The Lost Patient ending explained: Who killed Thomas’ family?

‘The Lost Patient’ or ‘Le Patient’ is a French psychological thriller film based on Thomas Grimaud, who wakes up after a three-year coma and attempts to remember who killed his family. 

Warning: This article contains heavy spoilers

Plot summary

An entire family is found murdered. One of the victims, a young boy named Thomas Grimaud, is the only survivor and has been comatose for three years.

He is informed that his parents, Betty and Marc, were shot to death, and he was found with a knife in his stomach, barely surviving.

Anna, a therapist, attempts to help him piece together his memories and figure out who killed his family. His first memory is of his sister, Laura.

Anna tells him that Laura has been missing ever since the incident. She begins venturing into Thomas’ memories alongside him. Thomas believes a mysterious figure killed his parents and wants to now kill him as well.

He remembers how Laura had a strained relationship with their parents, while Thomas was always the subdued and calmer one. She was also always resentful of her mother because of her affair.

During his physiotherapy sessions, he meets Bastien, who is suffering from a similar past and the two connect. He gets more flashes of Laura. She kissed a girl violently in school and got annoyed by the neighbour’s dog barking.

Anna then asks about his cousin, Dylan, who had come to stay with the Grimaud family for three weeks as his mother was sick.

Thomas recollects memories of Dylan. He had a tumultuous relationship with Laura and Thomas, with Laura even threatening him with her father’s gun at one point.

Dylan wanted to shift to a room upstairs as he did not like staying in the basement. Laura called him out for this, but he feigned ignorance.

One day, while on road, Betty almost hit a girl because she was being strangled by Laura. Although she loosened her grip, Betty was left fearful.

Thomas starts to get suspicious of Anna, but she reassures him that she is the only one who is actually looking out for him.

He remembers another incident. The neighbour’s dog that constantly barked was killed. Laura’s family believed she was the culprit.

The Lost Patient ending explained in detail:

Is Laura real or a figment of Thomas’ imagination?

Thomas’ memories start to take a hold of him. He is now able to walk again and attempts to leave his room.

However, his true memories suddenly start flooding his mind. He was constantly neglected by Betty and Marc, who were harsh on him even when he was just a baby, which made him a violent person. His sister, Laura, actually died when she was four years old. She was hit by a car just before Thomas was born.

While escaping the hospital, he tries to take Bastien with him. But, he believes Bastian wants to kill himself and he tries saving him, but is really the one who nearly kills him.

A nurse intervenes and criticises Anna, who fuelled Thomas’ delusions by claiming his sister ran away. There was never any Laura involved.

The fights with her family, the aggressive kiss with the girl, the strangling of his mother, every single memory he had of Laura was Thomas, himself.

Who was the one who killed Thomas’ family?

This meant that the death of the neighbour’s dog was also blamed on Thomas. His parents decided to move Dylan upstairs, as he did not want to live in the basement with Thomas.

Thomas tries to convince his parents that he did not kill the dog. But his helplessness soon turns into anger. His parents’ treatment of him, coupled with their protectiveness for Dylan, pushed him off the edge. He took his father’s gun and shot him first. Hearing the sound, Betty rushed downstairs and was shot as well.

Dylan was alarmed by the gunshot and concerned about Betty’s safety. Looking at Thomas with a gun, he was left frightened. He pleaded for Thomas to stop, but he didn’t; first shooting him, and then strangling him till his body loses any sign of life.

How did Thomas get stabbed? What caused him to imagine Laura?

Anna tells the nurse that she did not tell Thomas the truth because she wanted to know whether he was truly responsible for his actions or whether his mental instability caused the murders.

He imagined Laura to escape the pain of his own actions, which meant that he was overcome by tremendous guilt and grief after what he did.

She believes that Thomas deserves treatment despite the heinous deed that he committed, and apologises to Thomas for how things turned out in his life.

Thomas remembers the final pieces of the incident. He killed his family and left the house, but suddenly started imagining the mysterious figure. He re-entered his house, and stabbed himself, concocting a false storyline in his own head that he was a victim as well.

Right before he fell into a comatose state, he saw a woman in a music video, who became the inspiration for the face of Laura he imagined after waking up.

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