SPOILER ALERT: This story contains spoilers for “Everything Has Changed,” the premiere of Season 19 of “Grey’s Anatomy,” which first aired on Oct. 6 on ABC and streams on Hulu starting on Oct. 7.
“Grey’s Anatomy” is diving back into its past to begin its future. The Season 19 premiere of ABC’s long-running medical drama kicked off with a slew of brand-new cast members — the class of surgical interns on their first day at Grey Sloan Memorial Hospital, much like the pilot episode of “Grey’s Anatomy” introduced that cast on March 27, 2005.
These freshmen interns, though, are the opposite of the Meredith Greys and Cristina Yangs we met all those years ago. Because the Grey Sloan surgical residency program was shut down last season after a patient’s death, this new group was selected in desperation: They’re the rejects and malcontents who didn’t make it elsewhere. New series regulars Harry Shum Jr., Adelaide Kane, Alexis Floyd, Midori Francis and Niko Terho play the interns, and their backstories will unfold throughout the season.
Chief of surgery Meredith Grey (Ellen Pompeo) is now six months into the job that Bailey (Chandra Wilson) dumped on her in the Season 18 finale after quitting. It’s Meredith who’s giving these interns a chance, especially to Lucas Adams (Terho), who in the premiere’s biggest twist, turns out to be the nephew of her late husband Derek (the son of one of his many sisters).
“It’s a beautiful day to save lives,” Lucas says before he assists on a transplant surgery, after which the audience then sees Meredith and Lucas’ aunt, Amelia (Caterina Scorsone), discussing him. “He worshiped Derek,” Amelia tells Meredith, who responds: “He’s you. He’s got the spark. He’s got the drive. He just needs the chance.”
Hanging over the premiere is that Pompeo — around whom “Grey’s Anatomy” has revolved all these years — will be appearing in only eight episodes this season, due to her commitment to Hulu’s (as of yet untitled) limited series in which she’s starring and executive producing. Krista Vernoff, the “Grey’s” showrunner, told Variety this week that Pompeo is “really excited to spread her wings, and we want to support her in that — while she will always be in the fabric of our show.”
And it’s possible, of course, that Pompeo may decide either that she’d like to keep being part-time on “Grey’s Anatomy,” or will want to leave altogether. When asked about that, Vernoff said she thinks the show could continue without Pompeo: “I think that Ellen is extraordinary, and she’s been an extraordinary center of this show for a really long time. And if her career takes her in another direction, I believe that we’ve got a show here with a lot of amazing characters that our fans love. And this new class of interns is really exciting.”
In the season premiere, though, there’s no sign of why Meredith will step away from Grey Sloan to mirror Pompeo’s absence from the show. Vernoff would only hint that what’s coming is “something happens with her kids that changes the course of her plans for her life.”
But in “Everything Has Changed,” Meredith is diligently working to rebuild the Grey Sloan internship program, and trying to mend her romantic relationship with Nick Marsh (Scott Speedman), the Minnesotan transplant surgeon with whom she fell in love in Season 18. By the end of the episode, she’s offered Nick a job at the Seattle hospital — which he’s considering — only to see that veteran surgeons are also returning to help. Owen (Kevin McKidd) and Teddy (Kim Raver) come back from their exile at the end of last season, when they had to go on the run for fear that Owen would be busted after he’d illegally aiding terminally ill veterans with assisted suicides.
In other words, there’s a lot going on at Grey Sloan! Vernoff discussed all these developments and more, as she broke down the “Grey’s Anatomy” season premiere.
Lucas turns out to be Derek’s nephew, which we learn when he says before the transplant surgery, “It’s beautiful day to save lives.” What does that twist bring to the show?
That was an early idea of mine as I was looking at how to connect this class to the original fabric of the series without repeating those characters, or retreading story. Derek had all these sisters, who had all these kids — I remember writing about them in the early years of the show. With Addison, I remember writing a conversation where they were talking about Christmas gifts for all of the sisters.
Lucas was born of the idea of he’s a little bit of Derek, and he’s a little bit of Amelia: But we didn’t meet Derek and Amelia when they were surgical interns! And this gives us that connection, but brand-new territory.
There are other throwbacks to the “Grey’s” pilot: Griffith the intern is late, as Meredith was on her first day. We see the new interns standing around the lockers, and lying on the gurneys at the end. Can you talk about those visual callbacks and Easter eggs in the premiere?
That’s exactly what they are: They’re Easter eggs! It’s a way of saying, “Hey, we’re the same show that you’ve always loved — but different.” They are different, fundamentally, in that they weren’t hired for their grades. That first group, they were top of their class, right? They were the crème de la crème. And this group are diamonds in the rough.
We built the tunnel set — we haven’t had that set in a long time, because we didn’t own that set, and we didn’t have access to the location where we’d shoot it. So that was one of the big creative, fun decisions: What new sets do we build, and what sets do we build that bring back a little bit of the old?
Who’s your favorite intern?
Oh, gosh! We spent so much time finding those actors. Nobody got a break between seasons, because we looked and looked. I wrote so many different sides — there’s a character whose name changed three times. Because we would write the sides for the character, see a bunch of auditions and go, “Oh, none of those actors made that work, and therefore the character is wrong.” And then if I’m going to completely reinvent the character, I can’t do that with the character having the same name. I drove casting crazy. But we put so much time and care and love into creating those characters, and finding those actors, I’m in love with all of them.
There’s one reference to abortion in this episode, when Jo says she ordered the black scrubs because “the female body has become a war zone in this country, and pink is a peace-time color.” How much is “Grey’s” going to lean into what’s going on with abortion, post-Dobbs?
The impact on women’s health of that decision is profound, and we’re a medical show. And just as we profoundly explored the impact of COVID, because we’re a medical show, we have a responsibility to explore the impact of that decision through the eyes of our doctors.
Meredith and Nick: Is he endgame for her? It sure seemed like that, but then she sent him away for six months for some reason that I didn’t quite understand.
Let me try to explain that! Through trying to leave, she was walking through a day where she was remembering her entire life in this hospital. And people revert, you know? They revert to younger versions of themself when they’re trying to say goodbye. Where it didn’t make a ton of sense, the lashing out at Nick felt like an older, younger version of Meredith. But that wasn’t your question.
No, that’s good! Will Scott Speedman be on the show even when Ellen Pompeo isn’t?
Everybody has to tune in to see what happens with Meredith and Nick.
Teddy and Owen: Their legal problems are gone now! Or … are they?
This is a question that we spent a lot of time talking to doctors and hospital administrators and lawyers in our writers’ room at the beginning of the season. We love Kevin McKidd and Kim Raver, and we did this big thing last season: How do we bring them back from it? Does Owen have to be in jail? Are they on the run?
And the thing that we got from all the doctors and lawyers is — as with everything else related to justice in this country — it’s about money. If Owen hires the right lawyer and spends enough money, he can have his medical license back, but it’s suspended and he has to be supervised. And that is a really exciting place for a bunch of writers to jump off. Because what that gave us was, well, we can have these doctors back at the hospital.
But Owen absolutely unable to practice medicine in the ways that he’s used to practicing medicine. And what is the impact on a marriage of your decision-making causing a near bankruptcy? That gave us a jumping off place that we were like, “Oh my God, what if they come back as George and Martha from ‘Who’s Afraid of Virginia Woolf?’” You’re in love with this person, you’re married to this person, you’ve always loved this person. The fans have always seen you loving each other. And now the last six months have undone your marriage.
That has been, for us, a gold mine. Two people who have the history that those characters have, but have had a six months that make them hate each other.
We see Miranda Bailey show up to watch a surgery in the premiere. What would it take for her to work at Grey Sloan again?
One of the conversations with Chandra for many years now has been: What does someone who’s as ambitious as Bailey do with all that ambition when she’s reached the peak, which is chief of surgery? “That just caused me a really, really big headache, a huge amount of paperwork, and a lot of stress. So what else?” And Bailey has some ambitious projects that she takes on this season without the stress of the chiefdom.
What’s something I haven’t asked you that’s going to be huge this season?
Other than getting to know these interns, and this hospital through their eyes, one of the big things for me this season is the will-they-or-won’t-they of Jo [Camilla Luddington] and Link [Chris Carmack]. We are so split in that writers’ room as to whether or not Jo and Link are meant to be — or are meant to be best friends forever.
I love it when our writers’ room is split. And we are split. And that means the fandom will be too.
This interview has been edited and condensed.