The Patient Finale Recap and Ending, Explained: Is Alan Dead?

Image Credit: Suzanne Tenner/FX

The tenth episode of FX on Hulu’s thriller series ‘The Patient,’ titled ‘The Cantor’s Husband,’ follows the aftermath of Sam Fortner’s decision to kill his father. Sam sets out to do the same and meets his father but surprising him, he fails to do what he intends. Alan Strauss makes a breakthrough in his therapy sessions with Sam but his aspiration to get freed from his confinement doesn’t meet the desired end. The intriguing episode ends with shocking developments and unanswered questions. If you are trying to make sense of the ending of episode 10, let us share our thoughts concerning the same! SPOILERS AHEAD.

The Patient Finale Recap

‘The Cantor’s Husband’ begins with Sam setting out to kill his father for indirectly making him a murderer. His father lets him into his house and prepares food for him. When Sam asks why he had beaten the former up, the serial killer’s father lets him know that he was a difficult child to raise. Sam tries to kill his father by choking him but frees him before he could die. The serial killer returns to Alan and asks the therapist why he couldn’t kill his father, only for Alan to answer that Sam doesn’t want to be like him.

Image Credit: Suzanne Tenner/FX

Alan adds that Sam’s decision to not kill his father is a breakthrough in their case. The therapist tells Sam that the incident is possibly an indication of his permanent change and he may not kill again. To a changed Sam, Alan says that he needs to go back home to mend his relationship with his son Ezra. Alan informs the serial killer that he cannot turn him in to the police because of the therapist’s legal and ethical obligation to keep their affairs confidential.

Sam, however, believes that therapy is a slow process and he needs Alan with him for years if he wants to heal completely. Sam brings a couch and mini fridge to the basement and lets Alan know that he cannot let the latter go.

The Patient Finale Ending: Is Alan Dead? Why Does Sam Kill Him?

Yes, Alan is dead. When Sam lets him know that he wants the therapist to stay longer, possibly indefinitely, with him, Alan realizes that it is time to put an end to the predicament. He informs Sam that his homicidal impulses are almost uncontrollable and that the only way for him to deal with them is to get confined. Alan asks him to turn himself into the police so that he will be imprisoned, closing every door for him to commit murders again. Alan also informs him that he needs confinement for his childhood traumas, which are the root cause of his murderous urges, to heal.

Image Credit: Suzanne Tenner/FX

Alan also realizes that Sam is trying to replace his abusive father with him. The serial killer never had a father who supported or guided him at any stage of his life. It is Alan who helps Sam deal with his homicidal impulses and nearly puts an end to his killing spree. Instead of Sam’s real father, Alan supports him to overcome a terrifying phase of his life. Thus, Sam fills the void of a father in his life with Alan, who cannot remain in Sam’s life as a father figure. He threatens to kill Sam’s mother Candace Fortner if the serial killer doesn’t turn himself in.

Ultimately, Sam kills Alan to stop him from killing Candace. He must have also realized that Alan cannot be a therapist or even a father figure to him anymore since he is demanding Sam’s confinement. In a way, Alan also accepts his death since he doesn’t want to live anymore if his life is limited to the four walls of a serial killer’s basement. Alan also knows that Sam will kill him if the latter decides against turning himself in. The therapist must have accepted his own death for making Sam realize that his homicidal urges haven’t evaporated from him just because he couldn’t kill his father.

Will Sam Kill Again? Why Does He Lock Himself Up?

Although Sam decides against turning himself in to the police, he locks himself up in the same basement Alan was confined to. Sam must have realized the depth of his homicidal urges when he kills Alan. When he fails to kill his father and Alan considers the same as an end to his killing spree, Sam rejoices that he has finally grown beyond the murderer in him. But Alan’s death must have made him realize that his murderous urges won’t leave him that easily. He locks himself up as a last resort to put an end to the murders he commits.

Image Credit: Suzanne Tenner/FX

Sam meets a dead end when he kills Alan. He must have realized that a different outcome is impossible even if he confines another therapist in his basement to change him. He accepts his defeat and follows what Alan has instructed him to do: be confined. After killing Alan, who has become a father figure to him, Sam must have understood that he cannot mentally stop his homicidal impulses, leading him to his physical confinement. However, it doesn’t mean that Sam will never kill again.

Sam most likely will not commit another murder as long as he remains confined. But how long Candace will keep him locked up is a matter of concern. Since she is an old woman who may not even be able to take care of herself in a few years, Sam cannot depend on his mother to look after him while he is locked up in the basement. After a few years, she may need to either free him or seek the help of someone else to look after him. Considering that Candace was a silent enabler of Sam’s murders, who hasn’t done anything to protect him or stop him from committing murders, she may even free her son after a while without caring about the consequences. If that’s the case, Sam may kill again.

Does Ezra Forgive Alan?

While being confined by Sam, Alan realizes the mistakes he had made as a father. After contemplating his relationship with Ezra, Alan understands that he hasn’t been a good father to his son at all. Along with his acceptance of his death, Alan also accepts that he may not see Ezra again to reconnect with him. Thus, he writes a letter to Ezra and Shoshana. In the letter, he admits the mistakes he had committed as a father to Ezra, seeking his forgiveness. Even though Alan’s admission of his mistakes is too late for Ezra to regain his relationship with the former, the son seemingly does forgive his father.

Image Credit: Suzanne Tenner/FX

‘The Patient’ ends with Ezra consulting a therapist to deal with Alan’s death. As a son, he mourns the death and absence of his father, which is an indication of his forgiveness. He even expresses his wish to read Alan’s book to his therapist, which can be seen as his way of getting closer to his father after the latter’s death. Before the therapist’s letter, he has banished Alan from his life. Ezra not even having a copy of his father’s book is an indication of how the son wanted to stay away from his father. By wanting to get a copy of the same, Ezra must be trying to welcome his father back to his life even after the latter’s death.

Read More: Is The Patient Based on a True Story?

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