‘The Patient’ Co-Creators Explain Those Serial Killer Quirks and the ‘Spark’ Between Stars Steve Carell and Domhnall Gleeson

“We both believe that there’s humor in dark places,” Joe Weisberg said of his partnership with Joel Fields

Domhnall Gleeson and Steve Carell in The Patient
“THE PATIENT” — Pictured (L-R): Domhnall Gleeson as Sam Fortner, Steve Carell as Alan Strauss. CR: Suzanne Tenner/FX

Spoiler alert: The following article discusses the entirety of Episodes 1 and 2 of “The Patient.”

FX’s “The Patient,” from “The Americans” executive producers Joel Fields and Joe Weisberg, immediately paints a picture of a disturbed serial killer (Domhnall Gleeson) with — if not the willpower to curb his murderous tendencies — the self-awareness that he should at least get some help. And despite the terrifying predicament that kidnapped therapist Dr. Alan Strauss (Steve Carell) finds himself in, the psychothriller manages to elicit laughs from the audience; namely, at the murderer’s expense, for things like his penchant for Dunkin’ coffee and his “not unrelated” need to pee for tens of seconds on end.

“We never set out to write jokes or even to create funny moments,” Weisberg, who co-created, executive produced and wrote the series with Fields, told TheWrap in a joint interview. “I think we both believe that there’s humor in dark places. You think of what are some of the craziest belly laughs you’ve had, some of them are in your worst moments.” 

For his part, Fields added that “it is our intention to have quite a few laughs of all kinds of odd varieties.” The decision is all part of the EPs’ desire to be unpredictable in the crime-thriller genre, which has now become saturated with a flood of series hoping to curb our culture’s appetite for adrenaline-pumping, mind-bending and oft-gruesome mysteries.

“We very purposefully set out to … not to get stuck in the trap, feeling obligated to deliver the tropes or moves of their genre, but to let the character’s story unfold as it felt like it wanted to to us,” Fields said.

“The Patient” opens with an extended scene featuring Strauss coming to the horrific realization that he’s locked in someone’s basement. After the title card rolls around, the series establishes Carell’s character as a successful therapist working through his own struggles, contending with the remnant grief of losing his wife and attempting to connect with his adult children. Among his patients is Sam Fortner, who has been undergoing therapy under a false name and pretenses for months leading up to his eventual abduction of Strauss.

When it came time to cast the two leading roles, Fields likened the situation to kismet, saying the duo had been “longtime Steve Carell fans” and just happened to be writing the project with no particular actor in mind when they separately heard the “Asteroid City” star was interested in meeting with them. After that came the crucial chemistry test, where various actors read lines alongside Carell. 

“It was a very difficult part to cast, a serial killer with some sort of conscience or [who] inhabits something from the first time you see him,” Weisberg said. “We put the two of them [Carell and Gleeson] together and it was like putting [‘The Americans’ stars] Matthew [Rhys] and Keri [Russell] together but without the romantic spark. They had the serial killer-therapist spark.”

Fields joked, “We had Domhnall kill four people,” in response to being asked what element he and Weisberg were looking for when casting Sam Fortner. In a separate interview, Gleeson added to the bit: “There were originally six writers, and [Weisberg and Fields] basically used my audition process to get rid of the competition. They wanted to be front and center, and fair play to the boys — it worked out well for them.”

On a more serious note, “The Patient” leaned heavily on research surrounding the fields of therapy and psychology with the help of consultant Dennis Palumbo, a writer and licensed psychotherapist. In the series, Sam is attempting to break out of a cycle of violence first perpetrated by his abusive father.

“If you have a lot of therapy, the idea of cyclical anything becomes very obvious,” Weisberg said. “That’s just how people work. That’s also what makes it powerful and interesting to do a story about somebody trying to break out of that cycle. Whatever it is that you’re repeating — whether it’s alcoholism, violence, different kinds of abuse or even less aggressive things, just ways that people suffer — it’s very, very courageous to be the generation that’s going to try to change and try not to follow in those footsteps. And in a way, that’s exactly what Sam is trying to do.”

At the same time, Fields contends, Sam has been comfortable using his status as a survivor of abuse to excuse his own violent actions.

“He feels traumatized and he feels victimized is the reason that he’s entitled to everything he does,” he said. “And that’s a whole other challenge for him to attempt to get over and for his therapist to work under very extreme circumstances with rather high stakes.”

The first two episodes of “The Patient” are streaming on Hulu, with subsequent weekly episodes available on Tuesdays.