In May 1988, medical dramaSt. Elsewherecame to an end after six seasons, but in a highly unexpected fashion. The entire world of the show was implied to be a figment of a small boy’s imagination, with the building of its fictional hospital, St. Eligius, contained within the snow globe he was seen playing with.

This shocking twist to end such aninfluential network TV procedural serieswas enough to confuse audiences as a standalone event. But the late great Dwayne McDuffie, comic book and TV writer known for his work in the DC Animated Universe, took things a step further by proposing a theory he called “The Six Degrees ofSt. Elsewhere” (viaCBR).

St. Elsewhere

Named after the social theory suggesting there are only six degrees of separation between any two people, McDuffie’s theory, which began as a joke, gave rise to thebiggest hypothetical shared universein TV history.St. Elsewhere’s ending was no longer just a disconcerting plot twist. It was the window intoa world populated by thousands of TV characters.

St. Elsewhere’s Ending Originated The Tommy Westphall Shared Universe Theory

The Theory Suggests Over 400 Shows Take Place Inside One Boy’s Head

Widely considered themost controversial series finale plot twistof all time, the idea thatSt. Elsewhere’s entire story took place in the mind of Tommy Westphall, a child with autism, stunned the show’s audience. But it also opened up a black hole in the fabric of TV’s space-time continuum, taking the stories of various other shows along with it.

The most notableSt. Elsewherecrossover was Dr. Roxanne Turner inHomicide: Life on the Street. There were various crossovers betweenCheersandSt. Elsewhere, too.

IfSt. Elsewhereall took place inside Tommy’s head, then it was only a small step to infer that other related shows did as well.Multiple characters fromSt. Elsewherecrossed over into other series at some point, the most notable being Dr. RoxanneTurner in Homicide: Life on the Street. There were various crossovers betweenCheersandSt. Elsewhere, too.

Why The Tommy Westphall Shared Universe Includes So Many TV Shows

Various Tenuous Connections Can Be Made Between St. Elsewhere & Other Shows

There were actually dozens of shows on the roster of TV network NBC around the same time asSt. Elsewherewhich are linked to the show by some form of cross-reference.Many of these shows shared writers or producers with the medical drama, so it’s hardly surprising that their scripts contained Easter eggs suggesting a single shared universe.

However,St. Elsewhere’s writers didn’t just reference contemporaneous NBC shows in their scripts. They also drewconnections between older shows likeMAS*Hand their own series, implying a far larger shared universe in which anything with the remotest connection toSt. Elsewhereis fair game to include.

The more tenuous the links are, the murkier the Tommy Westphall Shared Universe theory becomes. The fact is, shows of various stripes reference one another all the time. But of course, they’re not necessarily implying a specific shared universe contained within the ending of St.Elsewhere. They’re simply acknowledging the broader shared universe of the televisual medium itself.