Grey's Anatomy's Season 20 Premiere Finally Broke A Multi-Season Streak

Improbably as it might seem, "Grey's Anatomy" may very well be going back to its roots ... and entering a new era after years of drudgery.

Shonda Rhimes' medical drama entered its 20th season on Thursday, March 14 — and that fact alone feels sort of absurd. Even "E.R." only ran for 15 seasons before calling it quits, but "Grey's Anatomy," which is ostensibly centered around the main character Dr. Meredith Grey (Ellen Pompeo), shows absolutely zero sign of slowing down. In fact, the Season 20 premiere, titled "We've Only Just Begun," suggests that the show is embarking on a brand new path after a few difficult seasons. 

Between the COVID-19 pandemic and Pompeo's official exit from the series (though she features prominently in this premiere, a fact we'll return to shortly), it seemed as if "Grey's Anatomy" was done for. Like "Scrubs" before it, the series attempted to pull a full reset with a brand-new group of interns at the end of Season 19, but it seemed like the returns were, at best, diminishing. 

Now? "Grey's Anatomy" might be making a turn for the better, nearly 20 years since it premiered as a humble mid-season replacement. So what worked about "We've Only Just Begun"? It capitalizes on the drama set up in the Season 19 finale, Meredith gets to pass the baton, and one of the show's very best characters is fully back in action.

"Grey's Anatomy" had a dour few years, from the series' wildly committed approach to the COVID-19 pandemic (which they dealt with by sticking Meredith Grey in a coma for nearly a full season, for some reason) to the fact that several series regulars like Jesse Williams and Justin Chambers left the show after working on it for decades. The Season 19 finale — titled "Happily Ever After?" — performed CPR on the ailing series, packing it full of wild details that felt like the show was returning to its roots.

Sure, there wasn't a giant ferry-boat crash, a dangerous mudslide, or a bomb inside a body cavity, but "Happily Ever After?" included two major "Grey's Anatomy" staples: a wedding gone wrong and an imperiled doctor. Dr. Teddy Altman (Kim Raver) mysteriously collapses at the end of the episode, leaving her colleagues and her husband, Dr. Owen Hunt (Kevin McKidd), to save her life. Based on how many doctors have died during this show's run — frankly, the doctors always feel like they're in more danger than the actual patients — Teddy's medical emergency is a return to form. 

Beyond that, Dr. Simone Griffith (Alexis Floyd) is all set to walk down the aisle with Dr. Trey Delgado (William Martinez) ... until her fellow intern Dr. Lucas Adams (Niko Terho) sweeps in and declares his love. A woman running away from her own nuptials in a giant white gown? That's classic "Grey's Anatomy" nonsense. As the kids say, we are so back.

Although Ellen Pompeo was happy with her decision to leave "Grey's Anatomy," she nonetheless was on hand for "We've Only Just Begun." During the Season 19 premiere — at which point Pompeo had already left the show but was still making guest appearances — Meredith realized that her research into Alzheimer's disease might be inherently flawed. As any "Grey's Anatomy" fan worth their salt knows, Meredith's mother, Dr. Ellis Grey (Kate Burton), a celebrated surgeon of her time, develops early-onset Alzheimer's and passes away due to complications from the disease. 

As Season 19 concludes, Meredith tells her fellow surgeons that all Alzheimer's research might actually be incorrect ... and while this will undoubtedly be important throughout Season 20, it also places her at Grey Sloan Memorial Hospital in Seattle, right in the middle of the action.

Meredith has to abandon her research pursuits briefly in the Season 20 premiere to help Miranda Bailey (Chandra Wilson) teach an intern to do an exploratory laparotomy, all while the intern is trapped inside of an ambulance being battered by a self-driving car, no less. Her presence in this sequence is more than welcome. It truly feels like the actor and the character are blessing the younger generation — but in terms of said generation getting the true "Grey's Anatomy" treatment, the best is yet to come.

At the very end of the Season 20 premiere, Dr. Nick Marsh (Scott Speedman), tells the group of interns that he does have faith in them, but it's time for him to leave Grey Sloan Memorial Hospital behind — ostensibly to move to Boston with Meredith Grey. Enter Miranda Bailey (Chandra Wilson), former chief of the hospital and current attending surgeon who also happens to be the resident in charge of the five original interns on "Grey's Anatomy."

As Nick leaves, Miranda enters the room and utters four iconic words: "I have five rules." That was the very first sentence Bailey uttered on the series — Wilson is one of two original cast members at this point — and diehard fans know that the rules include gems like "don't bother sucking up; I already hate you, that's not going to change" and "when I move, you move." The idea of Miranda Bailey, the toughest and best teacher in the history of "Grey's Anatomy," whipping the new generation of interns into shape is nothing short of incredible. The rest of Season 20 has a lot to prove, but "We've Only Just Begun" is a strong start — and may very well indicate that "Grey's Anatomy" has seen the error of its ways and fixed multiple seasons' worth of mistakes.