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The Tommy Westphall universe hypothesis is an idea discussed among some television fans, it makes the claim that not only does St. Elsewhere take place within Tommy’s mind, but so do numerous other television series which are directly and indirectly connected to St. Elsewhere through fictional crossovers and spin-offs, resulting in a large fictional universe taking place entirely within Tommy’s mind. This hypothesis comes from St. Elsewhere’s last episode “The Last One”. In which it’s implied that the whole St. Elsewhere’s series had been a product of his imagination. 
The Last One
“The Last One” was the last episode of St. Elswhere, the camera pans out of St. Eligius Hospital, and changes to a scene where Tommy Westphall (an austic boy and minor character) is holding a snow globe with a replica of the hospital inside. His father works into the room, and says to Tommy’s grandfather:
“I don’t understand this autism. I talk to my boy, but…I’m not even sure if he ever hears me…Tommy’s locked inside his own world. Staring at that toy all day long. What does he think about?”
This one scene suggests that the whole TV show was dreamed up by Tommy. In 2003 on BBC news online, the creator of St. Elsewhere Tom Fontana wrote:
“Someone did the math once… and something like 90 percent of all television took place in Tommy Westphall’s mind. God love him.”
Example of the hypothesis
St. Elsewhere characters Dr. Roxanne Turner and Dr. Victor Ehrlich appeared on appeared on Homicide: Life on the Street.  So according to the Tommy Westphall universe hypothesis, because of this crossover, the two series exist within the same fictional universe, and within Tommy Westphall’s mind. By extension this hypothesis can therefore be extended to hundreds of TV series that have connection from each other. Including shows as Law & Order, The X-Files and the CSI series.
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The earliest online found mention of this hypothesis was written by Dwayne McDuffie for the Slush Factory website, entitled Six Degrees of St. Elsewhere. A website documenting TV series that take part of this hypothesis was made.  However, there has been people arguing and questioning about the hypothesis. 
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