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The curse of St Elsewhere: inside the craziest finale in TV history

Chad Allen as Tommy Westphall, the surprising star of the St Elsewhere finale
Chad Allen as Tommy Westphall, the surprising star of the St Elsewhere finale

Emma Stone is currently the awards-winning toast of Hollywood, with Golden Globe and Critics Circle awards for her career-best performance in Poor Things, and almost certain Bafta and Oscar nominations to follow imminently. Yet she’s also been in the spotlight recently for quite another reason. Stone is the star of the much-discussed new show The Curse, a warped black comedy revolving around the difficult relationship between a married couple who are working on a reality TV show in which they try and perform self-publicising acts of largesse for the residents of a city in New Mexico, as they attempt to conceive a child.

As you might expect from creators Benny Safdie and Nathan Fielder, who have been collectively responsible for the anxiety-inducing Adam Sandler thriller Uncut Gems and the profoundly awkward series Nathan for You and The Rehearsal, The Curse is not interested in allowing the audience to relax. As one critic wrote, some of its most protracted scenes “elicit an uneasiness that makes some of The Office’s most awkward moments seem like an episode of The Repair Shop.” It is blackly hilarious at points, and Fielder and Stone have an attractively strange chemistry together. But the unnerving spirit of David Lynch and Twin Peaks is alive and well, as can be seen by the jaw-droppingly strange finale.

In it, Stone’s character Whitney is pregnant, and the pair are preparing for their child to be born, when Fielder’s Asher finds himself no longer susceptible to the laws of gravity and he is, in his horrified description, ‘falling up’, after a curse that he was inflicted within the first episode finally takes effect. Eventually, after the attempts of the local fire brigade to bring him down to earth fail, he finds himself floating off into space, ending the episode frozen as an oblivious Whitney gives birth to their son via a C-section.

Emma Stone and Nathan Fielder in the finale of The Curse
Emma Stone and Nathan Fielder in the finale of The Curse - Jeff Neumann

For a show that has hitherto appeared to offer a naturalistic and relatively straightforward – if satirical and cringeworthy – account of the mores of modern American entrepreneurial life, it has suddenly shot off into a completely new genre, and has thereby taken its place amongst the most head-scratching series endings ever filmed. Reviews have ranged from “bizarre [and] wildly misconceived” (Rolling Stone) to “horrifying and humanistic” (The New Yorker).

But The Curse is not the first show with a series finale that turned everything that had passed before completely on its head. Recently, Brit Marling’s jaw-droppingly strange and oddly humourless series The OA concluded its first instalment by having a high school shooting foiled by interpretive dance – and it’s even weirder than it sounds on screen – and the excellent 30 Rock ended in 2013 with the (admittedly tongue-in-cheek) revelation that Jack McBrayer’s perpetually cheerful TV assistant Kenneth is, in fact, immortal.

There have been many frustratingly ambiguous or disappointing endings to popular shows – one thinks of Lost or Game of Thrones, and the last shot of The Sopranos will never cease to be debated – but it’s one thing to let down an audience, and quite another to come up with something that will be discussed in terms of awestruck surprise for decades afterwards.

In British television, the conclusion of Byker Grove remains perplexing, as a show that had previously been a naturalistic youth drama set in Newcastle concluded with a 2006 episode, knowingly entitled Deux Ex Machina, in which the characters suddenly become aware that they are fictitious figures being manipulated by an omnipotent creator – the screenwriter – and fight back. Aliens, a T-rex, references to the “benevolent scribe” and a concluding montage set to the Beatles’ In My Life all feature. It’s one of the oddest things ever seen on our screens, and it surely owes a debt to the series finale that laid the groundwork for all the experimental and baffling shows that would follow subsequently: that of the 1980s American medical drama St Elsewhere.

The cast of St Elsewhere
The cast of St Elsewhere - NBC

Over the course of its 137 episodes, the show appeared to be, for the most part, a naturalistic drama set in St Eligius, a failing hospital in Boston, revolving around the relationship between senior doctors and ambitious interns. It was intended to be a companion piece to its network NBC’s successful police series Hill Street Blues, and indeed was advertised as “Hill Street Blues in a hospital”.

Yet as its sixth series wore on, its creators Joshua Brand and John Falsey brought in increasingly baroque flourishes. Season three, for instance, ended with guest appearances by many of the cast of Cheers, another NBC show also set in Boston, and in one series five episode, Howie Mandel’s character, wounded by a near-fatal gunshot, travels between Heaven, Hell and Purgatory as his colleagues attempt to save his life. You certainly wouldn’t see such a thing in Casualty.

But all this pales into insignificance when compared to its justly celebrated final episode, The Last One, which aired on May 25 1988. It ends with its lead character Dr Westphall and his autistic son Tommy together, and with Tommy Westphall shaking a snow globe; the final shot is of a replica of St Eligius in the globe, suggesting that every event during the previous six seasons is nothing more than the imagination of an autistic boy.

There had been countless “and it was all a dream” endings or revelations in television before, of which the most notorious is the moment in Dallas when it is casually revealed that the entirety of season nine has been a fantasy, thanks to Bobby Ewing’s shower-set unexpected return to life. Many of them have been treated with a mixture of weariness and contempt by disappointed audiences, who have invested time and interest in the characters and storylines, only to have their efforts betrayed by a supercilious scriptwriter.

Yet St. Elsewhere was altogether different. The ending was expected to be divisive; executive producer (and father to Gwyneth) Bruce Paltrow told the Chicago Tribune that “I think some people will think it’s extraordinary and existential and quintessential St. Elsewhere. I think other people will find it puzzling, odd, maybe unfulfilling in some way.”

What Paltrow did not say was that the showrunner Tom Fontana had handed him a list of other potential endings, including David Morse’s character Dr Morrison announcing, as if at random, that he was the second gunman on the grassy knoll before killing one of his colleagues, and the entire cast being wiped out in a nuclear explosion, and that the producer described the snow globe ending as “the least bad option.”

Yet as Fontana also recalled, “the great thing about writing that show was Bruce had a wonderful capacity for sort of letting us run free and then pulling us back just before we fell over the edge of the cliff…he was always encouraging us. He put up with stuff that mortal men would not have put up with.” As he said, “what I wanted to say was that this show, this series took place in the mind of an autistic child. It is not real, and it’s over now. And that’s why a lot of people were angry that we did that, but a lot of people thought it was fantastic too.”

The ending was rich in meta-televisual allusions, containing references to everything from The Fugitive to The Mary Tyler Moore Show; Fontana even said that the idea was “let’s do a homage to the end of every television show”, emphasising the artificiality of the central conceit. Yet what Fontana, Paltrow and the others could barely have conceived of was that St Elsewhere would give rise to what has been described as “the Tommy Westphall Universe”, given the interconnected way that characters would interact with one another.

The original series had direct links to 13 other programmes via a mixture of cameos and crossover references, ranging from Cheers to Homicide: Life on the Street. Many of these in turn spawned their own crossovers; for instance, Cheers featured Frasier, who would later go on to star in his own series, but he also cameoed in the sitcom Wings. However, others would be considerably more esoteric.

Two friends, Keith Gow and Ash Crowe, began discussing “The Tommy Westphall Universe” in 1999, and eventually drew up a flow chart in 2011, which soon doubled in size. By 2022 it had grown to encompassed 500 shows, which include everything from Buffy the Vampire Slayer to The Fresh Prince of Bel Air. It has been estimated that up to 90 per cent of American television shows might have some connection to St Elsewhere and the character who imagined all the six seasons’ exploits. It is an impressive, even daunting achievement. As Fontana said: “The first time I saw it it just completely devastated me, because it was like what [television critic] Matt Zoller Seitz said about the show being a speck in the universe.”

It speaks volumes about the affection with which St. Elsewhere continues to be regarded, nearly four decades after its audacious conclusion. Time will tell whether the finale of The Curse proves to be similarly influential, or if its loopy audacity is seen as an inspired one-off (Safdie and Fielder seem in no hurry to explain themselves). Yet at a time when countless shows have failed to take risks and end up either boring or disappointing, the existence of such leaps of imagination should be cherished, and restored to their fitting place in the Tommy Westphall universe.

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