Why Is Tommy Still Alive? - [s6e4]

While the tumor was fake, Tommy’s real-world symptoms like seizures and hallucinations were likely triggered by extreme stress, PTSD , or alcohol withdrawal after he stopped drinking earlier in the season.

However, the reason Tommy is "still alive" by the end of the series is one of the show's biggest twists. It turns out he was never actually terminally ill. The Great Deception [S6E4] Why Is Tommy Still Alive?

In Peaky Blinders Season 6, Episode 4, titled "Sapphire," Tommy Shelby receives a devastating medical diagnosis that seems to seal his fate: an in his brain stem. His doctor, Dr. Holford, gives him just 12 to 18 months to live, explaining that the growth was likely contracted from his daughter, Ruby. While the tumor was fake, Tommy’s real-world symptoms

By the end of the season, Tommy burns his wagon and personal effects, symbolizing the death of his old gangster identity. He rides away on a white horse , signifying a fresh start as a man no longer bound by his past. The Great Deception In Peaky Blinders Season 6,

The diagnosis was a orchestrated by his political rival, Sir Oswald Mosley.

Tommy only discovers the truth in the series finale after seeing a newspaper clipping of Mosley’s wedding, which featured Dr. Holford as a guest. Why He Didn't Die