With just one more episode left in season four of This Is Us, there’s no telling what drama may happen due to Randall’s (Sterling K. Brown) latest therapy developments. 

Last week’s episode ended with Randall and Kevin (Justin Hartley) arguing about whether or not Rebecca (Mandy Moore) should do a clinical trial in St. Louis. The argument ends with Randall telling Kevin that he thinks about what life would’ve been like if Jack (Milo Ventimiglia) hadn’t died in the house fire. 

This week, Randall gets to explore that thought in therapy as he works through with his therapist what life would’ve been like if Jack hadn’t died in the fire when Randall was 17. 

First, Randall explores the good scenario as a teenager (Niles Fitch). Jack lives, Rebecca tells him about Randall’s birth father, William (Ron Cephas Jones), and as a result, Randall grows closer with his father and is almost unable to forgive his mother. 

Jack takes Randall to meet William, and the two hit it off immediately. They spend a lot of time together, Randall goes to college and still meets Beth (Rachel Hilson) and he ends up catching William’s stomach cancer early and is able to get him cured. Everything goes exactly as the audience would love to see, with rose colored glasses. 

However, his therapist tells him that’s not a realistic view of what would happen. She asks him to explore a more realistic sense of what may have happened. 

Jack lives, Rebecca tells Jack about Randall’s birth father, but instead of being understanding, Jack despises Rebecca for not telling the truth. William doesn’t want to see Randall, and he’s so devastated that he goes to Howard for college early instead of Carnegie Mellon. He never meets Beth, he continues to despise his mother, Jack’s alcoholism gets worse and Randall becomes a professor who sleeps with an endless stream of his teacher’s assistants. 

The bad scenario ends with Rebecca getting sick, and Randall decides to forgive her. 

Randall isn’t thrilled with either of the scenarios. His therapist explains to him there wasn’t much that he could’ve done to save Jack, but Randall wishes that he could live with himself now, knowing he tried to save him before he died. He explains he was able to find more peace after trying everything he could to help William before he died.

The breakthrough comes when his therapist makes him realize that in both scenarios, even though he chose his father to cozy up to, he always redeemed his mother in the end. Though he never confronted Rebecca for keeping William from him for so long, he explains that he has no intention to. He doesn’t want to reopen that wound for either of them, but instead, he wants to spend time with her and do everything he can to try and cure her. He explains that losing Rebecca would be losing his fourth parent, and it would break him. 

“I lost my father, and I couldn’t stop it,” Randall said. “I lost my second father, and I couldn’t fix that either. And now my mother is sick, and there are options.”

After leaving his therapist’s office, he goes home to call Rebecca. He explains to her that he’s been a good son, that he’s always tried to take care of her, not cause a fuss or resent her for the things she kept from him. He explains how never once in his life has he asked her for anything, but now he is asking her, begging her, to do this clinical trial. 

Finally, Rebecca agrees to go to St. Louis and do the trial.

This episode is a huge turning point for Randall. He finally embraces his feelings and takes his therapy sessions seriously. It’s great to see him doing this, but this is sure to cause problems between him and Kevin next week on the season finale. 

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The season finale of This Is Us airs Tuesday at 9 p.m. on NBC.

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