Original Airdate: October 6, 2022
There may never have been a more appropriately titled episode than Grey’s Anatomy’s season 19 premiere, “Everything Has Changed.” Six months have passed since the season 18 finale, where the surgical residency program imploded and was shut down, Bailey and Richard took leaves of absence, Teddy and Owen were on the run from the police, Meredith was named interim chief of surgery, and Nick left for Minnesota after one bad day ruined his relationship with Meredith. Now, the staff of Grey Sloan Memorial Hospital continues to pick up the pieces of the wreckage and start anew with mixed results. This premiere also doubles as a soft reboot/retooling of the show that is likely to create mixed feelings for longtime fans.
FIRST DAY JITTERS
The episode opens on the first day of the new surgical residency program. A tornado swept through Seattle the day before and has left some irreparable damage in its wake, as seen in Station 19’s season six premiere. It’s interesting that a literal tornado opens this season when a figurative tornado closed the previous one. We are immediately introduced to the five new interns who have joined the cast as series regulars, and much of the hour revolves around getting to know the rookies. Up first is Simone Griffith, who keeps getting lost and flustered on her way into and through the hospital, causing her to be late. Then, Jules Millin awkwardly runs into Link inside the hospital. It turns out they met a few nights prior at a bar and slept together. Link tells Jules he knows he hasn’t called yet, which doesn’t bother her in the slightest. Jules asks where to find scrubs and reveals she works at Grey Sloan Memorial now, which throws Link for a loop.
Jules runs off to meet Mika Yasuda, who she recognizes from the interview process. They go into the intern locker room to get ready for the day. Joining them, along with a slew of other unnamed interns, are Benson “Blue” Kwan and Lucas “Luke” Adams. Luke is nervous and asks the group to not call him Skywalker, which was his first mistake and prompts him to be ribbed with the nickname all day. Wide-eyed Simone is running through the halls looking for the locker room and is caught by Richard, who tells her to slow down. She makes it right as everyone is on their way out.
The group is brought into the OR by Mer in a carbon copy scene of the pilot where Richard does the same with Mer’s intern class. The new group is in awe of the high-tech equipment and receives a welcome speech from Mer. The highlights include how the OR technology is useless without the surgeons and that each intern was picked for their fight and is being given a second chance. Simone comes flying into the OR, interrupting the chief’s speech, for which Mer wants an explanation. Other attendings, including Amelia and Richard, are watching from the gallery. Bailey walks into the gallery in street clothes, which excites the attendings. Bailey announces that she isn’t back to work, but she wanted to see the new interns for herself. She is dismayed to see that they have no senior residents, and Richard explains that their previous residents are settled in new programs now.
Cut to Schmitt working with Jo to deliver a baby. He is now an OB resident and wearing the pink scrubs. It’s clear from his facial expressions that he isn’t thrilled with his current position. Bailey and Richard walk through the halls together and have a typical conversation. Bailey complains that Richard went around the world with Catherine and opened the residency program six months too soon. She even manages to throw shade about Catherine spending money on new surgical equipment. Bailey doesn’t understand why they made a residency class from the bottom of the barrel reject doctors. Richard fends for the youngsters by saying that there were hundreds of applicants and he and Mer carefully selected the best. He knows this class might not have had straight A’s in med school, but they do have heart, empathy, and stories to help them succeed. His highly optimistic viewpoint is courtesy of his trip, which he claims gave him a new way of thinking. Schmitt interrupts the conversation to talk to Richard. He knows he is risking his job and friendship with Jo to get his surgical residency job back, but he hates OB so much that it is worth it. Schmitt even wants to be chief resident and knows the job is open. Bailey chuckles and wishes Richard luck before walking out the door. Richard tells Schmitt he will need to talk to Chief Grey about switching residencies.
After Mer’s OR trip, the interns are handed off to Amelia, who will be supervising them for the day. They are immediately being thrown to the trenches with their day one assignment. Amelia brings the group outside to talk about the tornado dropping a bus off a cliff. There are many brain injuries, and Amelia asks the interns what the steps to declare brain death are. Several interns raise their hands, and Amelia picks Blue, who answers correctly. Luke speaks up to ask a question, and Amelia snaps at him that they all need to raise their hands before speaking. She calls on Luke, who wants to know how many patients they have. Amelia reveals there are fourteen potential brain dead patients and nine of them are potential organ donors. Mika makes a snarky, inappropriate comments under her breath, so Amelia demands that Mika not talk for the rest of the day.
Amelia tells the group that transplant surgeons from across the country are in the building to aid in organ retrieval surgeries before bringing them inside to a ward of patients on life support with their families at their sides. The job instantly becomes real for the once excited interns, as they realize they are in over their heads. The interns start assessing their patients for brain death, with Amelia doing the final tests and signing off on the diagnoses. Amelia gives some of the interns an even tougher first day assignment: telling the families that their loved one is brain dead.
IT'S ALL ABOUT PERSPECTIVE
Maggie is pacing in the hallway, and Winston finds her to give updates on the rounds of her patients. She is excited because she might have a transplant match for her patient Howard, who has been waiting a long time for a new heart. Jules pops into the scene and comes up to Maggie as a total fangirl. She has read Maggie’s articles and is a huge fan. Jules also has good news, as UNOS has a heart for Howard. Maggie and Winston are excited, and the latter goes to start filling out paperwork. Jules asks Maggie if she can join her in the OR, and Maggie nods approvingly.
Back in the other ward, Mika tells the mother of her young patient, Marina, that her daughter has some brain activity and might live. Marina’s eyes are tracking movement, which is a good sign. The mother is too afraid to hope after seeing all the other families get bad news. Mika tells the mother that she has seven sisters and one is around the age of Marina, so she will hope for Marina as she would her own sister. It is a nice moment of warmth from the otherwise standoffish character and shows there is some depth there.
We then see Maggie, with Jules in tow, telling Howard and his husband the good news about the heart transplant. Howard’s husband can’t stop crying happy tears. Maggie asks Jules to take Howard’s blood pressure, which prompts the older gentlemen to comment that Jules looks like she is twelve years old.
Elsewhere, Jo happily gets a package of black scrubs for the OB department and Link happens to be there too. He questions the black scrubs and Jo explains that pink is a peaceful color, but women’s bodies are now a war zone in this country. She decided to make a statement by changing the color of the scrubs; this will likely be an ongoing story and not the only time we will hear about the overturning of Roe v. Wade on the show. As a resident, it’s unclear how Jo had the power to change the scrubs, but the show does not go into it. Link asks Jo if she remembers the girl he brought home the other night, and Jo makes it clear that Link has been sleeping around a lot. Link tells her that Jules is now a surgical intern at Grey Sloan Memorial, causing Jo to laugh a lot at him. She says he will be fine because he didn’t know Jules would be working at the hospital. Link is worried he will get fired and doesn’t know what to do, so Jo tells him to go talk to Mer.
Winston is walking through the hall and sees the transplant specialists lining the walls ready to operate when called upon. He comes upon Nick, and the two men are genuinely happy to see each other after six months. Blue and Luke bring their brain dead patients down for organ retrieval, so Blue takes the opportunity to ask Winston if he can scrub in to see a transplant procurement. Luke piggybacks and asks if he can also join. Winston agrees to have both of them in the surgery, so they wait in line with the other doctors. It is good to see these interns immediately taking initiative and wanting to get as much experience as possible on day one.
The doctors talk about how bleak the day is with all the deaths, but Nick jumps in to say that the eight deaths can save forty lives with organ donation. Those donors can also give their skin and corneas to help countless other patients. Nick tells them that transplant surgeons spin the viewpoint that way to keep themselves from getting too depressed with their job, and Luke says that the thought process is comforting, even though Nick was really just talking to Winston. Nick asks Winston how things have been at the hospital. Winston replies that it has been awful because the junior attendings, like him, have had to act like residents, and he is no longer enjoying having Maggie as his boss. Since Winston didn’t bring it up, Nick asks how Mer is. Winston confirms what we all knew, that Mer is doing well and makes a great chief of surgery. He goes on to say that Mer is still the interim chief, but after six months, it seems pretty official that she is staying in that role to him. Maggie rounds the corner and spots Nick and quickly runs away before she is noticed.
Mer is on the phone with UNOS in her office with Link patiently sitting in a chair waiting to talk to her. Maggie runs into the office without knocking on the closed door and asks to speak to Mer alone. Mer gets put on hold and tells her sister that Link was there first. Link blurts out that he slept with an intern, but that it occurred before she started working there and he didn’t know her position. It’s super awkward, but without missing a beat, Mer says that she is in no position to judge him and advises him to stay away from elevators for the foreseeable future. It’s a hilarious callback that works perfectly. Mer tells Link to go to HR because they have paperwork for this kind of thing and he leaves.
Maggie tells Mer that Nick is at Grey Sloan Memorial, and Mer shows no reaction and isn’t surprised given that all the transplant surgeons are there. Maggie wants Mer to immediately go talk to Nick, but Mer is on a call still. Maggie argues that Mer has been sad for six months and it’s so obvious that her children know it. Zola noticed and asked Maggie for Nick’s phone number the week before to call Nick and explain why Mer didn’t go to Minnesota in hopes of making him understand and convince him to come visit. Maggie tells her sister to not be an idiot and go see the man she loves. Mer, in classic stubborn Mer fashion, is more focused on the fact that Maggie hadn’t told her that story. Schmitt runs into the office right as Mer gets off the phone with good news. She immediately knows why he is there and guesses that he hates OB and wants his old job back. Schmitt quips that he hates OB more than war. Mer says that he would make a good chief resident, much to Schmitt’s surprise. And to no one’s surprise, Schmitt is back as the only senior resident and is now chief resident.
Mer and Maggie then walk through the halls where the transplant teams are waiting. Mer sees Nick and stops to say hi. He says hi back sheepishly. Mer is all business and asks Luke if he brought his patient down. She then tells Nick that UNOS has approved a triple transplant for one of her patients. She asks Nick if he would stay and do the 25-hour surgery since it would be too hard for her to jump into the OR for that long on the first day of the new residency program. Nick asks his assistant if he can bring their assigned organ back to Minnesota, which that guy agrees to allowing Nick to agree to do Mer’s transplant. The two doctors walk off together to go meet the patient and her family. Maggie tells Winston that the reunion wasn’t how she thought it would go and Winston agrees. Simone comes running over to ask Luke where a patient named Liam Collins is, so Luke says he is being prepped for organ retrieval. She wants to know why he didn’t speak to Liam’s family and that his mom is screaming at Amelia in the ICU. Luke remembers talking to somebody’s mother and the two go running off.
FIXING YOUR OWN MISTAKES
Amelia is apologizing the best she can to Mrs. Collins and knows their mistake can’t be fixed. She apologizes that her intern gave the news to the wrong family and assures Mrs. Collins that she did the final tests herself and that Liam is in fact brain dead. The mother can’t trust Amelia and is terribly upset that she didn’t get to say goodbye to her son. Luke and some other doctors wheel Liam back to the ICU, and Luke sincerely apologizes to Mrs. Collins. Amelia asks if she would like the last test run again, and Mrs. Collins decides that she wants all the tests run again. Luke pulls Amelia to the side and tells her that Liam is the donor for Mer’s triple transplant. Amelia very sternly tells the intern to go talk to Mer and instructs Simone to go with him to ensure that he doesn’t screw up again.
Nick and Mer give the good news about the triple transplant to their patient and her family. Luke taps on the glass of the room to get their attention, so Mer and Nick leave the room. Mer makes Luke explain what happened twice and looks like she is ready to pounce on him. Nick tells Luke to hold his shame spiral until after his shift because they need to focus on the patient. Simone tells Mer that Mrs. Collins wanted Amelia to run all the tests again before they can get the organ donation. Nick wants to know if Liam was stable, and Mer clarifies that if Liam codes and his heart fails before the tests are done, Luke gets to tell the family that their one-in-a-million match was wasted by his error. Mer tells them to go help Amelia, so the interns run off. Luke stops after a few steps to puke in a garbage can along the way.
When they get back, Amelia pulls Luke and Simone aside to tell them that Mrs. Collins has her family physician at the hospital now to sign off on the tests because she no longer trusts them. Luke explains that two patient’s moms had the same first name, and he didn’t check the last name with them. He wanted to use their first name to be more personable with such bad news, but now he knows why doctors don’t only use first names. Luke checked and the woman he told her child was brain dead is actually brain dead, so there was not a second foul.
Simone goes to find Mrs. Collins and her doctor at Liam’s bedside. The family doctor is an older gentleman who can’t walk well and moves very slowly. He knows time is of the essence, and Simone has the brilliant idea of putting him in a wheelchair and running him back to the scan room to meet up with Amelia to sign off on the tests, which is another example of great initiative. Simone runs back to the ICU and gets lost along the way. When she finds Mrs. Collins, she gives her the bad news and tells her that the family doctor has confirmed Liam is brain dead. When he sees Simone struggling with the distraught mother, Blue comes over from across the room to talk to Mrs. Collins. He tells a moving story about losing his brother in an accident as a teenager and that his brother saved a lot of lives by donating organs. He thinks about it a lot, believes that the act gave his brother’s death meaning, and clings to that still. Mrs. Collins consents to the organ donation, so Blue and Simone go to give Mer the good news. Simone thanks Blue for the help, and he reveals that the story was a lie. He never had a brother and also wants in on the triple transplant.
GO TIME
Mer and Nick anxiously await news on whether their transplant is a go. She wants to know what his gut says, and Nick feels the patient will get the organs. Mer blurts out that she shouldn’t have told him to go back to Minnesota and she called back for him but he didn’t hear her. He said he heard her, which surprises Mer. Nick was hurt and wanted her to do more than call his name: he wanted more effort. Mer says it was a bad day, and Nick counters that it has been six months. Mer informs him that it has been a very difficult six months, and they know that they are both stubborn and proud. Simone and Blue interrupt the moment to say they got the approval for the surgery. Mer says they both can be in the surgery, and since Nick is still the lead surgeon, he agrees to let them in too. The interns go prep the patient, who tells her family that she wants her body turned into a pod after she’s gone to cut down on pollution and become a tree for her family to eventually sit under, so that way she can watch over the family forever.
In the OR, Maggie, Schmitt, and Jules operate to retrieve the heart for Howard. Maggie declares that the heart has too many hematomas and is not suitable for transplant. Maggie tells Jules to close up, and Jules panics and wants to know what will happen to Howard. Maggie tells her that they will tell him that it wasn’t his day and that he will stay on the transplant list. Maggie knows that it sucks, but they have to take the good with the bad in this job. She leaves and tells Schmitt to watch over the intern.
In another OR, Nick is getting ready to scrub in for the triple transplant and finds Luke in the scrub room. Luke wanted to check in on his screw up and thinks he is going to get fired. Nick invites him to scrub in and advises the young doctor to learn from his mistakes and to end the day better than it started. Luke excitedly scrubs in with Nick, Richard, and Winston. Before they start operating, Nick tells the team about Liam and the patient receiving the organs. Luke quietly says, “It’s a beautiful day to save lives,” then repeats himself. Richard crinkles his brow in surprise and looks up into the gallery at Mer and Amelia.
The unexpected moment becomes even more shocking when Amelia tells Mer, “Derek was a god to him,” and Mer smiles and warmly says, “I know.” Amelia reveals that Luke was Derek’s favorite nephew, and she hates to say it, but she isn’t sure her nephew has what it takes to be a surgeon. Amelia continues to say that Luke is a mess, doesn’t follow instructions, and has to do everything his own way. She asks if Mer hired him because of Derek, but Mer had other reasons for the hire. She knows Luke is a mess and needs to do things his own way, but he also has a stroke of the Shepherd family genius. He’s a bit of a black sheep and knows that he is like Amelia. Mer knows he has the spark and needed a chance, so she gave it to him. Amelia reminds her that she needed a lot of supervision at that age, and Mer asks Amelia to mentor their nephew. This reveal was quite unexpected and brings a very interesting twist to this season. It also explains Mer and Amelia’s behavior towards Luke in this episode. Two big questions remain: when will the other interns learn of Luke’s identity, and which Shepherd sister is Luke’s mom?
NOT BAD AFTER ALL
We get a montage of the triple transplant surgery, which shows Blue and Simone watching to take notes and give regular updates to the family. The other interns and attendings come and go from the gallery to watch. The surgery winds up being a success, and the gallery applauds. Simone gets to give the family the good news.
Link waits in the hall outside the intern locker room after the surgery to talk to Jules. He asks how her first shift is going. She replies that it is endless and devastating, but she already loves the job. He wants her to sign a piece of paper from HR that says their relationship predates her employment there. Jules tells Link that he is nice and they had fun, but they don’t have a relationship. Link doesn’t want a relationship with her either. Jules sort of calls Link a stalker for waiting for her outside the locker room and tells him they should be friends. Link has no idea what just happened and walks off semi-stunned.
Mika is still watching over Marina and is shocked when Marina moves her hand and wakes up. Mika wakes up the mother to tell her Marina is awake. The mom can’t believe the good news either, and Amelia quietly arrives to see the moment from the background. The triple transplant recipient also wakes up and asks if she is a tree. All the doctors are there and tell her that she can see her family in a few days after she recovers enough. She wants to thank the donor’s family because she knows a child died to save her. Simone leaves the hospital room after becoming emotional and goes outside for some fresh air. Richard finds her and asks if she is okay. Simone reveals that her mom died giving birth to her at GSM and that she hadn’t been to the hospital since. She also says that she wasn’t late due to the tornado but because she had a panic attack. She had been picturing the hospital her whole life and found it disorienting to be there. She apologizes for being late and lying and says it won’t happen again.
Link walks out of the hospital to go home and with Jo in her black scrubs by his side. She’s laughing at him again after hearing his latest Jules story. Schmitt walks up to them, and Jo gets super serious instantly and tells him to keep walking and that they aren’t on speaking terms before the poor guy can even say a word. Jo goes right back to laughing at Link after Schmitt leaves.
Back inside, Nick goes to Mer’s office to talk. He thanks her for the surgery and says he had never done a triple transplant before. The patient is doing well and is grateful, so he is ready to leave. Mer asks him to stay because she needs a residency director, and Nick is the best teacher she knows. She explains that this intern class is a lot like Nick was at that age and says they didn’t match anywhere else or got kicked out of their previous programs. She reveals she wouldn’t have hired the interns if she didn’t know Nick and his story and believes that he inspired the hires. She tempts him by again saying she needs a residency director, it offers great pay, he wouldn’t travel as much, and she would love it if he would consider the offer. Nick smiles and they are again interrupted. This time it’s Teddy and Owen knocking on Mer’s door.
Mer is happy to see her friends. She called them three weeks ago and is confused why they are showing up now. Owen says he couldn’t work three weeks ago, but he can now. Teddy quickly adds that Owen can only work if supervised. Teddy spitefully goes on to say that Owen is very tan from surfing all day every day while they spent all their money on an expensive attorney. Owen rebuffs that Teddy is angrily drinking wine all day but you don’t see him criticizing her. Things are clearly great for this married couple. Nick tries to escape the awkwardness by saying he is leaving and will consider Mer’s offer. Mer asks Teddy and Owen to sit down and talk and wants to know the full situation. Owen reveals that their attorney got all the charges against him dropped... for the low cost of $250,000, Teddy reminds him. His medical license is still suspended, so he has to be supervised for the next six months. Teddy is very bitter about the whole situation, and it will definitely be an interesting storyline throughout the season.
The episode ends on another scene that will be very familiar to diehard Grey’s Anatomy fans. After a long day, the five interns are laying on gurneys in a hallway in the basement having a conversation that sounds eerily similar to ones had in the early episodes of the show. Luke is on an adrenaline high from operating while everyone else is beat. Luke asks Simone if she has a nickname, which she doesn’t. Blue tells the group that people call him Blue like the ribbon because he always wins. Simone quips that he clearly doesn’t always win since this is a program for rejects and losers. None of them say they identify that way, except for Luke, who wants to prove himself wrong. Blue wants to know what Simone did to get in here with a quippy jail reference. Simone answers, “Wouldn’t you like to know,” as all their pagers go off and they go running to help more patients.
What do you think of the rebooted, or should I say retooled, Grey’s Anatomy? It certainly feels different and a bit odd with so many new characters being the focus of the episode and the regular characters all in new roles but relegated to the background. It will be interesting to see how the show winds up balancing the new and returning characters from here on out. Even more interesting will be whether these five interns become the reincarnations of the original five Grey’s Anatomy interns. At the moment, there aren’t clear-cut copies in my mind. Luke most certainly is George, Mika might be in the Alex role, Blue is more than likely Cristina, and it’s a toss-up between Simone and Jules for Meredith and Izzy. It will be a difficult transition, but time will tell if this new storytelling will work or not.
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