Chicago Med season 10 episode 18 brings back a key character, reopens emotional wounds, and presents life-altering medical decisions with a powerful, heartfelt finale.
Episode 18 of Chicago Med season 10, titled “Together One Last Time”, delivers a powerful blend of emotions, with the return of a key character to the emergency department and a pivotal moment for one of the show’s most talked-about couples: Dr. Ripley and Hannah. After a short hiatus, the series comes back strong, reigniting questions about their future and presenting a medical case that mirrors the real-world tensions of social media culture.
The story opens with Hannah walking with her sister Lizzie, to whom she confesses that she told Ripley she loved him while he was trapped in a well—but they haven’t spoken since. This uncertainty becomes the emotional core of the episode, as Lizzie, suffering from digestive issues, is brought to the ED at Hannah’s insistence.
A young patient, a snake, and a critique of influencer culture
At the hospital, Ripley and Hannah have a brief but tense reunion. Before they can talk further, they must treat a young boy who’s been bitten by a snake. What initially appears to be a straightforward case becomes more complicated when they realize the antivenom isn’t working.
The boy’s parents, who are social media influencers, try to leverage their followers to help identify the snake. This enrages Dr. Frost, who confronts them for prioritizing their image over their child’s safety. The clash serves as a subtle critique of how online personas can influence real-life decisions and highlights Frost’s own unresolved frustrations.
When the father returns with the supposed snake in a burlap sack, chaos ensues as it escapes into the hospital. Thanks to Dr. Naomi’s quick thinking—she traps it with a trash can—and the teamwork of Ripley, Frost, and Lenox, the situation is defused. The scene underscores both the team’s efficiency and the underlying tensions between its members.
Lizzie faces devastating loss, and Hannah shows strength
Parallel to the hospital chaos, Lizzie receives heartbreaking news: she has lost her baby. Her situation worsens when complications lead to a total hysterectomy, ending her chances of having children in the future. Hannah, balancing her roles as both doctor and sister, remains composed, providing strength and support through the ordeal.
This moment also acts as a turning point for Hannah and Ripley’s relationship. Ripley apologizes sincerely, acknowledging that he sabotaged their relationship and is working on himself. He understands that Hannah’s forgiveness won’t come easily. Their exchange leaves the door open for the future while showing a mature confrontation with their shared past.
How do you face a terminal truth and move forward?
Another emotionally charged arc features Dr. Charles and Dr. Lenox as they treat Ron, a cardiac patient, and his ex-wife Cynthia. Initially focused on Ron, it soon becomes clear that Cynthia is also struggling—she has trouble speaking and displays other concerning symptoms.
As Ron agrees to undergo surgery, Cynthia’s tests reveal a terminal diagnosis. She’s afraid to tell him, not wanting to burden him. But eventually, she decides to be honest. What follows is one of the episode’s most moving scenes: Ron, far from withdrawing, proposes to Cynthia and promises to stand by her.
This act inspires Lenox, who, after keeping her distance from Hayes throughout the episode, decides to open up to the possibility of a relationship, mentioning Myrtle Beach as a potential getaway.
