The episode begins with an emotionally hungover Steven, who is eating ice cream, watching a preview of a Dogcopter movie (which is ironically about Dogcopter getting married) and laments how everyone is getting married except him and glows pink in frustration.
He calls the Gems on his phone but cannot reach them due to them doing a field trip for Little Homeschool. He skips calling Connie and calls Greg, who manages to get through the phone to Steven's delight, but Greg is managing Sadie on tour which is extended, and Greg loses the call when they go through a tunnel. While going to the fridge, he sees Connie's glow bracelet and glows pink again while he grows and accidentally rips the freezer door off. As Connie calls him, Steven at first decides to let her message go to voicemail, but his hand grows big so that he accidentally accepts her call. On video, Connie expresses her worry for him as she sees his face and body begin to grow and swell up, but Steven responds to her concern about it not being a big deal. She suggests he goes to see her mother.
Dr. Priyanka Maheswaran had a cancellation and sees Steven to determine what is going on. Connie assures Steven everything will be alright, and she exits the room while on the phone. Dr. Maheswaran checks his temperature and then his heart beat after he turns pink, getting a sound from his gem. As she takes his blood pressure, his right arm swells and breaks the cuff, concluding his blood pressure is high. She asks about his general practitioner, and Steven states that he never went to the doctor until now. Her surprise accidentally provokes him to glow and swell up, and she manages to calm him before running more tests.
After taking an x-ray, she first shows Steven a human skeleton on an x-ray as an example, then shows Steven the x-rays of the other Gems (revealing only their gemstone shows up on the scan except for Amethyst whose x-ray also shows food in her stomach) but, since Steven has a human body, his x-ray does reveal a human skeleton albeit with the gem visible on the navel. His x-ray, however, shows numerous unusual fractures on his bones across his body. Despite "miraculous recoveries", she wonders if he has suffered emotional trauma in addition to the physical trauma his body has survived. She asks him if there were any childhood experiences that stuck with him and he replies...
Dr. Maheswaran concludes that everything he's been through during his childhood has caused him incredible stress through his life, and it's affecting his ability to handle new forms of stress in a healthy way. Since the stress of major threats to his life is all he's ever known, his body is now responding to the stress of minor threats as if his life was in danger. Steven shows concern as to why this is happening now, and Dr. Maheswaran suggests a couple possibilities, including losing his emotional support systems however Steven particularly reacts when it comes to the possibility of having a recent experience that didn't go so well for him. As he thinks about his proposal to Connie backfiring, he starts to glow pink again and grow exponentially.
As Connie comes into the room, she witnesses Steven's glowing pink and growing out of control and her mother demands to know what is going on. When Connie realizes that Steven's rejected proposal the other day was the doing of this and that their presence is making Steven's condition worse, Steven continues to grow more and becomes even more stressed when he learns Connie never told her mother about what happened (in "Together Forever"), and persuades them to leave when shouting, "I... Can't... BE AROUND YOU RIGHT NOW!" The entire room is damaged as Greg arrives at the last second. He rushes into the room and explains Connie called him about Steven's condition, and before Connie and Priyanka leave to give Steven the space he needs, Steven thanks Connie softly. Greg apologizes for not knowing what Steven has been through, but he assures him that it wasn't his fault. Steven reveals his proposal to Connie to him, and he begins weeping as he doesn't know how to deal with all of this stress. Greg assures him that he'll be there when he needs him and is able to calm him down and get him back to normal size.
Back at the house, Steven and Greg talk about how making mistakes is okay and normal to most people, which makes Steven realize that his future is for him to decide. Steven begins to show concern for pulling his father away from his tour, however, Greg waves off the concern. He suggests Steven gets some rest and tells him to take care of his problems one at a time, putting Steven a bit more at ease.
Tropes:
- An Aesop:
- Your problems won't go away if you act like you don't have them. Something as simple as talking about them with someone willing to listen can do a world of good.
- You don't need to have your life figured out at sixteen.
- Ascended Fridge Horror: One of the most discussed arguments is how did Steven manage to stay sane after everything he has gone through, from fighting monsters and stopping a millennia-long war to becoming everyone's Living Emotional Crutch. This episodes reveals that he never did, as not did only these experiences cause him real physical damages (his skeleton is full of cracks never completely healed), but also mental trauma in the form of PTSD (or "Adverse Childhood Experiences" as Connie's mother puts it) that is starting to catch up with him.
- Attack of the 50-Foot Whatever: Steven is growing randomly due to stress; in the climax, he grows so big he takes up almost the entire hospital room.
- Blunt "Yes":Dr. Maheswaran: Get undressed and let's get you into a hospital gown.
Steven: Is that one of those blue things that doesn't cover your butt?
Dr. Maheswaran: Yes. Now let's get started. - Bread, Eggs, Milk, Squick: Steven starts his Long List of trauma with "I kind of freaked out when they cancelled my favorite ice cream." Everything he mentions after that is genuinely terrible.
- Call-Back: In "Nightmare Hospital", Steven said he has never been to a doctor before. Now it turns out doing so would have shown some of the physical toll Steven's activities have taken on him.
- Cerebus Retcon: Steven's entire life of Amusing Injuries and as a Kid Hero is deconstructed with serious consequences. The diagnosis from Dr. Maheswaren for Steven losing control of his shapeshifting abilities when stressed reveals that Steven is in fact dealing with genuine PTSD from the psychological trauma of all he's lived through for the past four years. Now he can't cope with minor stress from mundane life because his body responds like his life is in danger, since that's what he's been experiencing for so long. It's also found that Steven's hybrid Gem-human physiology (as well as Rose's natural healing powers he has inherited) has resulted in him having a sort of Healing Factor that near-instantaneously heals his wounds, but he also has numerous fractures from impact trauma from his adventures over the last four years that have healed over.Dr. Maheswaren: I think all of these experiences have been subjecting your body to a harmful amount of stress, and that's affecting your ability to respond to new forms of stress in a healthy way. You've been dealing with genuine threats from such a young age that your body is responding to minor threats as if your life were in danger!
- Comical Overreaction: Deconstructed. Steven's budding Pink Form powers activate at the slightest provocation because he's been in real danger his whole life, and has no healthy way to moderate his instinctive reactions.
- Conditioned to Accept Horror: It's brought up that Steven takes the traumatic events of his life for granted, but Dr. Maheswaran explains that this doesn't mean they were harmless. Because Steven's always been in life-threatening situations, his body now overreacts to minor stressors.Steven: How do I live life when it always feels like I'm about to die?
- Continuity Cavalcade: Dr. Maheswaran asks Steven if he'd lived through any physical or emotional trauma, and he starts listing ones from previous episodes (which are rapidly shown to the audience in the background) in order, only getting up to the end of the first season before he's interrupted.
- Continuity Nod: Steven's call ringtone for Connie is still the one originally heard in "Full Disclosure".
- Covered with Scars: In a bizarre internal variant, Steven's skin is unmarked, but his skeleton is proliferated with fracture marks.
- Deconstruction: This episode shows all the consequences of Steven being a Kid Hero in the earlier seasons, especially mentally.
- Delayed Reaction: This entire episode is Steven's stress from the past few years catching up with him in the worst way. His expression grows grimmer and grimmer with each trauma-inducing moment he lists off as if realizing for the first time how bad each of those situations was now that he's saying them out loud.
- Dented Iron: Played with; all of Steven's injuries from the past have left many fracture marks on his bones, but this seems to just be a cosmetic difference. What worries Dr. Maheswaran is that repeated exposure to trauma has distorted Steven's mental ability to cope with stress.
- Double Entendre: When Dr. Maheswaran orders Steven to put on a hospital gown, he asks if it's "one of those blue things that doesn't cover your butt". She replies that it is, then pulls on a rubber glove and announces that they're going to "get started."
- Double-Meaning Title: Steven experiences "growing pains" in that he's enduring sudden growth of body parts. He also learns the full effects of the pains he went through while he was growing up.
- Embarrassing Hospital Gown: Steven visits Dr. Priyanka Maheswaran in the hospital due to him glowing pink and random parts of his body swelling and shrinking rapidly. When instructed to put on a hospital gown, he asks the following:Steven: Is that one of those blue things that doesn't cover your butt?
Dr. Maheswaran: [throws the gown next to Steven] Yes. Now let's get started. - Family Versus Career: Greg has been on tour with Sadie and Shep for a while, and its extension leads to Steven missing a chance to talk to him about the proposal. Greg would have been fine taking off, if only Steven had been willing to let him know, and ends up coming back anyway when Connie calls.
- Flashback-Montage Realization: As Dr. Maheswaran tells Steven that life-threatening events in his childhood could have led to his present post-traumatic stress, Steven begins flashing back to all the dangers he encountered in the series ever since he was 13.
- Foreshadowing: Dr. Maheswaran, after expressing shock that Steven's never been to a doctor before, grumbles that she'll be talking to Greg about that later. The very next episode shows that Greg's relaxed style of parenting wasn't the best for Steven's overall well-being, with Steven himself echoing Dr. Maheswaran statement that never taking Steven to see a medical professional is not okay.
- Freeze-Frame Bonus:
- When Steven opens his freezer, there is a carton of edible cookie dough labeled "Slow Burn" and another that says "I can't".
- Dr. Maheswaran's clipboard is used for a camera wipe, showing some things about Steven written on it:
- His social security number is "N/A".
- Steven's middle name is actually written as "Quartz Cutie Pie DeMayo Diamond".
- His current employment is "retired" while his previous employment was "Earth ambassador".
- He's 5'6" tall and he weighs 145 lbs.
- He "exercises moderately / takes vitamins".
- Steven's birthdate is August 15th, the same as Steven Sugar's real birthday.
- Amethyst's X-ray (see below) shows that her stomach contents at the time were a donut, a submarine sandwich, a tin can and a baseball.
- Funny X-Ray: When Garnet, Amethyst, and Pearl took an X-ray, their projected bodies didn't show up, just their gemstones and (in Amethyst's case) anything that she had eaten recently.
- Glove Snap: Dr. Maheswaran slides on and snaps latex gloves before beginning Steven's medical exam.
- Healing Factor: It turns out Steven doesn't just have Super-Toughness, but the ability to heal quickly and easily from many severe injuries. It hasn't worked perfectly, as many fractures have left their mark on Steven's skeleton. And, as Dr. Maheswaran points out in the page quote, the idea that this means being injured is no big deal for Steven is heavily deconstructed: His injuries have been patched up physically, sure, but they still took an emotional and mental toll on him, and that's the one place his healing powers clearly haven't reached.
- Heartbreak and Ice Cream: Depressed from the events of the previous episode, Steven indulges on a tub of ice cream among other snacks.
- Hold Your Hippogriffs: When talking about the sources of his stress with Greg, Steven describes them as "Third-Era problems".
- HULK MASH!-Up: Steven's shapeshifting powers malfunctioning under stress has several visual and thematic parallels with Bruce Banner turning into the Hulk: both are triggered by stress, result in them changing color (green in Banner's case, pink in Steven's), and lead to them growing to point of destroying their clothing apart from whatever is covering their crotch.
- Immediate Self-Contradiction: As Connie leaves the room for Steven to get his medical exam, she say she's sure everything will be fine. As she walks away, clearly not noticing Steven can see her through the window, she is visibly worried and making a phone call.
- Innocently Insensitive:
- Right when Steven is saying that he's glad that Greg will be back from his tour soon, Greg is distracted and misses what he says, then tells him that the tour is being extended.
- Dr Maheswaran's diagnosis of what is causing Steven's shapeshifting power to fluctuate so suddenly — that he no longer feels he has the support system he previously used to cope with stress, or a particularly bad recent event that might have set him off — proves to be more right than she knew: just talking about it causes Steven to recall the still very recent botched proposal he made to Connie, and triggers a violent transformation. It turns out that this wasn't her fault, as Connie hadn't told her yet.
- Leaning on the Fourth Wall: After recalling his most traumatic experiences from Season 1, Steven says "that was just the early stuff". Early in his life, or early in the series?
- Magic Pants: Steven stresses out so much that he grows half the size of the medical room, ripping his medical gown but not his underpants.
- Mailman vs. Dog: In the Dogcopter movie at the beginning, Dogcopter has to be reminded to go after the blue car and not the mail truck driving next to it.
- Meaningful Background Event: Shortly after Connie leaves the room, she can be seen calling someone before walking off. It turns out she'd called Greg, who showed up at the end of the episode.
- Mess of Woe: Steven's bedroom becomes littered with clothes, ice cream, and junk food following his failed proposal to Connie.
- Mouth Cam: The POV is from the inside of Steven's mouth while Dr. Maheswaran examines it.
- Physical Scars, Psychological Scars: While Steven's powers have left him externally unscarred from the harsher events of his life, an X-ray shows indelible markings of them throughout his body. It is emblematic of how Steven may seem well-adjusted when he's actually anything but.
- Power Incontinence: Steven's emotional turmoil has him glowing pink throughout much of the episode, and randomly growing and shrinking, among a few other power mishaps, like instinctively forming a bubble when Dr. Maheswaran tries to test his reflexes.
- Ridiculous Future Sequelisation: Dogcopter was already on its third movie when we first saw it, Keep Beach City Weird mentioned a fourth, and the opening of this episode shows there's at least six.
- Shell-Shocked Veteran: Dr. Maheswaran's theory ultimately becomes that Steven has experienced so much crisis and trauma that his body is no longer able to distinguish between small and major stresses anymore. This is a problem that people who have PTSD from combat situations really face.
- Spit Take: Steven spits up his hot chocolate upon realizing that Greg may be late for his next tour, but Greg tells him not to worry about it.
- Thought They Knew Already: When Connie realizes that Steven's proposal attempt is what's straining him, she tries to talk to him about it. But when he tries to assure her it isn't that, her mother asks what they're talking about, shocking Steven as he thought Connie told her parents about it.
- Transformation Horror: Steven's shapeshifting goes haywire, causing parts of him to randomly swell up tremendously or stretch out.
- Trauma Conga Line: Steven lays out the absolute hell his last few years have been. He doesn't even get through the first season before Dr. Maheswaran has plenty to work with.
- What the Hell, Hero?: Though she holds her tongue in front of Steven, Dr. Maheswaran makes it clear she'll say some choice words to Greg over him never taking his son to a doctor before.
- You Have GOT to Be Kidding Me!: Dr. Maheswaran is dumbfounded that she's the first person to give Steven a medical exam, yelling "You're 16 years old and you've never been to the doctor?!".
- Your Television Hates You: While Steven is wallowing from having his proposal to Connie turned down, the Dogcopter movie he's watching turns out to be about the title character getting married.Steven: Everyone's getting married but me!
