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Season 6, episode 22

The Last One
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!
Release date: 25 May 1988
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St. Elsewhere