Q was introduced in the series pilot as a villain, sort of like Roddenberry’s idea of what he imagined God to be like, a chaotic despot with no regard for humanity. However, by the third season, Q evolved. In the episode “Q Who”, he became human and learned to see how much humans value each other, even those who annoy them. In fact, my theory is that it’s Data’s actions in that episode that inspired Q’s motives in this episode.
Here we see a different side to Q, one I like more than how he started off. To me Q is at his best when he is chaotic neutral rather than chaotic evil. He does what he wants, but not for evil intent. He does it instead to teach Picard something he should have learned from his youth.
The episode builds on something that was revealed in season 2: Picard’s artificial heart. He had to have a transplant at an early age in order to lengthen his life after a moment of egotistical weakness made him value his pride over his life. Since then, he had often wished he hadn’t made that near-fatal mistake. Especially at the start of this episode when he learns that the very thing that saved his life so long ago is now killing him.