Spoilers ahead for This Is Us Season 4, Episode 17. Fans know that Randall is scared about losing his mom, but manipulating Rebecca into doing the clinical trial on This Is Us is not only pretty unforgivable — it also may be pointless. Last week during the March 10 episode, Rebecca made it very clear to both Kevin and Randall that she had no interest in going to St. Louis for nine months to participate in the Alzheimer's trial.
"I want to spend however many good years I have left — I want to spend it with my family," she explained to her sons. "I want to try new things ... I want to make up for all of my 'next times.' ... and I really don't want to hear what either of you has to say about it, because I have made the decision for myself."
Kevin immediately respected her decision, but Randall just couldn't let it go. After an intense therapy session where he realized he's holding onto some lingering resentment over Rebecca keeping his birth father from him, Randall expressed his fear over his mom dying — the fourth parent he'd be losing. "I know that losing my mother would break me," Randall told his therapist. "I would do anything to keep that from happening."
Apparently that "anything" included calling his mom up and laying on so much guilt that she would cave. "Mom, I've been a good son ... after Dad died, I stayed at home, I took care of you," Randall said. "I have been a good son and I've let things go, Mom. Things that were kept from me. Things that I should have resented you for, but I never did because I knew that it would be painful for you." He added, "I lost my father and I couldn't stop it ... now my mother is sick and there are options. I have never asked you for anything, Mom ... I am asking you for this now."
Rebecca's end of the manipulative phone call was juxtaposed with Rebecca looking into the living room at Kevin, Kate, Toby, and Miguel playing charades. As she glanced out at the people she would have to leave behind, the very people she originally turned the trial down for, she caved under the immense weight of Randall's guilt trip and agreed to go.
If you were also screaming at Randall through your TV, that was the point. Executive Producer Elizabeth Berger told Entertainment Weekly that they wanted viewers to understand both why Rebecca didn't want to go, but also why Randall (or any child) would want her to. "We like to live in those gray areas where you really could see both sides of this and there is no right answer, really. Which makes it extra-maddening for everyone," she said. It's incredibly maddening, and so it's understandable that it's also going to potentially be a breaking point for Kevin. The fight in New York was only just the beginning for the brothers. Executive Producer Isaac Aptaker told EW ahead of this episode airing, "These last two [episodes] are very much about the fracture between the brothers, their difference of opinion on how to care for Rebecca."
But even if Rebecca does do the trial, it doesn't seem to have helped much. In the 40th birthday flash forward, Rebecca already seems much more confused. For example, she didn't remember that Randall and Kevin weren't talking. That flash forward can't be very far into the future since the Big Three are midway into age 39 now. If she's started the trial, things don't seem to be getting better. And Randall didn't even show up for the birthday dinner to spend time with his mom. So if she does go get treatment and he won't even make up with Kevin to be there with his mom, truly what was the point of all this? Plus, in the big flash forward with Old Rebecca, which has been reported to be about a decade or so ahead, she's seems to have completely lost her memory. Randall has to tell his mom who he is.
Obviously Randall can't see the future and how all of this work out, but fans can, so it's devastating that Randall isn't listening to his mother's wishes and is selfishly trying to send her to the trial because he can't handle losing a parent. What about Kate and Kevin who have respected their mother's wishes? They'll no doubt be sad if something happens to her, but they've let her own decision precede their personal feelings. Randall seems incapable thus far of doing that, and all he's hurting is himself (by not showing up for family events to actually see his mom) and his mom who was just bullied into making a decision by the son who should be respecting her original one.