Season 19 Premiere of ‘Grey’s Anatomy’: Meredith’s Future and Interns Twist

SPOILER ALERT This story contains spoilers “Everything Has Changed,”The premiere of Season 19 “Grey’s Anatomy,”This first aired Oct. 6, on ABC, and streamed on Hulu beginning Oct. 7.

“Grey’s Anatomy”It is looking back at its past to start 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”This casting was made on March 27, 2005.

The freshmen interns are, however, the exact opposite of the Meredith Greys, Cristina Yangs and 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. The interns are played by Harry Shum Jr. and Alexis Floyd. Their backstories will be revealed throughout the season.

Meredith Grey, chief of surgery (Ellen Pompeo), is six months into her job. Bailey (Chandra Wilson), who had quit the job in Season 18, dumped Grey on her. 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,”Meredith responds to Amelia: “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 is the “Grey’s” showrunner, told VarietyThis week, 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 that you will be leaving. Vernoff responded that she believes the show could continue even 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 works diligently to rebuild Grey Sloan’s internship program. She also tries to heal her romantic relationship to Nick Marsh (Scott Speedman), a Minnesotan transplant surgeon with which 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 spoke about all of these developments as well as more in her breakdown of 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 this twist mean for 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. I can recall having a conversation with Addison where they were discussing Christmas gifts for all their 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.

Other throwbacks exist to the “Grey’s”Pilot: Griffith, the intern is late as Meredith was her first day. We see the interns in the lockers. They are also seen lying on the gurneys at end. Were there visual callbacks or Easter eggs?

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. You’d think that they would have been the best in their class if they had been part of the first group. They were the crème de la crème. This group is a diamond 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. That was a big, creative decision. What sets should we make?

Who’s your favorite intern?

Oh, gosh! We spent so much time looking for those actors. We looked and looked, so nobody got a break in between seasons. I wrote so many different sides — there’s a character whose name changed three times. Because we would each write the sides, then go to auditions. “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. Casting was my passioncrazy. 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 does it cost? “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 & Nick: Is this her endgame? 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 explain! She was trying to leave but was actually walking through a day in which she was reliving her entire life in the hospital. You know what people do? 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?

Everyone must tune in to find out what happens to Nick and Meredith.

Teddy and Owen: Your legal problems are over 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 are big fans of Kim Raver and Kevin McKidd.Bigthing last season: How do we bring them back from it? Owen should he be in jail? Are they on the loose?

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. This is an exciting place for writers to jump off. We can now have these doctors back in the hospital.

But Owen absolutely unable to practice medicine in the ways that he’s used to practicing medicine. What is the effect on a marriage if your decision-making causes a near bankruptcy? This gave us a starting point that allowed us to be 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. Your love for each other has been a constant theme among your fans. And now the last six months have undone your marriage.

This has been a gold mine for us. Two people with the same history as those characters, but who have been together for six months and have come to hate one another.

Miranda Bailey appears to be there to witness a surgery at the premiere. How would she get back to Grey Sloan?

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?”Bailey also has ambitious plans that she tackles this season, without having to worry about 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]Follow this 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. We are.split.And that means the fandom will be too.

This interview was edited and condensed.