As Gleason explained New York Times, he did not want to present Sam as a grim compelling figure, like many serial killers in the media. Hannibal Lecter comes to mind, but a more recent example is Zac Efron portraying Ted Bundy in Extremely Wicked, Shockingly Evil and Vile.
“I understand where the charm comes from, but they end up being put on some weird pedestal where they’re charming,” Gleason explained. “It’s like a bad boy at a party: everyone is wondering, ‘Who is this guy?'” he added. “In real life, it’s really disgusting, pathetic.”
Gleason developed these thoughts in an interview with Wrapperin which he gave a deeper analysis of the character. For Gleason, Sam has a “deep well of pitiful self-hatred” in his heart that drives him to change.
Gleason tried to avoid a common mistake associated with images of serial killers: making them likable. Gleason has nothing to root for Sam. Sam’s desire to change is not sincere. For Gleason, if Sam really wanted to change, he would have given up.
“Patient” boasts an 87% freshness rating on rotten tomatoes among critics and 83% Fresh among fans. The review site says The Patient offers “arguably the best job of a career” from two hosts. Thus, it seems that the rejection of common stereotypes of serial killers has paid off.