
Though her return was a surprise, Rachel Dipillo’s Sarah Reese had a good reason for leaving Chicago Med at the beginning of season 4 and returning in season 10. Reese was originally a medical intern who had a difficult time finding her footing. She almost quit medicine after deciding Pathology was not for her, but Dr. Charles (Oliver Platt) convinced her to work for him instead. Thus, Reese was part of the original cast of the One Chicago universe’s medical drama, though she disappeared for six years after her exit.
Reese parted with Gaffney Medical Center on poor terms with Dr. Charles after she felt betrayed by him and supposedly went to Texas. However, when she returned in season 10, she revealed she had been working in Chicago for the past four years and was now working at a psychiatric clinic nearby. Thus, she could become a recurring part of the Chicago Med season 10 cast who is occasionally a thorn in Charles’ side.
Dr. Sarah Reese Decided To Leave Gaffney In Chicago Med Season 4
Reese Felt Betrayed By Charles After Her Father’s Death
Reese left Chicago Med after the season 4 premiere because she felt that Dr. Charles had betrayed her. This decision came after the climax of a long arc in which Reese struggled with whether to allow her father, who had abandoned her as a child, to come back into her life, something she considered seriously despite brain scans proving he was a psychopath. Reese’s father died of a heart attack after Dr. Charles confronted him with proof that he had killed two girls in Wisconsin, and, unfortunately, Reese believed Charles didn’t try hard enough to save him.
There were still storyline opportunities for Reese to deal with the fallout of her father’s death without leaving Chicago Med. Additionally, DiPillo did not play any other roles between the time she left Chicago Med and her return in season 10. It is, therefore, possible that the actress chose to leave the series because she wanted to stop acting and do something else. However, this is only speculation, as DiPillo has not made any public comments about leaving the series.

Dr. Reese’s Chicago Med Season 10 Return Explained
One Of Her Patients Was In The ED
Reese’s return in Chicago Med season 10, episode 8, puts her in direct conflict with Dr. Charles again. At the beginning of the episode, while Charles is trying to help a patient who has seemingly overdosed on anti-depressants, Reese walks in and tells him the patient is having a panic attack. She knows because she has been treating this patient for several months and asks Charles for temporary privileges at Gaffney so she can assist with this case.
Unfortunately, the civility between Reese and Charles doesn’t last long, and they are soon at each other’s throats over this potentially suicidal patient. Charles disapproves of Reese’s treatment decisions with this patient, specifically that Reese is secretly giving the patient a placebo while telling her it’s an anti-depressant.
If Reese returns again, Charles will likely oppose her treatment recommendations, leading to a strong conflict for them both.
Surprisingly, Reese doesn’t bring up the previous incident with her father when Charles suggests her behavior is unethical. However, the returning Chicago Med character accuses Charles of thinking he’s always right when she learns he put her patient on a 72-hour hold. Thus, Charles and Reese part on even worse terms than before.
How Did Chicago Med Fare Without Rachel DiPillo?
Fans Missed DiPillo When She Left Chicago Med
The truth is that shows like Chicago Med and others have a significant turnover in their casts all the time. Rachel DiPillo was an entertaining cast member on the show, but the series never missed a beat after she left. When the show wrote her off, her character had no open-ended storylines other than her conflict with Dr. Charles and her return in season 10 didn’t even really touch on their final moments with her dad. Dr. Charles has always been a bigger fan favorite character, so he is who fans focused on after Sarah left.
However, some fans hated her departure. A Reddit thread discussed her leaving the show, with the OP saying that the show had a drop-off in quality after DiPillo left. “I had always said that Dr. Charles was my favourite character however how distraught I felt over Reese leaving makes me think overwise,” jamienev22_ wrote. Another agreed and said they would watch a show with just Reese as the lead character:
“Dr Reece’s storyline and her dynamic with Dr Charles was one of the most compelling storylines and she was an interesting and complex character… I’d watch a show that was just about her tbh. And I don’t even like or watch medical dramas. I’ve never even watched one episode greys anatomy and literally don’t care but I would def watch Sarah Reece MD or whatever.”
It seems like most social media posts are about how much fans miss Rachel DiPillo on Chicago Med, but the series hasn’t missed a beat, still brings in large ratings, and continues to move along despite cast members coming and going. Having her make a special return had to make many fans happy, but this is likely to be the best Chicago Med does for the character, as the actress is slowing down in her career in general.