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As is though, her ultimate takes another turn to set up, which is still fine, but outside of that her two other abilities are rather lackluster in Commander

Then their son was born

The Companions A Doctor has to have a companion, and there are plenty to pick from in these Commander decks

Shes a more Commander viable Jeskai general than Shu Yun, the Silent Tempest, who I had always wanted to make work, but never quite stuck the landing

Then put all cards exiled this way that werent cast on the bottom of your library in a random order. (This is the only part of the interaction that is affected by the rules change.) So with Cascade, this means that the combined converted mana costs of both halves of the card need to be less than the CMC of the spell thats the source of the Cascade trigger