"St. Elsewhere"
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Tommy Westphall is Dr. Westphall's autistic teenage son, who appeared in occasional episodes. In the final episode, we meet Tommy again, but his father is not a doctor, and Dr. Auschlander is his grandfather. The final shot is of Tommy staring into a snow globe containing a model of St. Eligius - suggesting that everything that happened on the show was entirely in Tommy's imagination.

Because the show and its characters had direct crossovers with other shows - notably Cheers, The White Shadow, and Homicide: Life on the Street - it can be said that those shows exist in the same "universe" as St. Elsewhere. And since those shows had crossovers to still more shows (notably Homicide's John Munch (Richard Belzer) on the Law & Order and The X Files franchises, those shows are in the universe as well. Excluding animated and "reality" shows, the "universe" encompasses over 280 shows (as of 2007). The oldest is I Love Lucy.

In real time, six years. In TV time, three years. Since the producers wanted to make the show correspond with the residencies of many of the young doctors, they chose to make it span three years instead of six years, which is a possible but less common time span for a residency. The first episode begins with the start of their residency and the last episode concludes with the end of their residency. On one episode, Fiscus' mother jokes that "Wayne has been at the hospital for three years, although it seems more like six."

Axelrod survives a heart attack but dies after hallucinating and getting out of his recovery bed, disconnecting the IV supply. Luther gets married and becomes a physician's assistant. Fiscus accepts a position to work in Central America. Chandler quits medicine after revealing that he only went to medical school to satisfy his father. Morrison moves back to Seattle to get back with his wife and kids. Craig reconciles with his wife and moves to Cleveland with her. Ehrlich takes over Craig's position as head of surgery. Auschlander saves the hospital from closing but dies of a stroke. Gideon resigns as director and appoints Westphall as his successor.

However, all this becomes a moot point when it is revealed that the whole St. Elsewhere series was a figment of Dr. Westphall's autistic son's imagination.

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