Summary

When Grey's Anatomy began airing as a mid-season pickup in March 2005, no one could have predicted how quickly the show would rise to national and international acclaim. Audiences immediately enjoyed watching the five main interns navigate their first year in medicine, and the show became known for its dramatic storylines, incredible soundtrack, and big speeches. With a cast of mostly unknown actors, Patrick Dempsey as Dr. Derek Shepherd was the initial draw for many viewers, but it was his relationship with Meredith Grey (Ellen Pompeo) and the dynamic friendships (and rivalries!) that kept people coming back.

With the end of the WGA and SAG-AFTRA strikes, Grey's Anatomy began filming its 20th season in November 2023, with a premiere date set for March 2024. Though expected to be considerably shorter than previous seasons, the upcoming season will be the show's first full season without the title character, given Pompeo's departure at the end of Season 19. Other characters, both regular and recurring, will return to the medical drama and its spin-off show, Station 19, which is now in its 7th season. Now the longest-running scripted primetime television medical drama ever and the second longest-running scripted primetime drama led by a woman, Season 20 of Grey's Anatomy is destined to be one for the history books.

When Season 1, Episode 1, "A Hard Day's Night," begins, Meredith Grey is beginning her surgical internship at the hospital where her mother, world-renowned surgeon Ellis Grey, once worked. Derek Shepherd, Meredith's one-night stand from the previous night, also happens to work at the hospital as an attending physician, and he and Meredith must try to figure out whether they're in a relationship while she is also trying to learn from her surgical resident, Miranda Bailey (Chandra Wilson), and navigate a relationship with Dr. Richard Webber (James Pickens, Jr.), the man with whom her mother once had an affair. As Meredith befriends the other interns, audiences begin to see just how tumultuous life can be, both in general and specifically while training to be a surgeon. These characters and their friendships and romantic relationships really guide the show, and fans often refer to the original five interns as M.A.G.I.C. -- Meredith Grey, Alex Karev (Justin Chambers), George O'Malley (T.R. Knight), Izzie Stevens (Katherine Heigl), and Cristina Yang (Sandra Oh).

The surgical interns at Grey-Sloan Memorial Hospital (initially called Seattle Grace) are central to the success of Grey's Anatomy. M.A.G.I.C. became residents in Season 4, which is when viewers met new interns like Lexie Grey (Chyler Leigh), Meredith's half-sister on her father's side, and Sadie Harris (Melissa George), Meredith's old friend from college. The Season 4 and 5 interns were responsible for the "Intern Cabal," which began in Season 5, Episode 7, "Rise Up," when several interns began performing procedures on themselves. The secret procedures nearly ended in tragedy in Season 5, Episode 9, "In the Midnight Hour," when the interns decide to perform a "routine" appendectomy on Sadie, which turns out to be not so routine. Interns that came later include Jo Wilson (Camilla Luddington), who arrived in Season 9, Episode 1, "Going, Going, Gone," and remains on the show as an OB/GYN resident, as well as Andrew DeLuca (Giacomo Gianniotti), who arrived in Season 11, Episode 23, "Time Stops," dated Meredith throughout Season 15, and died in Season 17, Episode 7, "Helplessly Hoping," after being stabbed. In Season 14, Episode 1, "Break Down the House," viewers met Levi Schmitt (Jake Borelli) and Taryn Helm (Jaicy Elliot), who were both displaced when the residency program was shut down at the end of Season 18 but became co-chief residents in Season 19, Episode 18, "Ready to Run."

Season 19, Episode 1, "Everything Has Changed," brought five new interns to the show, who some fans see as the second iteration of M.A.G.I.C., though this time it's spelled M.A.G.Y.K. Jules Millin (Adelaide Kane) is a little bossy, is the medical proxy for her 80-year-old landlord, and slept with Dr. Atticus "Link" Lincoln (Chris Carmack) before starting the program, though she didn't know he was an attending. Lucas Adams (Niko Terho) seems like a bit of a screw-up, deals with ADHD, and is eventually revealed to be the nephew of Derek Shepherd. Adams falls for fellow intern Simone Griffith (Alexis Floyd), who ends up at Grey-Sloan, the hospital where her mother died giving birth to her after her previous program booted her for having a breakdown while speaking out against the program's racism and sexism. Mika Yasuda (Midori Frances) starts the season living in a van, often speaks when she shouldn't, and is considered the most underrated intern. The final member of M.A.G.Y.K. is Benson "Blue" Kwan (Harry Shum Jr.), who is brilliant, competitive, and ends up falling for Millin, even though both of them try to prevent a relationship from forming. This new group of interns has everything the show needs to have great storylines in Season 20.

From its very first season, Grey's Anatomy has been known for its big dramatic moments and its love stories. The love story between Meredith and Derek starts in the very first episode, and though it is thwarted for a time by the appearance of Derek's estranged wife, Addison Forbes Montgomery-Shepherd (Kate Walsh) in Season 1, Episode 9, "Who's Zoomin' Who?," their relationship becomes the main thread of the show until Derek's untimely death in Season 11, Episode 21, "How to Save a Life." Their relationship continues to be a central theme in the remaining seasons as Meredith continues their Alzheimer's work, builds a relationship with Derek's sister Amelia (Caterina Scorsone), and raises their three children -- Zola, whom they adopted in Season 8, Episode 10, "Suddenly," Bailey, who was born in Season 9, Episode 24, "Perfect Storm," and Ellis, who was born in Season 11, Episodes 22 and 23, "She's Leaving Home." Meredith dates a few men after Derek's death, including Nathan Riggs (Martin Henderson), who is the estranged brother-in-law of Owen Hunt (Kevin McKidd), as well as Andrew DeLuca, and Nick Marsh (Scott Speedman), who becomes the director of the resident program in Season 19 and solidifies his relationship with Meredith in the Season 19 finale, Episode 20, "Happily Ever After?."

Beyond Meredith and Derek, how people love and connect with one another plays a major role in Grey's Anatomy. Characters on the show have fallen in love with other doctors, their students (or teachers), and even, in a few bizarre and unethical instances, their patients. The show plays with the boundaries of relationships in a way that challenges audiences to consider what might or might not be acceptable. Grey's Anatomy also looks at the relationships between friends and family members in a way that has impacted the zeitgeist. Meredith and Cristina refer to each other as their "person," which many fans have picked up for their closest friends, and Meredith continues to refer to Amelia as her "sister," even long after Derek has died, a habit that has shown audiences that family is as much chosen as it is blood. No matter which group of doctors is in their internship, it's clear that becoming a family and learning to love each other as much as they learn to work together is something the show wants to reinforce time and again.

As Grey's Anatomy carefully examines love and relationships, so does it examine death and grief. There are multiple incidents that have occurred throughout the 19 seasons that have taken patients, colleagues, and loved ones away from Meredith and the rest of the doctors at Grey-Sloan Memorial. While many of these moments have small ripples, the event with one of the largest impacts occurs in Season 8, Episode 23, "Migration," and Episode 24, "Flight," when Meredith, Derek, Cristina, Lexie, Mark Sloan (Eric Dane), and Arizona Robbins (Jessica Capshaw) are in a plane crash. Lexie's lower abdomen and legs are crushed under the plane, and she dies before they're found. Derek breaks his hand, Arizona gravely injures her leg, and Mark succumbs to his internal injuries after their return to Seattle. When the surviving doctors sue the hospital for putting them on the plane, their financial payout bankrupts Seattle Grace-Mercy West. They pool their money to buy the hospital with the help of the Harper Avery Foundation, putting Jackson Avery (Jesse Williams), already a doctor at the hospital, on the board. In Season 9, Episode 17, "Transplant Wasteland," Jackson suggests renaming the hospital "Grey-Sloan Memorial Hospital" in honor of Lexie and Mark.

Season 10, Episode 24, "Fear (Of the Unknown)," is a major turning point for Grey's Anatomy when Sandra Oh's Cristina Yang departs and the audience meets the woman Cristina chose to be the new head of cardio, Dr. Maggie Pierce (Kelly McCreary). Pierce reveals that her birth mother is Ellis Grey, making her Meredith's half-sister, and in Season 11, Episode 3, "Got to Be Real," Richard Webber admits that he is her father. Season 11, Episode 21, "How to Save a Life," changes everything when Derek dies after being hit by a semi-truck. The doctors at the hospital he is at do not perform a head CT in time, leaving Derek brain-dead, a mistake that comes back up several times, including when one of the doctors involved becomes a new resident at Grey-Sloan Memorial and in Season 16, Episode 8, "My Shot," when Meredith is on trial to determine the fate of her medical license after committing insurance fraud. When she discovers that one of the doctors on the panel is the surgeon who did not get a head CT for Derek, she confronts him about it, and he has a seizure. The panel wants to postpone the trial, but Alex brings in dozens of patients who were helped by Meredith to give statements, and she is allowed to keep her medical license and her job.

Season 17 sees Grey-Sloan Memorial dealing with the COVID-19 pandemic and has several episodes where Meredith, who caught the virus, has visions that she is on a beach speaking to departed loved ones like Derek, George, Mark, and Lexie. Meredith recovered from COVID-19 by the end of the season, but the doctors of Grey-Sloan Memorial lost numerous patients and even some people close to them to the virus. In Season 18, Meredith and Amelia spend time in Minnesota, working on a Parkinson's project funded by David Hamilton (Peter Gallagher), a former colleague of Meredith's mother, which reunites Meredith with her former colleague Nick Marsh. Though Hamilton wants Meredith to continue her work in Minnesota, she chooses to stay in Seattle, even as the residency program at Grey-Sloan Memorial falls apart. In Season 19, Meredith is the Interim Chief of Surgery and revives the program, bringing in the newest set of interns, though she leaves mid-way through the season, moving her family to Boston so Zola can attend a STEM-focused school for gifted students and so Meredith can focus on conducting research to cure Alzheimer's through the Catherine Fox Foundation.

With Meredith in Boston researching a cure for Alzheimer's, Grey's Anatomy has the opportunity to do some big new things in Season 20. Though the cast has changed a lot over the show's 19 seasons, there are some staple characters still around, including Miranda Bailey and Richard Webber. It's almost as if the show is getting an opportunity to start over, even with cliffhangers from the finale of Season 19. Bailey and Webber, along with their remaining attendings, get to shepherd the new interns through their program just like they did the original five, which provides a valuable structure for the show without feeling prescriptive.

With a new showrunner in Season 20, Grey's Anatomy has set itself up for a whole new world of storytelling. Grey's Anatomy has always been a show that pushes the boundaries of what is acceptable to talk about -- much like ER, the breakout '90s hit that was the longest-running primetime medical drama until Grey's Anatomy eclipsed its record back in season 15 -- and that continued to be true in Season 19 when the show had multiple episodes on how the overturning of Roe vs. Wade was going to impact the medical community. The show even had Meredith award Miranda Bailey the Catherine Fox Award in Season 19's Episode 20, "Happily Ever After?" despite not being nominated for it, for the work she had done "protecting reproductive rights and training the next generation of doctors on how to perform reproductive care." The show should continue this pattern in Season 20, including by bringing back Addison Montgomery, who supported Miranda in her work during Season 19.

Season 19 ended with several cliffhangers, including Meredith's abrupt announcement about new Alzheimer's information that might discredit her late husband's work, Richard relapsing with alcohol after the turbulent flight from Seattle to Boston for the Catherine Fox Award, the coupling up of Lucas and Simone, as well as Link and Jo, and the collapse of Teddy Altman (Kim Raver), who had been under stress all season dealing with issues in her marriage to Owen Hunt, had recently taken on the Chief of Surgery position, and was ignoring a toothache. Season 20 will likely begin with the effects of Teddy's collapse as, despite the cliffhanger, Deadline revealed just ahead of the finale that Raver, along with several other series regulars, would be back for Season 20. The new season, a major milestone for the show, will have the opportunity to prioritize characters who might have received less of a focus in favor of Meredith Grey, though Pompeo remains an executive producer on the show and may return for an episode or two here and there. Grey's Anatomy's 20th season will likely be about 10 episodes, and the show has already begun production for what is bound to be an unforgettable season.

Grey's Anatomy returns to ABC on March 14, 2024, at 9/8c. It can currently be streamed on Netflix.

Excerpt from:
Grey's Anatomy: Everything You Need to Know Before Season 20 - CBR - Comic Book Resources