The Lost Patient Ending, Explained: Who Killed the Family?

Based on the eponymous comic by Timothé Le Boucher, Netflix’s ‘The Lost Patient’ is a French mystery thriller film directed by Christophe Charrier. In the movie, a 19-year-old boy named Thomas wakes up from a 3-year-long coma in a hospital. However, he doesn’t remember how he ended up here. Anna Kieffer, a psychologist, informs the boy that his family has been murdered, he is the sole survivor, and his sister, Laura, is still missing. To find out how everything happened, Thomas starts attending sessions with Anna to recollect his memories. Here’s everything you need to know about the ending of ‘The Lost Patient.’ SPOILERS AHEAD!

The Lost Patient Plot Synopsis

The film begins with a hooded figure walking out of a house while it is raining at night. The next day, a kid discovers bodies in the same house belonging to the Grimauds family. We see Betta and Marc (Thomas’ parents), Dylan (Thomas’ cousin), and Thomas himself. While Betta, Marc, and Dylan have been shot, Thomas is stabbed with a knife. Three years later, Thomas wakes up from a coma and meets with Anna Kieffer, the psychologist. The two start meeting regularly for Thomas to recollect his memory and piece together what happened that night. During his sessions, Thomas slowly starts regaining fragments of his memories.

At first, he sees himself walking around his house until the empty room. In another vision, Laura gives Betty a gift on the dining table, which she doesn’t seem happy to have. Following this, Thomas and Laura are standing on the road, and Laura shouts at a man waiting for Betty outside the house. Thomas also sees his sister going into the forest with a girl and kissing her. But, as Laura does so, she starts hurting the girl, and the latter pushes her away. Besides these, the 19-year-old sees a few more visions. As the story progresses, we also learn that Dylan had come to Thomas’ house after his mother fell sick.

Amidst these fragments, Thomas also sees the hooded figure when he’s alone. The boy is also fixated on the cracked wallpaper in his hospital room, akin to the one in the empty room. However, we don’t understand what they mean. Thomas also becomes increasingly unsettled during his recollection and wonders where Laura is. Once Dylan shifts to the house, we see how Laura is not okay with his presence. In one scene, when Dylan is complaining about a barking dog, Laura tells how her father, Marc, has a gun that Dylan can use to put the dog to sleep. In the next scene, we find out the dog has been killed. Toward the end, when Thomas remembers the night more clearly, we know who killed the family.

The Lost Patient Ending: Who Killed the Family? How Do They Do It?

Thomas killed the entire family. In his last session with Anna, Thomas discovers that his sister died before he was born. Since Betty and Marc couldn’t handle the loss, they projected it onto Thomas. Since his childhood, Thomas was neglected by his parents, leading to his being traumatized. So, as Thomas grew up, he became increasingly disturbed, and his behavioral patterns were far beyond the normal spectrum.

In the movie, Thomas gets jealous when Dylan moves into the house. After Dylan receives the news that his mother is dying, Betty embraces the boy and tries to calm him down. The incident becomes the last straw, and Thomas decides to kill his family. We see that he is the hooded figure who walks out of the house after shooting everyone. When Thomas walks in the rain, he realizes what he’s done, so he returns, stabs himself with a knife, and goes into a coma.

One of the first instances, when Thomas faces neglect is when he’s a baby, and his parents are covering the empty bedroom with new wallpaper. Thomas is lying in his cradle and crying, but neither Betty nor Marc do anything about it. Instead, they ask him not to cry, which is not how one treats a newborn who doesn’t understand anything. In another instance, Thomas sees a family photo album without his pictures and gets agitated. Although the movie doesn’t reveal many incidents, it is clear that Betty and Marc had lost a part of themselves after their daughter’s death. The two couldn’t bear the loss and dealt with their grief unhealthily. Betty starts an affair with another person, and Marc keeps quiet despite knowing about it.

The family is broken right from the movie’s beginning, and as Thomas grows, he takes the role of a passive observer who feels rejected and is dying to become a part of Betty and Marc’s life. Thomas’ behavior and actions reflect what he observes in the house. We see how Thomas doesn’t know warmth or tenderness when he’s intimate with a girl. Thomas hurts the girl as he kisses her, so she pushes him away and walks off. Unable to handle yet another rejection, Thomas hits his head on a tree trunk and hurts himself.

Later, when Dylan enters the picture, he cannot fathom that Betty is comforting the boy. In one scene, Dylan stands in the empty bedroom, and Thomas says he shouldn’t be there. We soon discover that the bedroom belonged to his sister, and Betty decided that the room would remain empty after her passing. Thomas doesn’t like an outsider stepping into a room that ideally should have been his. Later, when the neighboring dog is found dead, Dylan tells Betty and Marc that Thomas killed it. Betty and Marc decide to move Dylan into the empty bedroom because they don’t think he’s safe with Thomas in the basement.

Thomas denies killing the dog but seems more than capable of doing it. In addition, Thomas starts spiraling after seeing Dylan move into his sister’s room. So, later in the night, Thomas takes Marc’s gun and shoots him. When Betty comes down after hearing the gunshot, Thomas shoots her too. Following this, Thomas finds Dylan on the stairs, and as the latter begs for his life, the former shoots him. However, the bullet doesn’t kill Dylan, so Thomas strangles him with his bare hands.

As Thomas’ psychologist, Anna, rightly says, Thomas is traumatized due to the negligence, which leads him to kill his entire family. However, Thomas did not want to take that step. When Thomas leaves the house, he realizes he’s more lonely than ever. Thomas feels abandoned and scared because he has nobody and nowhere to go. So, he returns to the house and stabs himself because the bullets in the gun are over. Fortunately or unfortunately, he doesn’t die but goes into a coma. This leaves us wondering about the girl in Thomas’ visions – Laura. Who is she? Is she real or merely a figment of Thomas’ imagination?

Who is Laura? Is She Real or Imaginary?

Laura is Thomas’ sister. She died in a car crash before Thomas was born. However, she isn’t the same person Thomas sees in his visions. When Thomas stabs himself, he sees a woman singing in a music video. When Thomas wakes up and starts getting visions of his past, his mind makes him believe that the woman is his sister, Laura. So, Laura and the woman are real people, but Thomas’ narrative around them is imaginary.

When Thomas wakes up, his mind cannot accept his actions. So, it tricks Thomas into believing that the woman in the music video is his sister, Laura. This way, Thomas can always find a way to blame all his actions and crimes on somebody else. In his visions, Laura is kissing and hurting the girl. Thomas also imagines Laura being jealous of Dylan and giving him the idea of killing the dog.

If we delve deeper into Thomas’ psyche, it is likely that his mind separates all the disturbing parts and instills them into another person. In this case, it is Laura because Thomas holds Laura responsible for everything that happens to him convolutedly. According to Thomas, if Laura were still alive, his parents would love him, and he would be a perfectly normal child. Thus, Thomas considers Laura the root cause of all problems and imagines it in a literal sense.

However, cognitive dissonance occurs as Thomas starts to regain his memory. Thomas’ brain cannot handle two conflicting scenarios. On the one hand, his imaginary narrative progresses; on the other hand, the visions of a car chasing Laura and the cracked wallpaper in Laura’s room make Thomas realize what’s real. For instance, Thomas when Thomas tries to see what’s behind the cracked wallpaper, he finds Laura standing there. The vision symbolizes that Laura is in the empty room even after her death. When one of the patients, Bastien, mentions how his family died in a car crash, Thomas feels unsettled because Laura died similarly.

In another instance, when Thomas and Betty drive with Dylan, the woman plays the same song Thomas hears when he stabs himself. Several such incidents show how Thomas deals with two sides of his mind. In the end, Anna mentions Laura’s death to Thomas and reveals how she died before he was born. At this moment, the boundary which separates Thomas’ visions and his actual memory breaks, and Thomas discovers the truth. Thomas remembers how his mother placed flowers on her sister’s grave when he was young. Thomas also replays all the visions without the woman and realizes that he’s the perpetrator, not his late sister. Thus, to reiterate, Laura is Thomas’ sister, but the woman he sees in his visions is not Laura.

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