Chicago Med season 11, episode 17 finds the Gaffney team racing to save one of their own as Dr. Charles’ fate is confirmed.
Chicago Med left fans with a major cliffhanger in its previous episode as “The Book of Charles” concluded with Dr. Charles collapsing in his office after having a stroke. The twist left viewers fearing the worst, and the week between new episodes felt longer than ever as fans waited to see whether Charles would live or die.
Heading into season 11, episode 17, “Altered States,” we knew it would be an emotional episode, and that was certainly the case with the writers making us wait as long as possible to find out Charles’ fate!
As the episode opens we hear Lenox telling her patient to hold on through blurry eyes as she tells him they’re going to help him and that his daughter is on the way. The individual begins to lose consciousness as Lenox shouts for them to stay with her, and our assumption quickly jumps to this being Charles she’s treating; however, when the camera finally pans out, we learn this is not the case. The patient is a man who hit his head on concrete after falling when taking down Christmas lights. All signs point towards the man being brain dead, but Lenox orders a CT to confirm.
Out in the ED, Archer asks Goodwin if she’s heard from Charles, as he’s in need of a psych consult, and she theorizes that Charles is cooling off somewhere and encourages Archer to give him some space. She tells Archer about their argument and Archer is surprised, as it doesn’t sound like Charles.
We cut to Charles, who is lying on the floor of his office unconscious as we enter his subconscious, where he’s sitting with his mother in their old home, trying to figure out why he’s here. His mother brings up his call with Gio and notes that the boy had the terrible luck of working up the courage to call for help only to have Charles answer on the phone. Charles asks what happened to her that made her feel so small that the only way she could feel good about herself was to make someone else miserable. His mom quips back that he still doesn’t get why they’re here. She notes this is where it all started, where “it” happened as we cut to a doorway and see smoke coming through.
Charles sees the ghost of Ripley’s past
Charles is raced down to the OR, but things aren’t looking promising. Anna arrives at the hospital after getting a call from Goodwin, who greets her and brings her up to speed. She doesn’t sugarcoat things but assures her they’re doing everything they can and will take it one step at a time.
As Abrams and Ripley work together to clear the clot, we return to Charles’ mind as he walks into a room where he finds a teenage boy who tells him he told Charles he didn’t want to see him again. The teen tells Charles to say what he’s going to say and get the hell out. Charles admits he thinks about things all the time and that he has some good news. This is when we learn the teen is a young Ripley, as Charles tells him how in 20 years they’ll meet again and work together.
In the real world, Ripley informs Anna that they performed a mechanical thrombectomy to manually remove the clot. It was a large clot, and they were able to remove some of it, but not all of it. They now have two options.
The first option is they can raise his blood pressure and wait and see, with the best-case scenario being he wakes completely fine while the worst case would be him needing a feeding tube and ventilator for the rest of his life. The other option is a direct bypass craniotomy, which would definitively restore blood flow; however, the tPA Archer and Ripley administered to break down the clot puts Charles at a higher risk for hemorrhagic complications during surgery
Anna is overwhelmed as Goodwin notes that she’s still here because Archer took a risk on the operating table, but notes there are no guarantees. Anna mentions calling Robin to get her thoughts, which is when Abrams interjects to reveal that it’s Goodwin who must make the decision as Charles’ medical power of attorney, news that surprises Goodwin just as much as it surprises Anna.
Chicago Med introduces Hannah’s replacement ahead of her maternity leave
Hannah arrives at Gaffney and asks Doris if she’s seen Archer, as she can’t seem to get through to him. Doris realizes that Hannah hasn’t heard about Charles and quickly fills her in. As Hannah tries to process the news, Lenox springs yet another piece of shocking news on her as she asks if Hannah is ready to onboard her substitute before she goes on maternity leave.
Hannah is surprised by Lenox’s actions as she points out that she was planning on working until close to her due date, which is still weeks away, and Lenox points out that she should know that babies don’t always abide by their due dates. Turns out the substitute Lenox has hired is Dr. Lovell, the same OB who Hannah had seen months earlier.
Goodwin and Anna sit down, and Goodwin notes she’s just as surprised as Anna that Charles gave her medical power of attorney. Goodwin replies that she would have said no if he had asked her, as that decision should belong to family as Anna points out that Goodwin is family; she’s always been Auntie Sharon to her and Robin, and she was friends with their dad years before she was born. She points out that there are only a few people her dad really trusts, and he certainly trusts Goodwin as she encourages them to make a decision together. Anna wants to do the surgery, and Goodwin agrees.
Anna senses there is something Goodwin isn’t telling her, and Goodwin admits to having an argument with Charles as well which was bad. Goodwin notes she went to his office to talk things out, and that’s when she found him.
Down in the ED, Hannah and Dr. Lovell team up, and it’s clear that Hannah is not a fan of Lovell’s approach to patient care. Among their patients is Summer, a woman who has come into the ED with stomach discomfort and painful intercourse. It seems she’s played internet doctor via TikTok, and Hannah encourages her to stay off the internet, which is full of incorrect information. As Hannah examines Summer, Lovell and Summer connect over a social media doctor, and Hannah cuts the conversation off. When Hannah goes to perform an exam, Summer requests Lovell perform the procedure instead as Hannah steps to the side.
In the OR, Charles is prepped for surgery, and we enter yet another memory. This time, we see Charles walk into the kitchen of his home, where he finds a young Robin eating breakfast at the table. She warns him he’s in big trouble as Charles’ ex-wife Caroline “Cece” Charles enters the room complaining about how Charles promised to be home in time to help get Robin to school, but then he decided to stick around at work and never bothered to call.
As Cece goes to leave, the backdrop of the memory changes as Anna’s mom, Sue Charles, enters the room, and we enter the memory of when Sue left him as nothing could compete with his fancy job. Charles assures her nothing was more important to him than her and Anna, but she points out how he would never let anyone else handle the next emergency, as that is who he is. That’s when a young Anna runs into the room crying as he embraces her and assures her she’ll see him all the time and they’ll have so much fun.
We again see the memory shift as Sue and Anna disappear and Charles is faced with the memory of a woman named Lucia. She reminds him how he said things would be different with them, but they never were. She points out that he didn’t need her as he doesn’t need anyone. Lucia seems to be Charles’ third wife, who had previously never appeared on the show or been mentioned by name.
Back in the ED, Lovell tries to clear the air with Hannah as she points out how it was clear she was pissed at her when treating Summer. Hannah points out how they shouldn’t be encouraging patients to seek medical advice on social media, to which Lovell points out that influencers are helping to break stigmas about seeking treatment. Hannah maintains that she felt Lovell sent mixed messages to Summer as Lovell quips she was simply trying to connect after Hannah dismissed her with her buzzkill energy. Summer’s results come through and Hannah asks if Lovell minds if she takes the lead in telling Summer, to which she replies that Hannah is the boss, at least until she takes over.