Warning: this review of the Season 4 premiere of "Being Erica" contains spoilers. Specifically, it reveals the identity of Erica's first patient, whose hand we saw at the end of last season. If you have yet to watch "Doctor Who?" and do not want to know the identity of the patient, then do not click the read more link.
If you got here via a direct link, and still don't want to be spoiled, then do not read beyond the picture below. This is your final warning.
And the mystery man in the glove is...
Sam's ex-husband Josh! Well, technically ex-husband-to-be, since their divorce isn't finalized. Honestly, when I put together my odds for Erica's first patient, I didn't even have him on the board, in part because I'd assumed that Sam and Josh's divorce was just sort of handled off screen, particularly since we hadn't seen Josh in so long and Sam had pretty much moved on to Lenin. But a few of the commenters on that piece guessed it was Josh, so kudos to them.
In reality, the identity of the patient is less important than how that person fits into the show's progression into the doctor-patient relationship, and "Doctor Who?" did a good job of explaining exactly how that would work, by showing us rather than just flat out telling us. Erica becoming a doctor -- or "doctor in training" as Dr. Tom so directly reminded her -- doesn't mean the focus of the show is changing at all. Erica's first "session" with Josh ends up being a lesson for her, which sets the stage for the rest of the season.
See, just because Erica has reached Phase 3 doesn't mean she's done growing or learning. She has just as much to learn from Josh as Josh does from her, just like Doctor Tom has had so much to learn from Erica (as we've seen directly in a handful of episodes throughout the years, most notably, Season 3's "Physician, Heal Thyself"). It also brings up one of the show's weirder lingering threads, Josh's admission of his feelings about Erica, and how that played into the breakdown of his relationship with Sam.
By the end of the episode, we've been on another trip back to the past with Erica, seen her learn another valuable lesson, complete with some gems by Doctor Tom, including what probably has to be the mission statement for Season 4: "You ARE your patient. You are every patient you will ever have and every person you will ever meet." Hell, Doctor Tom's wisdom is the thing I'm going to miss the most about this show when it's gone. Well, second-most, behind Erin Karpluk, who continues to be amazing, handling an incredible range of emotion in a 42-minute span. Plus, and this might just be my imagination, but I think she got hotter this year.