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'This Is Us': The Heartbreaking Truth Behind Kevin and Randall's Rift Sets Up a Major 'What If?'

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Warning: Do not proceed if you have not watched Tuesday's episode of This Is Us. You are about to approach spoiler territory.

So this is what tears Kevin and Randall apart.

This Is Us revealed the root of the main conflict that comes between the Pearson brothers on Tuesday's episode, which saw the family venture to New York City at three separate times in their history. And what causes Kevin (Justin Hartley) and Randall's (Sterling K. Brown) feud -- hopefully a temporary one -- is steeped in their differing opinions on how to care for Rebecca's early stage Alzheimer's and their contrasting perspectives on life in general.

While Randall thought it best for Rebecca (Mandy Moore) to take part in an experimental clinical trial all the way in St. Louis, Kevin wasn't so game for their mom to spend nine months away from family and loved ones when there was no guarantee that her Alzheimer's would be cured. Instead of presenting Rebecca with their plan for her to join the clinical trial the morning of Kevin's New York movie premiere like Randall had planned, they agreed the discussion would be tabled until the day after because Rebecca, Kevin argued, deserved to have one worry-free day. Except, that didn't happen.

When Kevin is pulled away to reconnect with his co-star and after Rebecca had a memory lapse, Randall decided to move forward with letting his mom in on the Big Three's agreed-upon plan alone. The decision for Randall to go back on his word drew immediate ire from Kevin, and understandably so, as he quickly called out Randall's "holier than thou" attitude and inability to let others' weigh in when it came to what was best for Rebecca. "I've been taking care of mom for 20 years," Randall tells Kevin, as the brothers have a full-blown fight in the middle of the after-party over their conflicting ideologies.

"I'm just trying to give her some hope," Randall argues. "And I'm just trying to give her one evening that's not about her losing her mind," Kevin fires right back, saying point-black that he may actually "know what's best for our mother." But it's much more than not seeing eye to eye on Rebecca's Alzheimer's care. The brothers -- while they've been on good terms -- have never been on the same page. Randall snarls that Kevin's been living his life on a whim for 39 years, while he says he's been looking after Rebecca and the family their entire lives. But Kevin doesn't back down, telling Randall that his acting career he's "never taken seriously," is funding Rebecca's medical care not Randall's modestly-paid job as a city councilman. Mic, meet floor.

This Is Us
NBC

It turns out Kevin seems to be more aligned with Rebecca on this matter, as she tells her well-meaning sons that she's decided not to go through with the clinical trial. See, the thing is, her life has been "full of next times" and this time, she's had enough of playing second fiddle and is prioritizing her own wants and desires. "Now I realize that I'm running out of time to do them," Rebecca calmly explains, not allowing them to sway her otherwise and content with her decision. "I want to spend however many good years I have left, I want to spend it with my family. I want to try new things like walking on red carpets and I want to make up for all of my next times." 

Later, Randall tells Kevin, in his own circuitous way, that Rebecca's decision to forego the clinical trial, may be a fatal mistake. "This could have saved her life," Randall says, disappointment etched in his voice as he insinuates Rebecca is acting out of fear and doesn't know what she wants. (We know years later that Rebecca is near-death and likely suffering from advanced Alzheimer's.) And that's when the reason for Randall's over-protectiveness over Rebecca surfaces -- and it's devastating: Randall has held on to the guilt over not being able to save Jack (Milo Ventimiglia), wondering for years after the house fire that played a factor in his death if he could have done more. (Short answer: Probably not.)

"I had a chance to save Mom and you blew it," Randall blames Kevin, who tries to tell his brother that his dad's death was a tragic accident. While Kevin makes it clear that he hasn't thought about what could have been had Jack not run back into the burning house to save Kate's dog, Randall says he has... "every single day." Cue a flashback to the inciting incident when everything changed for the Pearsons, except Jack heeds Randall's orders and he steps away from the burning house -- safe and sound, and most importantly, alive. So, what would have happened had Jack lived? That's the set-up for next Tuesday's penultimate season four episode and a part of us thinks it won't be as rosy as Randall might have dreamed.

This Is Us
NBC

This Is Us
NBC

Hartley warned earlier this year that Kevin and Randall's big fight was deeper than a superficial argument and he was 100 percent right. It's unclear how the repercussions of this possible turning point in their relationship will play out in the immediate aftermath, though we know things don't get worse between the two before they, fingers crossed, get better.

"It's big. No, it's big, big," Hartley told ET in February in previewing this episode. "It's more than a misunderstanding. I think it's a philosophy. It's like, 'This is how you handle your life and this is how you deal with things and this is what you think. I go about my business a different way,' and they just can't [see eye to eye]."

"This one's for real," the 43-year-old actor emphasized. "This is not like we're going to argue about something. This is two men, two brothers each taking a stand that suggests that if they don't bend, the other one will not be in their life. I mean, it is a big deal. It just gives them... it's a big deal."

Kevin and Randall's stalemate has been teased since the fall finale, when it was revealed Kevin and Randall were no longer on speaking terms when their 40th birthdays rolled around -- a complete 180 from their supportive brotherly bond in recent episodes. 

"It's definitely something that's coming out in the near future run of episodes. By the 40th birthday, by the start of next season, they've had this falling out. They're not on speaking terms," This Is Us co-showrunner Isaac Aptaker said in January. "In this episode [that aired Jan. 21], they're so beautifully there for each other and they have this pretty incredible brotherly relationship. So something big is coming in this next run before the end of our season that will tear these two apart."

This Is Us airs Tuesdays at 9 p.m. ET/PT on NBC.

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