Chicago Med Review: "Third Rails" Brings Gaffney a Case It Has Never Seen Before

CHICAGO · TUESDAY, OCTOBER 20, 2026

Twelve seasons in, the hardest trick for a medical drama is making the emergency department feel dangerous in a new way. "Third Rails," Chicago Med's second episode of Season 12, finds its way in through the subway: as NBC's official synopsis has it, subway surfers enter the E.D. with serious injuries — a run of the young, the fearless and the catastrophically hurt flooding Gaffney with the kind of trauma that is equal parts medical emergency and civic heartbreak. The episode never lectures, but it never looks away either, and that balance is Med at its best: the medicine is the story, and the story is always about people.

Then there is the storyline everyone will be talking about at work tomorrow. Faced with a patient who needs stabilizing, Dr. Hannah Asher and Dr. Sam Abrams employ what NBC's official synopsis — carried in CarterMatt's episode preview — calls "a surprising creature" to help stabilize a patient. No paraphrase does that phrasing justice. It is the kind of swing that could collapse into gimmick, and instead it becomes the hour's signature: played straight by Jessy Schram and Brennan Brown, grounded in the show's long tradition of doctors improvising with whatever the moment gives them, and weirdly moving by the end. Television seasons are long. Episodes that take one big, strange swing and connect are the ones you remember in May.

Charles, quietly doing Charles things

The hour's third engine is its most reliable one: Dr. Daniel Charles, set loose on a mysterious case. Oliver Platt has made a career-within-the-career out of these storylines — the patient nobody can read, the symptom that doesn't belong, the diagnosis hiding inside a conversation — and "Third Rails" gives him exactly the right amount of room. Charles episodes work because the show understands psychiatry as detective work conducted at bedside manner speed, and Platt's gentle, rumpled persistence remains one of the great pleasures of the One Chicago universe.

TVmaze's Season 12 listing tells the same three-engine story — surfers, creature, Charles — and the episode plays even better than it reads. Around the three engines, the episode keeps the department humming the way Med's best hours do — the controlled chaos of the E.D. floor, the staff's shorthand with each other, Sharon Goodwin's authority holding the whole building's center of gravity. S. Epatha Merkerson doesn't need many scenes to remind you whose hospital this is.

The nitpick: with three strong storylines running, one of them gets slightly less air than it deserves, and the subway-surfer thread — the hour's most socially resonant material — occasionally has to share its oxygen. It is the good kind of problem, an episode with more good ideas than minutes, but it is there.

The verdict

"Third Rails" is inventive, warm, and fleet — an early-season episode that plays like a show in mid-season form, with a wildcard swing that connects. Gaffney is in very good hands. Previously score: 8.6/10.