St. Elsewhere and the Everlasting Legacy of Its Strange Snow Globe Finale

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https://www.pastemagazine.com/tv/st-...lobe-explained

The Finale

“The Last One”

The show’s cast had seen ups and downs, additions and subtractions in its time, with Flanders’ character Westphall eventually stepping down as the hospital’s head to become a doctor there. The common thread running through the last season (besides a consistent plot about a special new artificial heart) is that St. Eligius is probably going to close, right around the same time the hospital’s residents (read: the younger main cast members) are all ending their residencies and about to head out into the depressing world of medicine.

Fiscus (Mandel), Morrison (Morse) and Ehrlich (Begley) are all dealing with their own issues around their impending exits. Mandel’s character, though, gets the easiest metaphor of the episode. As Dr. Fiscus struggles with the anxiety of leaving the hospital, his last patient at St. Eligius is the actress portraying a valkyrie in a Wagner opera who has, get this, laryngitis. Craig, always a prissy sort, is absolutely beside himself with the prospect that his wife Ellen is taking a job in (gasp) Ohio. Westphall, Auschlander, and Gideon (Cox) are stressing about how they can possibly keep the hospital open. Somehow, a literal airplane has crashed into the hospital.

It’s an episode of heartfelt goodbyes and dramatic exits. In the moments before he’s expected to announce the fate of the hospital, Auschlander suffers a catastrophic stroke off-screen and is discovered dead, with the cast gathering for a mournful goodbye. And in the end, Fiscus’ patient does finally sing.

But of course, none of that is what people really remember the last episode for. They remember it because of young Tommy Westphall (Chad Allen)—the autistic son of Dr. Westphall, who was a recurring character on the show. In the final scene of the series, the camera widens out from St. Eligius, until it becomes clear the hospital is a model inside a snow globe being shaken by Tommy as he plays on the floor of a small apartment. In the door comes Dr. Westphall, but he hangs up a construction worker’s hat. What world is Tommy imagining inside that snow globe, he wonders aloud.

That is the actual ending, a strange world-within-a-world. It seems to imply that the events of the show were all imagined by the mind of a non-verbal young boy. There’s a lot to unpack: is it simply making a statement on the show as a fictional world? Is it positing that the hopes and the fears and the suffering we endure in our lives are being watched by a deity who is interested and all-knowing but who can only gaze in at us and never interfere in our tribulations—where in all the world but an under-resourced hospital in the planet’s richest nation could the question of such a being’s love or cruelty be more pressing?

Nobody is too interested in that, though. They’re more interested in the colossal mind-f*** that is the Tommy Westphall Universe. For indeed, St. Elsewhere, like basically every television series that is set in “the present day,” had crossover episodes or cameos with other popular shows. At one point, St. Elsewhere characters got the business from Carla while drinking at Cheers, the bar from, uh, Cheers—and therefore, Frasier, a spinoff, must also exist somewhere in that snow globe. Through crossovers, spinoffs, cameos, or fictional brands or products appearing in more than one show, everything from Brooklyn Nine Nine and Law & Order to Everybody Hates Chris and Dr. Who were arguably all dreamed up by young Tommy.

Is all of American television the hallucination of an autistic child?? Are you and I??? This is more interesting than interrogating the deeper philosophical or metaphorical meaning behind the very last scene of a six-season show! It’s simultaneously a lot of what I find fun about the inside baseball or meta commentary on TV, and also most of what I hate about it.

St. Elsewhere was a solid drama that gave a boatload of great actors some steady work for a few years, but it will always be a peculiar show for that final detail.

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