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Steve Carell Was Completely Taken Aback By The Patient's Gruesome Finale

Warning: Contains spoiler for the series finale of "The Patient"

Created by Joel Fields and Joe Weisberg, the miniseries "The Patient" follows Alan Strauss (Steve Carell), a therapist mourning the recent death of his wife, who is kidnapped and held hostage by serial killer Sam Fortner (Domhnall Gleeson), who hopes therapy will "cure" him of his impulse to kill. Throughout the series, Alan attempts to genuinely help Sam, all while trying to figure out ways to escape. At one point, Alan manages to get a piece of paper with a note on it into the mouth of one of Sam's victims with the hope help will come when body is found — however, Sam changes his mind about leaving the body where it can be found and hides it.

In the finale, which aired on October 24 on Hulu, Alan attempts to escape once more by grabbing hold of Sam's mother Candace (Linda Emond) and threatening to cut her throat with his makeshift shiv if Sam doesn't call the police and turn himself in. We then cut to see Sam at home with his family, seemingly having made it out alive. However, that turns out to be a fantasy and we cut back to the hostage room where Sam has gotten Alan away from Candace and is now strangling him. Despite Candace's cries for him to stop, Sam goes through with killing Alan.

In the aftermath, Sam mails a letter that Alan left for his children, giving them some closure. Sam, thinking of Alan's advice that he needs to be constrained in order to stop killing, chains himself to Alan's bed. The series ends with Alan's son Ezra (Andrew Leeds) attending therapy.

It's a shocking ending, to say the least, as many viewers likely expected Alan to make it out alive — or at least for Sam to face consequences for his actions. So, what did the stars of the show think?

Carell was shocked by the ending

Following the finale of "The Patient," Steve Carell spoke with USA Today about his reaction to the surprising ending. Carell, as it turns out, was just as shocked as all of the viewers at home that Alan ends up dying at the hands of Sam.

"I was shocked to read it," Carell said. "Early on, nobody knew how it was going to end, so we all had guesses in our mind about what would happen. Would he escape? Would he end up killing Sam? Would the mother be involved somehow? There were all sorts of different ideas that people had."

Co-creators Joel Fields and Joe Weisberg wrote a few different endings before settling on the final choice, and Carell was able to read a few of the iterations. For those curious about what could've been, Fields told USA Today that they don't want to reveal their other ideas. Fields explained, "The real fear is people will like one of them better!"

Of the various iterations, Carell agrees with the showrunners that they chose the best possible option for the story's conclusion, even if it is quite grim. "It's not the Hollywood ending, [but it's more like] the ending that would've happened," the actor said. "It's a harder one to digest, but in a weird way, it's more satisfying."

Domhnall Gleeson was relieved the ending was realistic

Carell's co-star Domhnall Gleeson gave his own two cents on the ending in an interview with Vanity Fair. When asked what his reaction was when he found out that his character kills Alan, Gleeson revealed that he was weirdly relieved — namely because he found it authentic to the nature of a serial killer.

"I was relieved because one of my concerns all the way through was wanting to make Sam a real person, a human who was trying to get better," Gleeson said. Further, the actor would not have found it believable if Sam was suddenly cured after just a few sessions of therapy. At the same time, he's glad that there was growth.

He concluded, "Because that's not the way it works. [But] he got better, he gave the letter, he locks himself up. He has made huge strides. The guy at the beginning of the series would never have done that. But he is not capable of pure selflessness, and I don't think he ever will be."