The surgery was going badly. The malformed blood vessel in Nate's brain ruptured and the surgical team struggled to control the massive hemorrhage. As they work, the scene slowly fades to white and onscreen appears the following:
NATHANIEL SAMUEL FISHER, JR.
1965 - 2002
Is Nate Fisher really dead?
As it turns out, no one is more anxious to find out than Nate himself. To his amazement, he finds himself away from the operating room, wandering through a myriad of possible outcomes of his life: in one, his bald-headed corpse lies in an open casket; in another he survived the surgery but was left partially paralyzed and unable to speak; in another he's married to Brenda; in another his father's fatal car crash never happened and in yet another he's a beer-bellied couch potato watching a bizarre soap opera.
Eventually, Nate encounters Nathaniel, who leads him to a closed white casket in the Fishers' Slumber Room. When Nate asks his father whether he's dead, Nathaniel replies, "Yes. And no." He suggests that Nate's been moving through parallel universes. "In some places you're dead," Nathaniel tells him, "and in some places you're alive. Some places you never even existed . . . or, who knows, this could just be the anesthesia talking." The only way for Nate to find the answer is to open the casket and see for himself.
Whether Nate's out-of-time-and-body experience was the result of quantum superposition or medication may never be resolved, but his mortality status finally is: he's among the living. The surgery was a success and now, seven months later, he's married to Lisa and they're raising their infant daughter, Maya.
As for the rest of the Fishers and their loved ones, Claire is now a student at LAC-Arts and sparking a romance with a handsome young crematory worker/rock musician. Keith has a new job with a private security company, and he and David are in couples therapy. Federico also has new job responsibilities, as a licensed Funeral Director and partner in Fisher and Diaz. Ruth no longer has a job; she's delighted to spend as much time as possible helping out with her granddaughter.