'The Patient' Creators Talk Finale's Killer Therapist Showdown and Jewish Trauma in Hulu Series

Warning: This story contains spoilers for the 10th and final episode of The Patient, titled "The Cantor's Husband" and

streaming now on Hulu

. Read at your own risk!

It's hard to find a good therapist. 

Especially when you're secretly a serial killer who says you want to improve yourself.

Obviously, in this scenario, the best course of action is to kidnap the health provider and lock him in your basement to have one-on-one sessions for whenever you feel the urge to take out someone who's wronged you.

Or at least that's the logic taken by Sam Fortner, Domhnall Gleeson's Kenny Chesney-loving foodie with anger issues in the Hulu limited series, The Patient. He takes prisoner his therapist, Alan Strauss (Steve Carell) and, over a series of 10 episodes, the two compete in a game of mental gymnastics while Alan tries to reason with a man who does not possess common reasoning. 

During this, Alan also comes to grips with his own mistakes as a father to his two kids — particularly his son, Ezra (Andrew Leeds), whose decision to leave his upbringing in the more lax Reform Judaism tradition for the strict practices of the religion's Orthodox sect forever hurt Alan and his now-late wife Beth (Laura Niemi). 

A story like this can only end with one man left alive: the doctor or the patient. 

In the series finale, "The Cantor's Husband," audiences learn that Alan's time is up. But Sam does have a breakthrough: at the end, he realizes he is a danger to society and asks his overprotective mother to put him in Alan's chains.

In an interview with Metacritic, The Patient creators Joel Fields and Joe Weisberg discuss the ending, as well as whether the therapy actually worked. 

This show's ending feels like the movie Sliding Doors, where Gwyneth Paltrow's character is in alternate timelines. The only way for that movie to end was for one of the Gwyneths to die. Was there ever a scenario where both of these characters could have lived?

Joe Weisberg: If there was, we couldn't think of it. [Laughs]

Joel Fields: We really talked about every conceivable ending, I mean, talked about, wrote, considered — and this was our first instinct. And ultimately, it felt like the only authentic path.

J.W.: That's how we came to that ending. We knew the characters had to do whatever they would do. And it became increasingly clear that that's what they would do. Although, I do have another pitch that I never thought of till just now, in which Alan gets comfortable there. But that wouldn't be a good show.

Does the ending imply that the therapy actually worked? Sam locked himself away from society.

J.F.: That's the right question that we'd like people pondering.

This is a story about a Jewish family. There's an episode titled "Auschwitz" and Alan has frequent dreams or thoughts that he's in a Holocaust concentration camp. What is this show trying to say specifically about Jewish trauma and also about generational trauma that's passed down genetically? 

J.F.: As we imagined what it would feel like for us, as Jews, if we were kidnapped — especially by a guy who mentioned our Jewishness a couple of times, chained us to the floor, and forced us into labor that involve digging what was certainly a grave and what might wind up being our grave — it seemed that that's where our heads would go. And, in a bigger way, [a concentration camp] is one of the images of hell that your mind will conjure as things get dark.

J.W.: It occurred to me when you asked the question that no one said the phrase, or thought of the idea, of Jewish trauma. We were really working from more of what Joel said, which is a personal place.

J.F.: There's Jewish trauma there, of course, because the character's Jewish. But all of us carry trauma. And I think it's our hope with this — as with anything we do — that we're excavating [and] exploring universal themes and experiences and the common journeys that we're all on. 

This character is Jewish. We happen to be Jewish. So, it was made easier for us to access  those particulars. But it's not like we set out to say, "Oh, we want to write about Jewish trauma."

As Alan is being murdered, his mind flashes from a vision of his cancer-stricken wife and the gas chambers to a happier idea of him surviving all of this and sitting down to have dinner with both of his kids and their children. They also all unite in singing Hebrew prayers. Were you trying to emphasize that he'd found inner peace? 

J.W.: For us, it was almost the same as going to Auschwitz. This guy was taking his dying breath, and was probably close enough to unconscious that he was in no way in control of his thoughts. His lifetime brain was spinning this final setup, [and] it seemed to us that he would go to his wife and the gas chamber as he was dying. And then he would go to the happiest possible resolution, which is he's out and he's OK with his son. We could have had them golfing. But it's a little closer to the story to have the scene be about the thing they were struggling with.

J.F.:  As we sometimes find ourselves talking about the Jewish weeds here, but that prayer that they're all singing together after the Sabbath dinner is a prayer that they would have sung around the Reform Jewish household and that is sung around the Orthodox Jewish household.

Sam also has his own traditions. He loves good food, particularly mom-and-pop run restaurants. After one kill earlier in this season, he seems to be doing some self-flagellation by eating a convenience store hotdog. How did food become symbolic in this story?

J.W.: Oddly enough, it came out of the exact same place that Alan being Jewish came from: We had an idea for a serial killer who wants to get better and kidnaps his therapist, go! Well, after "go," the first place Joel and I usually go is not "here are all the things that will happen next." It's, "Who are these guys?" And one of the ways to discover who they are is to start adding specificity and character traits and things that are unique to them. 

And you try a lot of them on. And some of them almost immediately seem right. Alan being Jewish was a big one. We hadn't [really] written about a Jewish character before. And we understood immediately that that would work and open up things for us. The food thing probably seemed narrower in terms of what it would open up, but it was immediately appealing because it had a nice juxtaposition with the serial killer. I can't describe that juxtaposition. I just know it's good. When it later started having some sort of emotional, symbolic importance — for example, that hotdogs scene — you start to see how, when you give people personality traits that feel true, they start to expand.

Ezra uses religion as a rebellion against his parents. In your series, The Americans, teenage daughter Paige (Holly Taylor) finds Christianity to the chagrin of her KGB spy parents. Joel, your father was a rabbi. Is there a reason why you like to explore religion in these stories? 

J.F.: Boy, if we do it a third time... [Laughs] That had not occurred to us yet. We knew, in some way, we wanted to deal with the themes of intolerance. Although, as Joe says, we never sit down and say, "Here are the themes we want to write about." It's really more finding characters and then letting the other stuff come from our subconscious. But, I think part of what attracted us to this notion of the very active, very engaged Reform Jew whose child becomes Orthodox and the conflict that ensues is that, from the outside, it's a pretty small difference. There's something so universal about intolerance in the human condition, whether it's in families or between societies, that it just seemed interesting to us to explore it in that very specific way.

The series ends with Ezra going to his own therapist and trying to figure out where to begin his story. What was the significance of giving Ezra the last word?

J.W.: We don't want to say too much because it's a good one to interpret. But, it's probably got a few things about it that are a little obvious that people will get and appreciate just [the question of] what is Alan's legacy? What did he leave? There are multiple endings of the story. One of them is how this experience passes down to Ezra. And so the choices Ezra makes in that scene are our answer.

Asking as a parent, and as a viewer, is it possible to raise children without messing them up?

J.F.: Well, you can't raise children without having an impact on them. If you believe that if you have any impact on your child, that's what it means to be in a relationship. I think that's why all good writing has to do with relationships because we're really undefined except as we are defined by how we relate to, and are related to, the people around us.

J.W.: Your question is moving to me because I'm a parent and I struggle with those same things. And on the one hand, the funny questions are the really serious questions that we think about and worry about all the time. I think, as parents in America, in my era, we're very hard on ourselves, right? It's not just what you do that impacts your kids, it's that your kids have to grow up and live in the real world, which is really f---ed up and complicated. 

So, the idea that somehow we will present a model of perfect health and they will inherit it? They wouldn't be able to function. So, I just say, let's give ourselves a break. That's my view.

Get to know Joel Fields and Joe Weisberg:
Joel Fields and Joe Weisberg are best known for their partnership as showrunners of the Emmy-winning FX spy drama, The Americans (Metascore: 89), which Weisberg — a former CIA officer — created. His credits also include the FX drama Damages (78) and the TNT series Falling Skies (68). Fields' resume includes partnerships with the late TV creator Steven Bochco as well as the FX miniseries Fosse/Verdon (68) and the TNT police drama Rizzoli & Isles (63).