If you aren’t aware of the phenomenon of spin-offs, you haven’t been paying attention. When Fibber McGee and Molly’s supporting character Throckmorton P. Gildersleeve got his own radio show, The Great Gildersleeve, in 1947, spin-offs have been a staple of the entertainment world. Because of spin-offs, whole “universes” exist, such as the Marvel Cinematic Universe, where characters can bounce back and forth between different movies and television shows.

No, spin-offs are not difficult to understand. But what if we told you that well over 400 TV shows and movies are really spin-offs from one television series? Characters from such diverse shows as Doctor Who and Frasier all owe their existence to the same source. If that isn’t hard enough to swallow, what if we told you that many of the “spin-offs” are older than the show that gave birth to them?

Confused? Well, hold on, because you are about to get an education about the Tommy Westphall Universe Theory.

The Final Scene and the Big Plot Twist

On May 25, 1988, after six seasons of intense emotional roller coasters, NBC’s beloved St. Elsewhere bid its final farewell. Instead of a typical tear-jerker finale where the doctors would hug it out and entertain visits from prior cast members, St. Elsewhere did something that left viewers either scratching their heads or smashing their TV sets in disbelief. The show didn’t just come to an end — it imploded reality. It all happened with a snow globe.

In the final moments of the show, the camera zoomed in on Tommy Westphall, the young son of Dr. Donald Westphall, the hospital’s medical director. Tommy, who was on the autism spectrum, was holding a snow globe. Behind him stood his father, but not dressed in a doctor’s coat. Instead, he was decked out like a construction worker. As Tommy gazed into the snow globe, his father and grandfather had the following conversation:

Father: “Hi Pop, how you doing?”
Grandfather: “Good. How was your day up on the building?”
Father: “Well, we finally topped off the 22nd story. And I’m beat. How’s he been? (referring to Tommy) He give you any trouble?”
Grandfather: “He’s been sitting there ever since you left this morning, just like he does every day. World of his own.”
Father: “I don’t understand this autism thing, Pop. Here’s my son, I talk to him, I don’t even know if he can hear me. He sits there, all day long, in his own world, staring at that toy. What’s he thinking about?”

He takes the snow globe from Tommy and sets it on the television. As they leave the room, the camera zooms in, and we see St. Eligius, the hospital where the series has taken place, in the center of the snow globe.

Cue The Twilight Zone theme song. The implication is that the entire universe of St. Elsewhere, with all its drama, heartache, and medical miracles, existed solely within Tommy’s imagination, nestled comfortably inside that snow globe. It was as if the creators had dropped a bomb on the viewers’ understanding of the show—and not everyone was thrilled to be caught in the blast.

A Dream, A Nightmare, or Something Else Entirely?

Let’s not forget, this wasn’t the first time TV viewers had been ambushed by a twist like this. Just five years earlier, Dallas had pulled the infamous “dream season” stunt, where Bobby Ewing’s death was all a bad dream, making the entire season a complete waste of time. The outrage of Dallas fans was a surprise to the rest of us, who thought that all fourteen seasons were a waste of time. Understandably, audiences were wary of any narrative shenanigans that made them feel like they’d been had.

Bruce Paltrow, one of the executive producers of St. Elsewhere, seemed to know he was stirring a pot of controversy with the finale. “I expect a very mixed reaction,” he told the Chicago Tribune in 1988. “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.”

Oh, how right he was. What some found to be a brilliant existential twist, others saw as an unfulfilling slap in the face. Beyond the initial head-scratching and the existential dread about what just happened, something even more peculiar started to take shape. A fan theory began to develop that was unlike anything produced by any other show. The essence of the theory was that St. Elsewhere wasn’t just a TV show that Tommy dreamed up. If Tommy’s imagination had spawned this universe, then what about the other TV shows that had crossed over into the world of St. Eligius? Were they also a creation of Tommy’s snow globe imagination?

The Birth of the Tommy Westphall Universe

Welcome to the bizarre yet fascinating world of the Tommy Westphall Universe theory. You see, St. Elsewhere wasn’t just an isolated show—it had connections to a bunch of other TV series through character crossovers and shared references. For example, the doctors of St. Eligius once dropped by Sam Malone’s bar in Cheers—that’s right, the place where everybody knows your name. And from Cheers, we get to Frasier, and if you buckle up and stick with us, you can trace a tangled web of TV shows and end up in The X-Files, Star Trek, and the Marvel Cinematic Universe.

It didn’t take long for TV nerds to start piecing together these connections like a massive, multi-decade game of Six Degrees of Kevin Bacon. As of the last count, more than 400 shows can be linked to St. Elsewhere—all supposedly figments of Tommy Westphall’s imagination. That’s right, folks. According to this theory, a significant chunk of television history is nothing more than a daydream inside the mind of one very imaginative kid.

How it Started

Tom Fontana, one of the producers behind St. Elsewhere, never intended to dismantle the entire television landscape with this twist. In fact, his original idea for the show’s finale was even more apocalyptic—literally. Fontana envisioned an ending where St. Eligius’s staff would face the year 2013 as a toxic gas cloud passed over the hospital, the byproduct of some corporate war. NBC, however, wasn’t too keen on bankrolling such a grim, sci-fi spectacle, so the snow globe idea was born as a budget-friendly alternative. Ironically, this “simple” ending would go on to be one of the most complex and debated in TV history.

Years later, a playwright named Keith Gow, sitting in a Melbourne pub, started to wonder what the snow globe scene meant for every show connected to St. Elsewhere. He wasn’t alone in his musings. Gow, alongside U.S.-based fan Ash Crowe, began crafting what would become the ultimate crossover chart, linking St. Elsewhere to other TV shows in ways that would make your head spin. (Here’s a link to the website that contains the chart and a lot of explanation; it appears that it was last updated in 2016.)

Connecting the Dots: The Six Degrees of St. Elsewhere

Let’s break down one of the most absurdly intricate connections: how St. Elsewhere links to Doctor Who. Yes, that Doctor Who, the one with the time-traveling blue police box. (Here’s a link to a PDF that shows this and other connections in greater detail.)

1. St. Elsewhere’s Donald Westphall and two other doctors visit Sam Malone’s bar from Cheers.
2. Cheers gives us Frasier Crane, who later stars in Frasier.
3. On Frasier, John Hemingway from The John Larroquette Show calls in.
4. The John Larroquette Show mentions Yoyodyne, a client of law firm Wolfram and Hart.
5. Wolfram and Hart also counts Weyland-Yutani, a company that makes weapons for Firefly, as a client.
6. A Weyland-Yutani ship is seen in the BBC series Red Dwarf, which also features The Doctor’s TARDIS.

Just like that, Tommy’s daydream somehow has the TARDIS as one of its inhabitants. And that’s just one of the hundreds of connections. I Love Lucy? Check. The Flash? Oh, yeah. Thanks to a character named John Munch, who holds the record for most crossovers, the web extends across multiple shows, networks, and decades.

Since we got to Doctor Who, time travel certainly is a possibility. Along with time travel, we have some interesting paradoxes, as well. Consider, for a moment that Doctor Who first aired in November 1963 — 25 years before Tommy was staring into his snow globe.

If we can cover all of time and space, we might as well as about Spider-Man and his amazing friends from the Marvel Cinematic Universe? Yes, they are part of Tommy’s fertile imagination, too:

1. St. Elsewhere characters appeared on Homicide: Life on the Street.
2. Detective Munch from Homicide: Life on the Street appeared in the Arrested Development episode “Exit Strategy.”
3. Arrested Development’s Tobias Fünke appeared as an Easter egg in the Collector’s collection in Avengers: Infinity War.

From there, we can conclude that everyone from Doctor Strange to Rocket the Raccoon is simply the result of one child’s daydreams.

A Grand Unification Theory of Television?

In 2002, comic book writer Dwayne McDuffie, who had been pondering these connections, threw his hat into the ring with a blog post that really doubled down on the idea. “St. Elsewhere also shared characters with The White Shadow and It’s Garry Shandling’s Show,” McDuffie wrote. He connected the dots, showing that Tommy’s daydream could, in theory, encompass almost every show that had graced the airwaves.

If you’re feeling dizzy, you’re not alone. Even Tom Fontana, one of the masterminds behind the finale, was floored by the implications of the theory. In one of the more surreal moments of reflection, Fontana mused that this would mean “Tommy Westphall is the mind of God.” Just let that sink in for a moment.

Reality Check: The Critics Speak Out

As with any theory that blows up the internet (or in this case, the early 2000s equivalent), not everyone was on board. Critics argued that the connections were a stretch and that the whole idea misunderstood the creators’ intentions. Sure, the doctors from St. Elsewhere went to Cheers, but did the creators of Cheers ever consent to their show being part of an elaborate TV-wide hallucination? Probably not.

And what about the real-life cameos, like Alex Trebek showing up on Cheers? Is Alex Trebek a figment of Tommy’s imagination too? That’s when things start to get a little too Inception-esque for most people’s tastes.

But for those who loved the theory, these quibbles were just minor roadblocks on the way to a grand unification of television. And even if you don’t buy into the idea that Tommy Westphall dreamed up the entirety of TV history, you have to admit—it’s one heck of a mind-bending ride.

The Ever-Expanding Universe

As the years go by, the Tommy Westphall Universe continues to grow, with more shows being added to the Tommy Westphall Universe model. Enthralled fans still update their charts, linking new shows to the original St. Elsewhere with every crossover they can find.

Keep this in mind as you sit down to watch your favorite TV show tonight. Just think—you might just be watching the latest episode of Tommy Westphall’s active imagination. For that matter, perhaps you are living in his head right now.

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