamline storylines to the most advertiser-friendly format, allowing for freedom yet also indulgence. How many hourlong Netflix seasons have felt needlessly, painfully bloated yet how many shows have benefitted from putting story over Skittles ads?

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There were many reasons why the first season of Sam Esmail’s sleek Amazon thriller Homecoming was the finest of that year – an on-form Julia Roberts, stylish and surprising direction, that brilliantly borrowed score – but key to its success was the rare decision, for a drama, to make each episode around 30 minutes long. It was tight and unexpected at a time when so many shows were anything but, yet since then only a handful of other dramas have opted for something similar. In FX and Hulu’s ten-part thriller The Patient, The Americans’ writers Joel Fields and Joe Weisberg, keep their episodes as short as 21 minutes and, for the finale, as long as 46, a decision that works until it doesn’t, when intrigue starts morphing into frustration.

Steve Carell, continuing to focus more on his dramatic side, plays therapist Alan, who wakes up chained to an unfamiliar bed. Sam, played by Domhnall Gleeson, a recent patient of his, has decided that he wants his sessions to be a little more intimate, kidnapping him and keeping him in his house. Sam is a serial killer who wants to stop killing and Alan is the guy who is tasked with stopping him.

It’s a neat little premise for a contained thriller – high stakes therapy sessions with a murderous psychopath – and Fields and Weisberg make a concerted effort not to swerve their series into easy schlock, keeping it all grounded and at times mundane, a sane story about an insane person. Rather than Sam acting out some Zodiac-level spree, he’s motivated more by daily slights, the weird look from someone at work or the perceived rudeness at a restaurant, someone who can’t stop killing because society can’t stop forcing him to the edge. It’s one of the show’s many lived-in details, from Sam’s obsessive interest in the finest new restaurants to Alan’s flashbacks to long-stewing family disputes, and with two textured characters at its centre, unfurling piece by piece by the episode, it’s a genre show made with thought and care.

Alan is as plagued by unhappiness and remorse as Sam is, as a widower and as a father to a son whose move from Judaism to orthodoxy has led to deep, perhaps irreparable, damage. The unusual specificity of this relationship (his son bringing pre-prepared food to dinner at his house for the kids while later refusing to respect his mother’s agency as he once did) feels fresh, tense dynamics about religious difference usually going for the extreme leap (from, say, Christianity to a dangerous cult) rather than within the same religion but the script works so hard to give Alan and his family such depth that one often wishes it was just about them. In trying to mesh together two character studies with a suspense thriller, Fields and Weisberg often make us want more or less of the other, depending on the episode. Stories such as this, of captive and kidnapper, are usually unpacked with speed over a brief running time and The Patient feels like it might have been more efficiently told as a film. Tension dissipates, conversations repeat, and while some flashbacks hit, other dream sequences (involving Alan and Auschwitz) really don’t and too many episodes feel overly padded, slowly meandering toward the conclusion when it should be hurtling there instead.

It’s surprisingly perfect territory for Carell though, whose more serious work hasn’t always convinced, the forced quiet of his character and the way that he talks to others allowing his excesses barely any room to emerge. Carell’s dramatic extreme is often too similar to his comedic extreme and it’s only when he’s screaming at full-volume on odd occasions here that he slips into ham. Benefitting from a script that tackles a difficult character with difficult empathy, Gleeson makes for an effective sparring partner, selling the character’s unpredictable creepiness while also reminding us of his humanity. The therapy sessions feel rooted in the real as do Alan’s strategies for survival and the ending deserves points for being unexpected if also a little unsatisfying, one that will provoke extreme reactions when it airs later this year.

The Patient, like its central killer, is as fascinating as it is frustrating, the unusual format turning a dramatically juicy thriller into something a little repetitive and improperly paced. It’s a ten-part show about therapy that could have benefitted from being told in one long session.

  • The Patient is available on Tuesdays on Hulu in the US and Disney+ in Australia. A UK date has yet to be announced