Chicago Med season 10 episode 1 ending explained: Has Riley confessed his involvement in Pawel’s assault?

Chicago Med season 10 premiered with its first episode, Sink or Swim, on September 25, 2024. The NBC medical drama started with intense action as the hospital's emergency room was flooded with patients after a commuter ferry sank. The episode moved quickly, introducing new characters and exploring the personal issues of the show's key characters.

The first episode focuses on Dr. Ripley and his involvement in a violent situation with con artist Pawel. After learning that Pawel was beaten up, Ripley finds himself linked to the attack through his long-time friend, Sully, who took matters into his own hands. This puts Ripley in trouble, and he eventually confesses his involvement to Dr. Asher.

Chicago Med season 10 episode 1 leaves Ripley’s fate hanging, as he could get involved in the legal consequences of the issue. Even though Ripley tried to stop the attack, his presence could make him look guilty if Pawel decides to take legal action or if more witnesses come forward.

The synopsis of the show on Prime Video reads:

"Chicago Med is an emotional thrill ride through the day-to-day chaos of the city's newest state-of-the-art trauma center and into the lives of the courageous doctors, nurses and staff who hold it all together."

---

Chicago Med season 10: Ripley’s confession and its consequences

The main focus of the first episode of Chicago Med season 10 remains on Dr. Ripley's internal conflict about his knowledge of Pawel's assault. Later in the episode, Ripley admits to Dr. Asher that Sully, his troubled childhood friend, is the one who attacked Pawel. Even though Ripley didn't actually hurt Pawel himself, his presence during the incident can cause moral and legal trouble for him.

Ripley's effort to stop Sully from attacking Pawel puts him at risk of legal consequences. The guilt of not being able to stop the assault has clearly affected Ripley, and his confession to Dr. Asher leaves him emotionally vulnerable.

Meanwhile, Sully, who is already fighting lung cancer, shows no remorse for his actions. Ripley could be in serious trouble, especially if a new witness comes forward or Pawel decides to press charges. This confession makes viewers wonder how the situation can affect his job and career.

The confession also affects Ripley’s relationship with Dr. Asher. The two doctors were getting closer, but his connection to the attack created a feeling of distrust between them. Even though Dr. Asher doesn’t think Ripley is directly responsible, her doubts about his involvement in the violence pull them back from their developing love story.

As Chicago Med season 10 continues, the consequences of Dr. Ripley's role in the assault can lead him to legal issues that will affect his job and reputation at the hospital. If he is charged, Ripley might face professional problems, such as being suspension or termination, depending on how things develop.

In addition to Ripley’s challenges, Chicago Med season 10 also prepares for significant hospital management changes. The introduction of Dr. Caitlin Lenox as the new co-chief alongside Dr. Archer brings a new balance of power in the emergency department.

Dr. Archer’s hesitation about sharing control is immediately noticeable, and his tension with Lenox will likely cause more disputes. However, Lenox shows her capability as a strong and efficient leader during the ferry disaster, which could result in more disagreements with Archer as the season continues.

Ripley's legal troubles and the power struggle in the emergency department set a tense tone for the new season. The doctors at Chicago Med face greater challenges than before, and with unresolved conflicts still hanging, the show brings another season of intense drama, medical crises, and personal struggles.

---

Fans of the franchise can watch Chicago Med season 10 on NBC, Peacock, and Prime Video.