Due to spoilers throughout this post, I'm going to provide snippets of Series 4 to explain this episode.
Doctor Who is regenerating after receiving a fatal dose of radiation. This is the result of dealing with the Time Lords in the Series 4 finale. The regeneration which leads to the eleventh incarnation of the Doctor occurs as a result of the Daleks inducing a partial regeneration which leads to the Tardis creating a second Tenth Doctor from his hand (originally lost having a sword fight with an alien species at the start of Series 3) and Donna.
The partial regeneration was necessary as Series 4's cliff hangers involve a Dalek invasion. I'm not certain why 26 planets have to be hidden, but in quest of domination of the universe, Daleks are willing to do anything, even when the Doctor, with help of a lot of friends, barely manage.
At the end of the Ninth Doctor's run in Series 1, we had Rose Tyler given omniscience in the form of the time vortex by the Tardis to defeat the Daleks.
End of Series 2, Rose is replaced by Donna Noble and the theme of companion on the eve of her wedding first starts. This is short hand in Doctor Who for companions important to the Doctor (Donna Noble & Amy Pond).
The fact that River Song's chronology with the Doctor is backwards implies that she is very important.
At the end of Series 4, I was expecting the final farewells the Tenth Doctor did, but couldn't find it. (I'll note now that I'm referring to the synopses rather than the videos since they help me properly assimilate each episode. By providing the set and setting, I can watch the episode and know what comes next, which reduces viewing anxiety about what's going to happen. This anxiety then makes me bored with the episode, and thus I get a spotty view of it.
I'm still bothered by not reading of the Tenth Doctor's final farewells, as the "End of Time" was a two-part Christmas and New Years show to resolve the earlier episodes about the Master.
The fact that "End of Time" is not a regular episode is why it doesn't appear in the Series 4 synopses. Mystery solved!
So the Doctor's regenerating from cell death due to radiation poisoning. "End of Times" ends. Then fans await Series 5's start with "The Eleventh Hour", three months later.
First, the Eleventh Doctor is formed after special effects show "regeneration energy".
After he's fully formed, he takes an inventory of his parts - legs, teeth, and hair but "Still not ginger!". Then he discovers that the Tardis has been damaged by his regeneration and is careening about London. At some point, he's holding onto her and barely makes it over the Big Ben.
Then he crash lands with the Tardis on its side, and has to escape it briefly. He meets a 7 year old Amelia Pond, and is restored to health with custard and fish sticks. Then he is shown a crack in her bedroom, and briefly leaves with promise to return in "five minutes." When he returns, he gets knocked unconscious by an adult Amy Pond. Then he also meets Rory Williams, her boyfriend. It turns out that Prison Zero has escaped due to the crack, and the Atraxi want to destroy the world if he's not found. At the conclusion of the episode, the world is saved from the Atraxi after the Doctor scares them off. They were intent on leaving just like that once they had Prisoner Zero returned but the Doctor thought it best to prevent them from returning.
Please note the wedding dress at the end of the episode. It is a sign that both Rory Williams and Amy Pond are important to the Doctor.
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