Chicago Med’s Season 10 Premiere: A Review of the Biggest Moments

Chicago Med‘s new showrunner Allen MacDonald leaves his mark immediately with the Season 10 premiere — an episode so big that it actually gets hard to embrace. Season 10, Episode 1, “Sink or Swim,” is written by MacDonald, who took over from Diane Frolov and Andrew Schneider knowing that he had big shoes to fill. Not only was he replacing the only showrunners Chicago Med had ever known, but he had a cliffhanger to resolve and three significant cast changes.

MacDonald juggles all of that admirably, leaning into the chaos by framing all the on-screen changes as part of a mass casualty event involving two ships crashing into one another off Navy Pier. However, that ambition also backfires in some respects, because there are so many different things going on that none of them can get a full dose of attention. The Chicago Med Season 10 premiere is big and it’s bold, signaling that this is very much a new era for the NBC medical drama.

The Chicago Med Premiere Is Massive in Scope

Another Mass Casualty Event Hits the Hospital

It’s a neat choice for MacDonald to open Chicago Med Season 10 with a mass casualty event. Season premieres of TV shows are supposed to be some of the biggest episodes of any season, and for medical dramas specifically, that’s the best way to do a lot in a little amount of time. But there are also cons to go with those pros. The first is that longtime viewers are well used to mass casualty happenings at this hospital; the very first episode of Chicago Med involved a train crash, for example. What seems big in any other context feels a little old hat for this facility, which has gone beyond dramatic license and into just being a magnet for trouble. (See for example, the opening bit of a random kid finding the “Brick” that Maggie uses to oversee the Emergency Department. One thinks whoever had it last would be getting fired for not having that secured.)

Maggie Lockwood: I thought it was gonna be a quiet morning.

Dr. Dean Archer: That’s when the universe gets you.

The second issue is that more patients means more stories to juggle, and that’s where the Chicago Med Season 10 premiere really suffers. One of the show’s recurring problems has been that it doesn’t treat its “case of the week” characters that seriously; they lack depth and get forgotten once they’ve prompted whatever realization the main characters are supposed to have. MacDonald doesn’t make that mistake, but he doesn’t have enough time to dig into any one story completely. It becomes difficult at times for the viewer to keep up with which patient is which and several ideas kind of peter out. There’s some drama about a pregnant woman named Kelsey not being able to find her missing husband, and Maggie believing the man’s body is in the morgue. But that is almost instantly resolved when Dr. Hannah Asher tells Maggie that Kelsey’s husband was just “at a different hospital” and has now arrived.

The subplot that struggles the most is the premiere’s decision to get rid of recurring character Zach Hudgins. Hudgins is clearly uncomfortable during several scenes, and eventually panics and walks out on a patient when Sharon Goodwin needs his help. This is a pretty poignant idea; Chicago Med already addressed the issue of suicide among the medical profession several seasons ago, and burnout is another very real thing that doctors and nurses deal with. But because of the structure of the episode, Zach’s fateful decision isn’t revisited until closer to the episode’s end, and it’s just so newcomer Dr. Caitlyn Lenox can rebuke him. It’s understandable that Lenox fires him — his patient could have died because of his choice to leave. But it comes off as less of an exploration of that idea and more another example of how brash Lenox is. That’s a missed opportunity MacDonald might have been able to explore within a different episode.

Chicago Med’s New Characters Don’t Fare as Well

Dr. Lenox and Dr. Frost Have Rough Starts

The biggest plot point in Chicago Med Season 12, Episode 1 is the arrival of new characters played by Sarah Ramos and Darren Barnet. Dr. Caitlyn Lenox, Ramos’ character, shows up a week ahead of schedule and is revealed to be the new co-lead of the Emergency Department. The dramatic thrust of “Sink or Swim” is how she butts heads with nearly everyone she comes in contact with — most notably the existing head of the ED, Dr. Dean Archer. In her debut episode, Lenox never reaches the threshold of being a compelling character, because she’s viewed merely through the lens of her antagonizing people.Chicago Med very much needs someone who stands up and holds firm to the rules, but Archer has filled that role successfully for several seasons now, thanks to actor Steven Weber’s ability to do so with just the right amount of cynicism and disdain. Lenox, on the other hand, comes off as causing disruption simply because she can, under the guise of making things better.

Barnet’s character Dr. John Frost shows up later in a subplot about needing help for one of his patients, because Frost works at Jackson Monroe Hospital, which is about to close. Frost convinces the ever-busy Maggie Lockwood to help him out and audiences do get to see his care and concern for his young patient Zoey, which includes giving her all of the details about her brain surgery. But as an individual, he’s very close to being annoying. His over-the-top charm offensive when first introduced and his rambling quips are not funny or even interesting; they make him feel like a caricature. Hopefully that will tone down as the character develops and Barnet settles into the role. Yet both Frost and Lenox have a long way to go before they earn their places in the world of Chicago Med.

The two of them put together don’t fill the void left behind by the departure of Crockett Marcel, played by Dominic Rains. However, MacDonald deserves credit for taking time in “Sink or Swim” to specifically reference Crockett’s farewell party (which takes place the night before the episode) and saying that Crockett is on his way back to Boston. It gives the audience a very clear idea of where Crockett is headed and that he’s leaving in at least somewhat good spirits, which is more closure than Chicago PD gave viewers about Hailey Upton in its Season 12 premiere.

How Chicago Med Season 10 Fixes One of Its Biggest Mistakes

There’s Redemption for Dr. Mitch Ripley

One of the most frustrating things ever to come out of any season of Chicago Med was the Season 9 finale cliffhanger, suggesting that Dr. Mitch Ripley had assaulted Pawel Wapniarski as retribution for Pawel’s frivolous lawsuit against him. The overly dramatic plot twist felt like what the show tried to do with Crockett years earlier, when he was briefly accused of murder. But past that, it verged on character assassination for Ripley after the struggles he’d gone through in his first season. “Sink or Swim” has the chance to rectify that and MacDonald does it in the only way that makes any logical sense.

Dr. Mitch Ripley: You don’t always get a chance to apologize to the people you hurt.

In the premiere’s final act, Ripley has a very Ripley moment, confronting the man who caused the crash for not revealing his seizures to his employer. Ripley rightfully argues that he should have never been behind the wheel of a boat with that condition and now he’s killed almost 30 people. The man tearfully talks about how much he needed the job and how he thought it was just “one little lie.” It’s a specious argument but it lays the groundwork for Ripley to offer his own explanation to Asher (and by extension, the audience): he was indeed present when Pawel was attacked, but only after the assault had happened. It was Ripley’s childhood friend Sully and Sully’s friends who hurt Pawel, and Ripley arrived too late to stop them.

This explanation is a double-edged sword, because it does taint the Ripley and Sully arc from Season 9 in the sense that Sully maybe hasn’t changed that much after all (and who knows if he’ll face criminal charges in the future). But it makes sense for Ripley, in explaining his choice not to say anything and preserving his integrity. Ripley is the strongest character Chicago Med has, and he deserved better than that story. It ending also means that viewers say goodbye to Pawel’s polarizing sister Liliana, who dumps Dr. Daniel Charles at the start of the episode. But both she and her brother had never quite fit on the show, so it’s good to turn the page. And that’s what the Chicago Med Season 9 premiere does. It may not be a perfect episode, but it’s an episode that really feels like a step into a new era, and gives audiences a lot to think about for the rest of the season.

Chicago Med airs Wednesdays at 8:00 p.m. on NBC.