The circle of life and death is a topic that's well-covered in fiction, yet if it's written as well as "Do No Harm" you can't help but be deeply affected by the concept all over again.
No time is wasted in establishing the urgency of the situation. After Boone's lung collapses, Jack punctures a hole into his lung while everyone gasps in horror. It doesn't let up after that... blood transfusions, stitching of wounds, compartment syndrome in Boone's leg. It's a pretty gruesome scene from start to finish.
While Boone hangs onto life by a thread, Claire goes into labor in the middle of the jungle. Kate, Jin, and Charlie eventually come to her aid but Kate's ultimately nominated to deliver the baby. Scared out of her wits, Claire tries her best to suppress her own labor, but Kate gently coaxes her out of delaying the inevitable.
Flashbacks take us to the eve of Jack and Sarah's wedding. Jack is struggling to compose his vows, but what's really at the heart of his troubles is a fear of failure — at marriage, fatherhood, living up to Sarah's expectations. Christian joins him for a profound father-son chat, one where he pegs Jack's inability to "let go." This, of course, would become a critical theme in the series.
So we have three major storylines presented by Janet Tamaro, what does she do? She weaves the script beautifully such that all three culminate at roughly the same time, all the while ensuring none of them stall or forcefully yield to one another.
In flashbacks, Jack stands before Sarah at their wedding and offers heartfelt words in lieu of written vows. Boone persuades Jack to let him go, slipping away from the island just as Claire holds her baby for the first time. Fast-forward a bit and we see the baby being introduced to a smiling crowd of castaways, while Jack simultaneously delivers somber news to Shannon.
Even more bonus points for a few small details:
1. The first flashback leads us to believe Marc Silverman's getting married. The dialogue and the visuals seem to confirm it. But alas, we were tricked! The next tuxedo is brought in for the groom, i.e. Jack. Brilliant.
2. Jin rushes toward Jack to share the news of Claire's labor, only to have Sun translate for him. Given the fact that they currently weren't speaking, this was the cherry on top of an already intense situation.
At the end of the day, if you're not emotionally affected by the brilliant writing of Do No Harm you likely have the soul of an answering machine.
This is without a doubt Matthew Fox's finest performance in Season 1. When it's time for Fox to take charge of a scene, such as the mad scramble to keep Boone alive, he does it with precision and authority.
When you consider the contrast to Jack at the altar, eyes welling up with tears as he bears his soul to Sarah, it becomes indisputably clear that Fox is one of the few who are capable of carrying LOST on his back.
Ian Somerhalder deserves some major credit for applying the cliché "less is more." Any second-rate actor would've over-sold the excruciating pain, but Somerhalder sold the notion that he was drifting in and out of consciousness. The staggered breaths and repeated whispers were a nice touch.
Though I have some bitterness toward Sarah Shephard the character (due to later episodes), Julie Bowen is an amazing actress and slips right into her role as Jack's bride-to-be. The "heart and soul" scene immediately established the undeniable chemistry between Jack and Sarah, thanks to brilliant performances by both.
The most intense portion of the episode is undoubtedly Jack's attempt to save Boone, and as luck would have it that's where the directing and visuals really shine. Jack tears Boone's shirt open to reveal a spaghetti-like mess of gnarled skin and bone, a scene so gory I suspect it tested the limits of broadcast-network censorship.
To be clear, I'm not suggesting the visuals were gratuitous. In this case I believe it was done to truly underscore the horror and urgency of the situation, not to mention Jack's ability to render himself immune to such sights when it really counts.
Bonus points for the flashback scene with Jack and Christian, particularly the use of vibrant colors and the light reflecting off the pool.
I've enjoyed this episode just as much on the fifth watch as the first, in fact my September 2010 rewatch was probably the most significant and rewarding one of all, knowing the entire arc of the series. Certain moments in Season 6 retroactively bolster the impact of Do No Harm; I'll leave it up to you to figure out which ones I'm referring to.
Do No Harm is one of those episodes that often slip through the cracks as a potential classic, yet every time I watch it I say to myself, "My God, that is an amazing episode." More accurately, I say that after I've cleared my throat and regained my composure.
The episode's order in the season is an important contributing factor to its success. Had it aired earlier in the season I'm not sure it would've had the same impact, but by Episode #20 we're thoroughly invested in the characters. The sense of loss, and simultaneously the sense of hope, was very real. What's most interesting to me is that the extreme emotions didn't offset each other but instead shared the same space. You can indeed harbor intense yet conflicting emotions.
I'd be remiss if I didn't mention Michael Giacchino's music, which pretty much makes it impossible not to get swept up in the emotional narrative.
