Chicago Med season 11 is nearly in the books, and the penultimate hour of the season certainly brings about some major developments that help to put the stories ahead and pave the way for the season finale on May 13.

Heading into episode 20, there were many storylines on our radar after episode 19 as it became clear the show would be building on four particular storylines: Charles trying to keep his job as Theo comes for it; Hannah preparing to give birth; Frost confronting his past and the role his dad played in the abuse he suffered as a child actor; and the fallout of Ripley finally learning the truth about Lenox’s health.

As the episode opens, Dean and Sean are out for a father-son babymoon in the form of a paintball excursion. Dean admits he’s ready and excited as Sean asks how Jennifer is handling things, and he reveals they broke up as she was convinced he has romantic feelings for Hannah. Sean laughs it off and questions why his dad just can’t bring himself to tell Hannah that he’s in love with her and encourages him to tell her now before it gets crazy.

At Med, Hannah is preparing Lovell to fill in as her leave approaches. As they’re speaking about Hannah’s delivery plans, Doris informs the pair that Will and Natalie have welcomed their little one. Lovell then notices things are icy between Lenox and Ripley as Hannah encourages Lovell to steer clear of the drama. Abrams comes to Lenox to inform her that there is a new clinical trial for GGS and encourages her to look into things as he steps away.

Arriving for the day, Charles is greeted by Goodwin, who pulls him aside to talk about Theo. Goodwin reveals that there’s a board meeting tonight, and it’s about Theo’s leadership role at Gaffney; he’s trying to oust Daniel and ready to do all he can. She tells Daniel they have 10 hours to make sure Theo doesn’t oust him at the board meeting.

Naomi and Frost are next to arrive and we hear Frost mentioning accompanying Naomi to an event. As she heads off to drop off her things, Ripley walks with Frost and points out how Frost has been staying at Naomi’s place a lot lately. Ripley asks how things are going, and he admits he doesn’t like not being around Naomi. She’s open, easy to talk to, and there are no games with her. Sadly, he can’t relate as Ripley invites him to grab a beer after work.

Frost is pulled away to help a young man brought in after an altercation at juvie with a guard. Doris calls for Lenox as the fight between the pair led to a prison riot and a flood of patients is about to hit the ED. The ED quickly becomes a madhouse as prisoners are brought in for treatment and Goodwin quickly steps in to help manage things.

Doris assures Charles that everyone has his back as she hands off a psych consult that he quickly snagged from Theo. Meanwhile, Ripley helps tend to the head wound of a man who was about to be transferred to a new prison, fearing he has a skull fracture.

Maxwell, the young man brought in after the fight, needs surgery to remove his spleen, as Frost explains to him this is a life-threatening injury and internal bleeding could risk his life if they don’t act fast. Maxwell doesn’t want the surgery but knows they’ll do whatever they want and tells him to do whatever after a brief outburst that nearly got a trigger-happy guard to jump in.

With the influx of patients, Dean is called in from his day off and tries to pull Hannah aside to speak, clearly having been inspired after his conversation with Sean. Unfortunately, she has to put the conversation off as she accompanies a patient upstairs for some tests.

Maxwell is about to be transferred to the OR, and Frost asks Dean if they’ve spoken about the surgery. He feels like the kid has been ignored and there is more to the story, but Dean suggests he’s just being gullible. Elsewhere, a patient with a leg injury is brought in, and Lenox is warned to watch him as the EMTs had been warned about him having some rage issues. Abrams is brought in to check out Ripley’s patient who begins to herniate and needs to be rushed to the ER.

Hannah checks out Olivia and all seems to be fine. The baby stopped moving because she seems to be in the early stage of labor. While the baby is okay, the baby is breeched, and they only have two options. Olivia wants to avoid a C-section, leaving Hannah to try option two.

Between treating patients, Theo approaches Charles and notes that he recognizes this is a bit awkward but that he respects him tremendously. Charles isn’t having any of it as he quips they don’t need to pretend, accusing him of stabbing him in the back.

Charles notes that he’s the first to admit he had some challenges before the stroke, but he’s back to himself and questions Theo’s decision to make a play for his position. Theo remarks that he was asked to step up and he did, implementing theories that could help countless patients. Charles notes that the board cares about the bottom line as he questions whether Theo even cares about patients; that he’s so convinced machines can do their job is unsettling. Theo notes he came to Gaffney as he heard Charles was a genius, but he’s just like all the psychiatrists that he’s battled since he was five years old who make bad assumptions based on intuition rather than actual facts.