Chicago Med Season 11 Episode 20 Sets The Stage For An Unnecessarily Violent and Dramatic Finale

Critic’s Rating: 4 / 5.0

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What’s with all the violent crime at Gaffney?

Sharon’s attack, the person who accidentally shot Owen, and now a prisoner on the loose who will soon return to hold the hospital hostage yet AGAIN.

Chicago Med Season 11 Episode 20 started off on a far more interesting note before devolving into yet another story about escaped prisoners and a hospital on lockdown.

Chicago Med Season 11 Episode 20’s Maxwell Story Made a Better Point About Prison Life

When I was in social work school, I worked with people whose lives had been changed by the criminal justice system, so I was eager to find out where the “prisoners-as-patients” stories were headed.

TV almost always goes for violent prisoners and stereotypical guards, but there are so many better stories to tell about how imprisonment affects people, and Chicago Med started off on the right foot with Maxwell’s story.

Maxwell should have spoken with Dr. Charles — his refusal of the surgery seemed more about not wanting to live anymore than anything else, and the powerlessness imposed on him by the jail system wasn’t helping matters.

The second he tried to express how he felt, a guard came running into the room to scream at him as if he were threatening Frost. That was unnecessary and made matters worse.

And on top of that, Frost learned that Maxwell was held legally responsible for two murders because he was sitting in the car outside with no idea about what was going on inside the house his friends broke into.

I wish this had been developed into a full story, with Dr. Charles trying to diagnose and treat Maxwell’s depression while the guards continually insisted on trying to punish him for needing care.

That would have been a far more powerful and realistic story than using Maxwell’s distress for Frost’s throwaway line about how one decision can derail your life.

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If we ever found out what happened to Maxwell after the surgery, I missed it because Chicago Med Season 11 Episode 20 quickly shifted to chaos mode when Depere escaped.

That was unfortunate, considering that Depere’s story was the least interesting of all the prison riot subplots.

I especially liked the little bit we got of Isaac before he collapsed and Abrams discovered he had a serious and potentially fatal condition that he couldn’t treat yet because of brain swelling.

Although Isaac was a drug dealer, he was a friendly guy who made the doctors laugh and was trying to make the best of his situation. That tracks with what some of my clients were like — people who turned to dealing or other criminal activity because they didn’t know how else to meet their financial needs.

It’s heartbreaking that Isaac could die. I’m much more interested in that than this Depere nonsense.

I honestly thought that Depere’s story would go in a different direction as well.

Lenox decided before she even looked at his chart for the first time that he was faking a medical condition to delay returning to prison, and it’s annoying that she turned out to be right.

If the story had instead been about Lenox’s prejudices against a prisoner who was doing hard time for a violent crime, it would have turned the usual tropes on their heads and made a powerful point about the stigma associated with incarceration.

But nope, we have to have yet another escaped prisoner/hostage situation instead.

By the way, wasn’t the guard that Dupree knocked out the same one who was suffering a panic attack when they were brought in?

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I appreciated that subplot because it showed that not all guards were rage machines that enjoy holding power over prisoners — this one was far more human and, in some ways, was intimidated by the obligations of his job.

Meanwhile, Dr. Charles’ Story Took an Interesting and Unexpected Turn

Theo has been a pain who wants to steal Charles’ job for no apparent reason and is the world’s biggest cheerleader for removing human decision-making from psychiatric care.

I’m pro-AI and also pro-regulation to keep dystopian nightmares at bay like the one Theo proposes, so I couldn’t wait for him to get his comeuppance, and the accusation he lobbed at Charles about how Charles shouldn’t use intuition instead of “facts” to help people with emotional problems made him twice as unlikeable.

However, I didn’t expect Theo to have Anti-Social Personality Disorder.

I’m always leery when TV features this particular disorder. It isn’t shorthand for being a violent criminal, but most TV shows use it interchangeably with being a psychopathic murderer.

However, Chicago Med did a better job than most. Theo isn’t a criminal, nor is he violent. He was simply born without the ability to naturally empathize with others.

That doesn’t make any of what he is doing to Charles right, and I hope Charles wins the battle for his job.

Still, this new revelation makes the conflict more interesting, much more so than yet another hostage situation or more of Ripley and Lenox fighting while secretly being into each other.

Also, did anyone not see Hannah’s labor coming? I’ve been expecting it for a few weeks now, and with one episode left in the season, it was pretty much a given that she’d deliver in the most dramatic way possible.

What were your favorite and least favorite parts of Chicago Med Season 11 Episode 20?

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If you enjoyed this article, check out our coverage of Chicago Fire and Chicago PD.

Chicago Med Season 11 airs on NBC on Wednesdays at 8/7c and streams on Peacock on Thursdays. The season finale will air on May 13, 2026.

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