Steve Carell was 'shocked' by that 'Patient' finale: 'It's not the Hollywood ending'

Spoiler alert! This post contains important details about the ending of FX/Hulu miniseries "The Patient." 

Steve Carell's latest show is bound to take your breath away.

In the series finale of FX's "The Patient" (all episodes now streaming on Hulu), "The Office" actor's resilient Dr. Alan Strauss meets a merciless end at the hands of his patient, Sam (Domhnall Gleeson), a serial killer who kidnaps the therapist and chains him in his basement so Alan can cure him of his murderous impulses.

At the start of the 10th and final episode of the slow-burning thriller, Sam confronts and chokes his abusive father (Lance Guest), whom he blames for his homicidal urges, but stops short of killing him. Alan applauds Sam for his restraint and vows to continue their sessions, promising that he won't go to the police if Sam sets him free. But when Sam refuses, Alan puts Sam's mother (Linda Emond) in a chokehold and threatens to slit her throat.

'The Patient': Steve Carell, Domhnall Gleeson take therapy to 'surprising' new levels

Review: Wonderful 'White Lotus' is back for Season 2, and it's not a second too soon

Just before he does, the show flashes to Alan peacefully back at home with his grandkids and estranged son, Ezra (Andrew Leeds). But we soon learn that it was all a fantasy sequence and that Alan never did escape Sam's basement. Moments later, we see the two men thrashing on the basement floor as Sam strangles Alan to death.

"I was shocked to read it," Carell recalls. "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."

Carell read a few different versions of the ending before "Patient" co-creators Joel Fields and Joe Weisberg (FX's "The Americans") landed on the final episode. But Fields is reluctant to elaborate on the alternate endings, joking, "The real fear is people will like one of them better!"

The producers knew they wanted to have a fakeout of Alan safely returning to his family, giving audiences a false sense of hope before throwing them back into the character's grim reality.

"It never occurred to us that it was too cruel," Weisberg says. "When we came up with it, we understood how effective it would be. It's a very tough experience for the viewer, for sure, but it's tough because they're emotionally invested."

Carell was similarly blindsided by the misdirect, although he believes it was "the best choice for how to end" the limited series. "It’s not the Hollywood ending," Carell says, but it's more likely “the ending that would've happened. It's a harder one to digest, but in a weird way, it's more satisfying."

In the episode's final minutes, Ezra and his sister (Renata Friedman) read a letter Alan wrote them before his death, and Ezra chooses to go into therapy. Sam also decides to chain himself in the basement, but Weisberg and Fields refuse to say whether Alan's therapy really did break through to Sam in the end.

"The story wasn't over when he died – there was more to tell," Weisberg says. "We wanted to be very careful not to just check in with Ezra and Sam because you're supposed to. We wanted to make sure we had a real piece of our 10-episode story there and we thought we did."

But don't hold your breath for another season focusing on Sam or an entirely different patient-therapist dynamic.

"We're done after this," Fields says. "That's 'The Patient,' and we hope you enjoyed it. But we're not done making shows, so we're just trying to figure out what to do next."

This article originally appeared on USA TODAY: Steve Carell shocked by 'The Patient' finale: Not a 'Hollywood ending'