Rebecca Pearson has always served as the strong and prominent matriarch of her family, but in the This Is Us fall finale, viewers (and Randall) began to see her health deteriorate in small, subtle ways — a process that will continue throughout the rest of Season 4 when the series returns in January. However, Rebecca's illness on This Is Us won't be diagnosed right away. According to executive producer Isaac Aptaker, who spoke with Entertainment Weekly after the fall finale, it will take a great deal of "time and testing" before the Pearsons are able to reach any conclusions about what's ailing their beloved mother.
“There’s not an instant blood test where they can tell you what’s wrong," Aptaker told the outlet. "But it’s something that we’re going to be exploring in the back half of the season with as much medical accuracy as possible.” The series has yet to specify what exactly happens to Rebecca, though viewers know it has something to do with memory loss and falls along the lines of dementia or Alzheimer’s. And just like in reality, each case is different depending upon the person and the severity of their symptoms, so it's good that the writers are taking the time to delve into the strenuous diagnosing process. Because sometimes not knowing what's wrong can be just as difficult.
Sterling K. Brown spoke recently to Us Weekly about the pending second half of This Is Us Season 4, indicating that viewers aren't ready for what's to come. "The audience is going to collectively gasp when they see our premiere for the second half of the season. That’s all I can really say," the actor told the outlet. And while it's unclear if he was specifically referencing Rebecca's tragic storyline, he did take time to praise his on-screen mother and tease further exploration of her health problems. "It’s a beautiful story line, beautifully portrayed by Mandy Moore,” Brown stated. “That scene in the Chinese restaurant, by the way, at the end of the fall finale was just gorgeous, and that’s something that we will continue to explore.”
Indeed, Rebecca's illness could ultimately have quite the ripple effect on the entire family. In the latest flash-forward, it was revealed that Kevin and Randall are no longer on speaking terms. No one knows the reason behind their feud; however, it could potentially have something to do with Rebecca.
"So many of the people that we brought in to speak to what it’s like to have a parent with dementia or Alzheimer’s talked about the tensions that flare up between siblings, between spouses, when it comes to that person’s care," Aptaker explained during the same EW interview back in November. "There’s going to be a lot of complicated decision-making down the line regarding Rebecca’s treatment and care, and that all makes existing sibling rivalries rear their heads, for sure."
As usual, the Pearsons have a long and difficult road of suffering ahead, so make sure your tissue supply is well stocked when the show returns on Jan. 14, 2020.