The third season of nip/tuck begins where the last one left off, with the image of Christian Troy (Julian McMahon) lying in a pool of blood on his bed. His death and subsequent funeral turn out to be part of a recurring nightmare, introducing the intertwined themes of mutability and immobility that dominate the episode. On its surface, the show justifies the pursuit of one’s dreams by noting that life is fleeting. (One can almost hear Andrew Marvell reciting in the background, “I hear time’s winged chariot at my heels.”) But it also reveals the folly inherent in that philosophy, linking the American dream of acquisition and consumerism to the quest for beauty.

The season opener features Momma Boone (Kathy Lamkin), one of Sean’s charity cases, rooted figuratively and literally to her couch, no longer able to chase her dream. Momma is morbidly obese, so large that the EMTs must break through the wall of her house with a chainsaw to remove her, transporting her to the hospital on a flatbed truck. The EMTs find her sitting in front of the television with her remote, surrounded by food, furniture, and shelves holding her collection of dog bobble-head dolls. Dressed in a thin beige cotton shift that reveals huge lumps of flesh, she looks like an enormous russet potato.

She is the consummate consumer: she spends her days eating and watching her “stories,” recorded on TIVO. After sitting in one place in her own waste for three years, her gangrenous flesh has fused with the synthetic fabric of her couch, making her a grotesque hybrid of consumer and commodity, in contrast to the beautiful hybrids usually resulting from cosmetic surgery. Her immobility has kept Momma from realizing her dream of being a manicurist in “some fancy salon.” So, Momma represents both the realization of the American dream of total consumption, but also the dream never realized. She provides an object lesson in what happens to people who don’t go after their dreams.

At the hospital, in an attempt to separate her from the couch, Sean slices away the necrotized flesh. Her thigh looks like a piece of meat being carved (an unsubtle allusion to the serial slasher called the Carver who has terrorized Sean and Christian since last season). In conversation with Denny (J.E. Freeman), Momma’s husband, Sean makes the link more overt, describing Momma as a “veal calf” being fattened for the slaughter.

The episode uses Momma to illustrate the theme of being “stuck.” In the opening dream sequence, Julian wakes up when his coffin gets stuck and won’t descend into the grave. He speculates that it symbolizes being unable to move on. Later, he accuses Sean of being stuck, and advises him to sign the divorce papers and move on. Kimber (Kelly Carlson) refuses Christian’s half-hearted proposal of marriage because he “didn’t even get off the couch” to make it. Momma finally becomes unstuck from the couch when she dies. Only with her death do Sean and Christian also move on. Christian returns to his apartment and overcomes his impotency, and agrees with Sean to add a new partner to their practice. Sean signs the divorce papers. Both are moving forward. Yet, they are reminded repeatedly of the grave, and the very real danger still lurking from last season — the Carver.

With the Carver, the show effectively challenges the logic of cosmetic surgery, asking whether it is creative or destructive (his very name suggests both an artist and a butcher). When the Carver attacks his victims, he injects them with a drug that immobilizes them, then slashes and rapes them. His act, like cosmetic surgery, exaggerates the power relationship between surgeon and client. And in this context, the male surgeons can be seen as emblems of a patriarchy that imposes ideals of beauty on women, literally, with their instruments. The EMT’s forceful removal of Momma’s wall underlines such imposition, even though they mean to rescue her.

The Carver suggests that beauty is deceptive. He wears a Mardi Gras mask, marking his criminality. It’s also emblematic of the masks people wear socially and of the false face created by cosmetic surgery. When Sean first enters Momma’s home, he’s ordered by the police to wear a mask to protect himself from disease. When Julian goes to hold Momma’s hand, he removes his mask in a symbolic act of shedding his pretensions.

The inevitability of death is suggested by the lurking Carver, always a threat to Sean and Christian. It is also suggested by the two funeral scenes in the season’s opening episode: Christian’s nightmare and Momma’s actual funeral. Momma’s death, the fragile flower resting on top of the casket, and the dirt heaped into the grave by the bulldozer all connote impermanence. And this theme looks forward to changes in the series, mired in paternity and relationship issues last season. As a wag once said, “I think I hear time’s winged chariot changing gears.”