The hospital review board acquires a new member from the psychiatric floor; Chandler experiences long-suppressed resentments when he treats a Vietnamese patient; and Dr. Turner counsels an upwardly mobile couple who can't conceive a child.

The Craigs' reconciliation faces its first test; Drs. Auschlander and Gideon struggle together to save St. Eligius when Weigert decides to get out; Novino pushes Morrison to decide between her and Joanne; Griffin places his future in God's hands; Ehrlich returns from his odyssey; and Fiscus' last E.R. patient is a lady from the opera...

But is it really over? The jaw-dropping climax culminates in a blue-collared dad placing his young autistic son Tommy Westphall's miniature St. Eligius snow globe on the living room TV set, having summoned him to dinner. ""St. Elsewhere's"" entire six-year saga had all been a figment of little Tommy's imagination!