Grey’s Anatomy Season 19 Episode 1 Review: Everything Has Changed

Grey’s Anatomy has done it again. 

On Grey’s Anatomy Season 19 Episode 1, “Everything Has Changed,” a new group of interns arrives at Grey Sloan Memorial as the residency program gets a new start with Meredith Grey as Interim Chief.

From the start of the episode, everything feels fresh and new while honoring the story that Grey’s Anatomy has been telling from the beginning. I’ll be honest. I was hesitant about this season, not only because 19 seasons is… a lot, but also because it feels like the show has been working toward an ending for a long time.

Add to that, knowing that Ellen Pompeo will have a limited presence this season makes it feel like things were just going to go downhill fast.

But if this season premiere is any indication, that’s not the case at all. The new group of interns paired with a new spark from Meredith Grey brings new life to the hospital.

Really, it feels like a reboot of the series. While some TV shows end, then get a reboot or revival later, Grey’s Anatomy just keeps rebooting itself without calling it quits. And it works extremely well.

There are a lot of fun callbacks to the pilot episode, from the locker room to the break they all take together at the end of the episode, where there’s talk of nicknames and all I can think about is George O’Malley saying “Who here feels like they have no idea what they’re doing?”

Oh, and one of the interns has slept with an attending without knowing they’d be working together. 

Meredith’s reaction to Link on that one couldn’t be more perfect, acknowledging that she’s in no position to judge and suggesting he avoid elevators. It’s a funny little detail and I appreciate the care that’s being taken to honor the early days of the series.

The new group of interns is also great all on their own. They have a good energy and good chemistry with one another already. They’re all likable in their own ways, and because they’re underdogs, so to speak, they’re a group we’ll probably find ourselves rooting for even more than we have others in the past.

But what works best about this episode is that it gets back to basics.

We’re enthralled by seeing doctors helping patients and planning for big important surgeries. We see interns scrambling, learning, and failing along the way. We become invested in actual medical cases as well as in the doctors’ abilities to get things right.

And we see them struggling with the emotional and physical toll this job really takes. That’s the stuff that was always the most interesting to watch. 

We also see former interns and young residents acting as the old guard, and everyone acknowledging how much younger the new interns all seem these days. (BokHeei’s comment about this is especially hilarious.)

And one of those interns just happens to have a connection to Derek Shepherd. When Lucas starts saying “It’s a beautiful day to save lives,” everyone’s ears perk up a little. 

That’s Derek Shepherd’s nephew, and according to Meredith, he’s just like Amelia. 

It’s a brilliant way to keep everything connected even this many years down the line, and it makes for a sweet, emotional moment. It’s even more significant that this is the intern who made the biggest mistake on their first day.

I also really enjoy the fact that Meredith has taken on the role of Interim Chief. It’s a full-circle moment that makes complete sense, and she’s really good at it. She knows exactly what she’s doing and exactly how to lead. The story of Grey’s Anatomy feels like it was always leading to something like this.

If the show was going to last nearly two decades, then having the namesake work her way up from her first day as an intern to the chief of surgery is one heck of a story to tell.

Though in the six months that have passed, she’s also let the man she loves go. Because of course she has.

This is classic Meredith Grey behavior, no matter how frustrating it is to see. Luckily, it seems like Nick isn’t ready to give up on her.

There’s something really clever about their first interaction after all of this time too. Meredith’s love language is surgery, and asking him to step up for the transplant surgery is an obvious decision.

Nick is once again her perfect match. He accepts the surgery without much hesitation — it’s a big opportunity for him, after all. But the way they are both so focused and professional really just shows their chemistry more. 

Then she offers Nick a chance to stay at Grey Sloan. She even credits him with inspiring the way she’s re-building the program.

Meredith also brings back two more doctors we know and love. As happy as I am to see Owen and Teddy again, this part is my only real complaint about the episode.

Remember how high the stakes were for them on Grey’s Anatomy Season 18 Episode 20? When they literally dropped everything and went on the run?

Well six months later, that’s mostly fixed, it seems. Considering the way they left with such a major cliffhanger, it’s disappointing to see it all resolved so quickly and easily. Yes, they joke a little about the expensive lawyer and all of that, but to have them return so easily isn’t exactly satisfying. 

I suppose it will provide some interesting moments since Owen has to be supervised at work for six months, but otherwise, it’s a letdown that this is so rushed.

Amelia, Maggie, Winston, Link, and Richard are all leading the pack too, and many of the younger faces are missing. Save for Schmidt. 

He’s been working with Jo in OB, and well, he hates it. His willingness to run from it means some friction with Jo, but it also puts him in the perfect position to become Chief Resident. 

That progression is definitely satisfying to see, especially considering that he was such an underdog when he first arrived as an intern. 

I do wonder if any of the others in his class will appear again, though. It would be nice to see more familiar faces return.

Other thoughts:

• Bailey is still enjoying her time away, complete with a new hairstyle and a manicure. But she’s also invested enough to want to come to see the new class. She can’t be gone too long.
• Poor Link when Jules shoots him down the way she does. He’s just trying to do everything by the book, unlike some former attendings we used to know!
• I’m a bit disappointed that Meredith didn’t give the “Look around you. Say hello to your competition” speech.
• I absolutely love that Jo has seen to it that the scrubs in OB are changing from pink to black. 

What did you think of this episode of Grey’s Anatomy? Share your thoughts in the comments below!

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Grey’s Anatomy airs Thursdays at 9/8c on ABC.

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