The Patient is another incisive thriller from the duo behind The Americans

You’ve never seen Steve Carell as he is in The Patient. He anchors FX’s gripping limited series with his finest dramatic performance to date, a sublime and crushing work that sticks with you long after the credits roll in the finale. It transcends the memory of The Office’s Michael Scott and his big-screen dramatic turns in Foxcatcher and Beautiful Boy. The actor’s evocative work manages to carry The Patient when it falls into brief repetitive lapses. After the disappointing Space Force and a terribly written character on The Morning Show, it’s gratifying to watch Carell expertly spearhead a tense and engaging TV show.

He plays therapist and famed author Dr. Alan Strauss, who is kidnapped by a patient named Gene—who is quickly revealed to be Sam Fortner, a.k.a. the John Doe Killer (Domhnall Gleeson). Sam couldn’t openly share his criminal activities during regular sessions, so he abducts Alan and shackles him in his house’s tiny, minimally furnished basement. The hope is Alan can cure him of homicidal tendencies, even if it takes years and years of therapy. With one leg chained to a brick wall for the show’s duration (not counting Alan’s flashbacks and dream sequences), Carell uses the small space to his advantage, expressing fear, anxiety, grief, and loneliness while forcefully treating Sam.

The premiere wastes no time setting up Alan and Sam’s precarious circumstances, giving The Patient 10 episodes to peel back the curtain on Sam’s unpredictable psyche, why he kills, and whether Alan can ever figure it out and escape—or meet the same fate as Sam’s victims. The escalating tension from his captivity, and any subsequent attempts for freedom, are clearly the nail-biting portions of the series. But the slow-burn tension feels riveting and not dragged out, thanks to installments that are less than 30 minutes long. And that’s a real treat, alright. It’s rare for serious dramas to be a half hour apiece with tightly structured storytelling to boot. (A recent exception might be Barry, which evolved from being just a dramedy in season three). The Patient is a successful thriller because it is consciously bite-sized.

But those short episodes are just a bonus. The meat and overarching theme of The Patient is summarized in a quote from Alan: “People need meaning in their lives, probably more than anything else.” That line also recalls series co-creators and writers Joel Fields and Joe Weisberg’s former FX project, the award-winning spy thriller The Americans, which was an often heartbreaking dissection of Philip (Matthew Rhys) and Elizabeth Jennings’ (Keri Russell) marriage against a Cold War backdrop.

While The Patient doesn’t have similar scope, emotional heft, or time on its hands as that series, it’s still a worthwhile dissection of Alan and Sam’s personal issues and larger conflicts. One is an unhinged psychopath craving magical redemption, while the other has suddenly got all the time in the world to contend with his sorrowful past. And the show explores how (as Alan says), despite their totally dissimilar worldviews, they both draw meaning to their lives from their respective complicated father-son relationships.

Alan is in a fragile place when he becomes a hostage. He’s mourning his recently dead wife, Beth (Laura Niemi), and has a fraught bond with his estranged son, Ezra (Andrew Leeds). The unexpected isolation in Sam’s dreary universe turns him into a hostage of his own mind as well. He finds solace in imaginary conversations with his own therapist, Charlie Addison (David Alan Grier), which mercifully take place in a less bleak setting. As Alan remains trapped in a hellish new reality, he’s forced to reckon with a biased perception of his divided-by-religion family. Alan and Beth had a tough time when Ezra became an Orthodox Jew. The Patient’s messaging here seems initially murky, but then it matures into something deeper by the finale. (And that’s all we’ll say, as discussing anything more about the last episode is under strict embargo until it airs on October 25.)

The only drawback to The Patient is that it doesn’t give Sam the same cognizant character development as it does to Alan. He gets off-kilter traits like an obsession with food—he brings home fancy meals from different cuisines each night—and an undying adulation for singer-songwriter Kenny Chesney, but Sam doesn’t feel as fleshed out as his co-lead. There’s a strong attempt to examine his upbringing that comes a little too late, so the middle episodes feel repetitive (but never dull). Gleeson does justice to the dead-eyed Sam, spouting off lines like “I’m just kidding; I’m not going to fuck his skull,” but it’s still a one-dimensional take on a serial killer, one that pales in comparison to exceptional performances like Paul Walter Hauser in Black Bird and Cameron Britton in Mindhunter.

Speaking of those dramas, The Patient has a similar vibe of two people engaging in absorbing, creepy exchanges in suffocating surroundings. (Kudos to production designer Patricio M. Farrell for acing the look of Alan’s bare-boned new environment.) Carell also deserves props for using his comedic chops to bring subtle levity to his reactions and line deliveries, which complements his masterful performance, and the show’s razor-sharp writing and direction. While The Patient won’t make up for The Americans’ absence (nothing can fill that void, people), it’s nevertheless an astute and compelling follow-up from Fields and Weisberg, with a knockout lead performance.

[Note: An earlier version misspelled the creator’s name. We have updated it correctly]