"Come on, son, let's wash our hands"  - The last words spoken  on the finale episode No. 137 "The Last One," on the medical drama ST ELSEWHERE/NBC/1982-88. During the life of the series Dr. Donald Westphall (Ed Flanders) worked at St. Eligius Hospital in Boston and had to juggle a busy schedule that included tending to the needs of his hospital patients and Tommy, his physically-challenged autistic son (Chad Allen). In the final surreal scene of the series Ed Flanders is shown as a blue-collar construction worker retuning home to his autistic son and his father (Norman Lloyd - who played Dr. Auschlander on the series). Sitting in the comfort of his home's living room, Tommy stares into a small crystal ball -- the kind you turn upside down to make it snow inside. That "scene", considered by many to be obscure, anti-climatic and unsatisfying, unceremoniously ended the show's six year run. Sadly, the show's writers wanted viewers to believe that the entire world of St. Eligius (with all its storylines of doctors, nurses, and traumas) was just the idle product of Tommy's autistic imagination. So, as tiny flakes of shimmering snow fell inside the snow globe, we get a close-up of the building inside...a likeness of St. Eligius Hospital.

Transcript of the final scene of "St. Elsewhere"
Dr. Auschlander (Norman Lloyd) and Tommy (Chad Allen) in Westphall's Apartment.  Westphall (Ed Flanders) arrives home.
Westphall:	How you doing, Pop?
Auschlander	Good.  And your day up on the building?
Westphall:	Finally topped off the 22nd story.  I'm beat... Tommy give you any trouble?
Auschlander::	Been sitting that way since you left this morning.  Just like every day.  In a world of his own.
Westphall  crosses, crouches beside TOMMY, who gazes at object in his hand.
Westphall:	Remember son, be careful with that... (stares at Tommy; beat; to Auschlander, without looking). 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?
Tommy shakes the object in hand, then stares at it.  REVEAL GLASS SNOWBALL with snow eddying inside.
Westphall::	Come on, son, let's wash our hands.
Tommy shakes snowball again.  Westphall takes snowball from Tommy, places it on mantelpiece. All three exit.
On C.U. of SNOWBALL, model of St. Eligius inside, snow swirling about,
FADE OUT.
Note:  C.U. = "Close Up"
Transcript excerpt courtesy of  George Abbott from the "St. Elsewhere" archives at the Syracuse University Library, Syracuse, NY 13244

TRIVIA NOTE:  Each week, the series featured a closing tagline of the MTM kitty in a surgical mask. On the last episode, the MTM cat dies ("flatlines") as the final credit rolls.  Earlier on the final scene of the episode "Moon for the Misbegotten" (9/30/1987) on ST. ELSEWHERE staff physician Dr. Donald Westphall (Ed Flanders) became frustrated with the new administration that had taken over St. Eligius Hospital. In a final act of defiance, he pulled down his trousers and mooned Dr. John Gideon (Ronny Cox) saying "You can kiss my ass, pal." He then retired to his home in Peterborough, New Hampshire. This was Ed Flanders' last appearance as a regular. He would make two guest appearances, first on episode No. 132 when his friends travel to his home for a visit and on the last scene of  the series finale as mentioned above.