I think the very end is good, unexpected. It worked but not in the context of the rest of the episode. He's a shell of himself, yes. He "died" with Deb when he went into the hurricane and came out of it as a lumberjack of all things.
And Dexter is a professional long-distance swimmer to pull off that feat. In a hurricane no less. Which leads to the problems.
He still could have Hannah and Harrison. He could come out of this alive and unscathed with a flimsy explanation no one would look twice at given his situation leading up to his not-death at sea. He lost Deb but he still has his son and his woman. It makes his self-imposed exile only kind of sort of work there. Had they been lost to him, it would be complete. He'd literally have nothing but that isn't the case here. So maybe in a few months or a few years he regains some of his lost humanity and looks them up.
Debra's just fine fake out was ********. She should have been terminal from the start. It should never have been that false sense of relief because it felt fake. I was waiting for the truth to come out. That the damage was greater than they thought or that there were complications in surgery. Instead she has a sudden stroke and is a vegetable. That's a weak attempt to play up the drama. I think even those who didn't read spoilers would know she's going to die. They really had no choice but the prolonging part felt like filler so they could use it to get Saxon later.
If she had lived, Dexter probably wouldn't have done his Paul Bunyon imitation and instead gone off to be with Hannah and Harrison. I get that but it could've been handled differently. Losing all three would be the devestation Dexter needed to finish off his humanity. Alternatively, the "happy ending" Dexter gets to become more or less normal with Hannah, Harrison and the occasional visit from Deb and probably Quinn.
Hannah being Harrison's mother might work. I don't know yet what to make of it. She's obviously got some motherly instincts and cares for Harrison and they got away.
And the rest of the cast.
Masuka and his daughter... unresolved and utterly pointless subplot. Why was this ever introduced? She didn't contribute anything to the story at all except to give Masuka a few uncomfortable scenes and one liners. She could have played a bigger role somehow instead of taking up time doing absolutely nothing. Unless it was meant to show Masuka as maturing which was so half-assed it was laughable.
Quinn, he definitely took it hard and he's going to either go self-destructive and die in a dark alley somewhere or harden his resolve and clean his **** up. Whatever he does will be difficult and change him, if he lives through it. Doubtful he pulls a Dexter though.
Batista, I just feel sorry for all the **** he's gone through. He's a good man but a mediocre detective to have not picked up on Dexter especially after the Saxon scene. What he's been left to clean up is not as bad as it could have been but there's still much for him to deal with, losing both the Morgans, Saxon's death on his watch, etc. He's probably got the most sympathy after Quinn.
Saxon, this guy didn't warrant serious involvement the entire season when he could have been the greatest of Dexter's kills. The ultimate villian. Instead a complete waste of a character. His death was also lame. Stabbed in the neck with a pen?
Elway gets to live. He was smart enough to track Hannah down but dumb enough to get tranqed on the bus. He was annoying but more competent than Miami Metro.