‘This Is Us’ Season 4, Episode 10 Recap: Diagnoses & Hall Passes

We pick up where we left off with the young Pearsons, with Jack slightly drunk after a game of golf with Rebecca’s dad, Dave (Tim Matheson). As she drives him home, she asks if anything happened with her dad. He lies and says no to save her from getting upset. She drops him off at home and his landlord says he’s going to get evicted unless he pays his rent by the end of the week.

Later, they’re on a date and Rebecca tells Jack how stressed her mom is about her dad’s upcoming birthday party. Jack is silent and when Rebecca asks him what’s wrong, he tells her they need to take a break because they’re too different. He stresses the fact that he’s a part-time mechanic who can’t even afford pepperoni on his pizza. She’s completely dumbstruck.

That weekend, Rebecca attends her dad’s birthday party and her mom, Janet (Elizabeth Perkins), notices how hung up she is on Jack. She tells her mom that she loves Jack and her mother tries to explain that love isn’t all a relationship needs to thrive. Janet admits that she and Dave were scared when they saw how smitten Rebecca was with Jack because he doesn’t come from the right family or have any job prospects. But seeing how upset her daughter is, Janet tells Rebecca that Dave got in Jack’s head and said he wasn’t good enough. That’s why he’s been acting weird. It has nothing to do with Rebecca.

Since Rebecca confided in him about her memory loss, Randall has committed himself to finding her the best neurologist. He flies out to Los Angeles to go to the doctor with her and Miguel (Jon Huertas) still not having told his brother and sister. Before she goes in for a memory test, Rebecca assures Miguel and Randall that she’s going to be fine.

While she’s undergoing observation, Miguel and Randall butt heads. Miguel tells him that forgetting things when you’re older is normal. He doesn’t appreciate the fact that Randall flew in to save the day when everything was going perfectly fine.

But, after the tests, the doctor says Rebecca is suffering from “mild cognitive impairment.” Until they run some bloodwork and additional tests, she doesn’t want to give Rebecca’s condition a name. Rebecca is immediately defensive about her memory and Randall quickly goes into fix-it mode. Miguel is silent.

Later, Miguel gets honest with Randall and says that he’s noticed changes in Rebecca but that he’s been avoiding them. He begins to cry and promises Randall that he’ll take care of her. Randall assures him that they can all get through this together. And with that, they head home.

Kate, Toby (Chris Sullivan) and baby Jack are back home, but the tension between them is still palatable. Toby feels it and asks Kate what’s going on, so she admits that she saw the text from Cara, his CrossFit friend. (Ya know, the one that says she’s here if Toby needs to talk about his relationship issues?) Toby assures her they’re just friends and she decides to let it go. They hug and she says she just wants to get past this.

Meanwhile, sticking to his promise of landing a wife and a baby ASAP, Kevin hires a matchmaker and goes on a plethora of dates. One’s too smart for him and one’s even racist.

In order to get past their relationship lull, Kate decides to throw Toby a Jimmy Buffett themed surprise party and enlists Kevin and Madison (Caitlin Thompson) to help. Once they find the perfect ugly Hawaiian shirt for Toby to show off in front of his CrossFit friends, Kevin and Kate go to get a cup of coffee. He tells her he’s giving up on his match-making service and going to rely on the universe to find him a wife. And that’s when he spots a woman named Lizzy (Sophia Bush) who he can’t take his eyes off of.

They meet, hit it off and go to have lunch. Their chemistry is incredible but then she drops a bomb: She lives in Chicago. But Kevin is already smitten, so he tells her he’d love to whisk her off on a proper L.A. dream date. He says he has to make some calls and since she told him she loves John Legend, we suspect that’s probably who he’s about to call. And, yep, it turns out Kevin was able to secure the entire Hollywood Bowl and a private performance with John Legend just to make Lizzy smile. Damn, Kev.

While Kevin’s falling in love, Kate and Toby are falling apart. They barely speak at the surprise party and afterward they have a come to Jesus. Kate asks him why he switched gyms without telling her and he admits that Cara his CrossFit friend tried to kiss him. He wasn’t into it though and got away fast so that nothing more would happen. But this doesn’t explain why Toby has been avoiding Kate and their home. Finally, he says the reason he doesn’t want to be home lately is because Jack’s condition makes him sad. Kate doesn’t know how to react to this—she’s hurt, she feels alone, she’s offended. So, she takes Jack and goes into the other room.

Back in John Legend land, things are going well…until they aren’t. Kevin asks Lizzy how she’s enjoying the show and leans in to kiss her, but she stops him. It turns out she’s married, and Kevin is her hall pass. Ouch. Her husband has been calling her all day and she says it’s probably time she leaves. Kevin looks gutted and Lizzy awkwardly walks away. Guess she’s not his future baby mama!

We almost end the episode on a high note. Kate is feeding baby Jack when she realizes that he’s reaching for lights. The doctor said he might eventually see shadows and light and it looks like that’s right. Toby rushes in and they both marvel at the fact that their son is defying the odds.

Kevin heads to set to do reshoots and complains to a production assistant about what happened with Lizzy. He hands the PA his phone and asks him to hang onto it so he can concentrate. As Kevin walks away, the PA sees that Sophie (Alexandra Breckenridge) is calling him. What?!

Rebecca processes the news of her diagnosis and cries, all the while remembering the night of her dad’s birthday party when she rushed to Jack’s autobody and confessed her love to him.

And after Randall returns home and kisses Beth (Susan Kelechi Watson), he goes downstairs only to find a man with a knife standing in his family room. Is he real or is the stress causing Randall to hallucinate? We’re not quite sure which is worse.

This Is Us returns with episode 11 Tuesday, January 21, at 9 p.m. PT/ET on NBC.