The Grey’s Anatomy season 19 finale left fans with many big cliffhangers so it’s no surprise Grey’s Anatomy season 20 goes hard with its premiere. From Meredith's (Ellen Pompeo) temporary return at Grey Sloan Memorial to the interns dealing with drama similar to M.A.G.I.C.'s early days, the medical series plays with themes that it knows best.
Teddy's fate
After collapsing in the season 19 finale, Teddy (Kim Raver) has been resuscitated. It's revealed that she has bacterial endocarditis caused by a dental infection. She underwent an emergency valve replacement but there's still more to be checked. Amelia (Caterina Scorsone) takes it upon herself to look after Owen (Kevin McKidd), knowing he is in no condition to work or do anything while he's so concerned with Teddy.
Turns out Teddy also has a clot in her femoral artery, but thankfully Winston (Anthony Hill) takes care of it and she's okay. While the procedure is underway, Amelia stays by Owen's side; it's a beautiful testament to how far they have come over the years. Of course, Owen is by Teddy's bedside when she opens her eyes and the relief is obvious to everyone watching.
The interns are in trouble
The drama is in full force with the new class of interns. Nick (Scott Speedman) orders them to stay away from patients for the day at the very least while he figures things out. Simone (Alexis Floyd) wants to talk about what happened between her and Lucas (Niko Terho), but he doesn't, telling her to say it was his idea to open Sam as there will most likely be an investigation into his death. Before anything further can be discussed, they're asked by an EMT to help get a crash victim to the ER since their engine died.
Almost as soon as they get in the ambulance to help, a malfunctioning self-driving car crashes again and again into the back of their vehicle, leaving them trapped. Meredith and Miranda (Chandra Wilson) have to walk them through how to run the trauma in the ambulance, eventually calling Link (Chris Carmack) and Blue (Harry Shum Jr.) to try to deal with the car and non-driver, who is seated in the backseat. Simone doesn't want to open the patient up after Sam, not able to handle another death, but Lucas knows they have no choice and does what needs to be done. They're successful and Blue manages to stop the car by stabbing the tire, which means they can get the patient, Simone and Lucas out.
Miranda and Meredith are scrubbing in, giving the two of them the perfect opportunity to reminisce about when the latter was an intern.
Meanwhile, Jules (Adelaide Kane) sits by Maxine's bedside to go through her love confession to Blue and complicated feelings of what he did to save the older woman, which he only did because he did not want her to lose someone she loved. Jules backtracks and apologizes for giving Blue the wrong idea, even though that's clearly not true, and he agrees, adding it's better this way.
Mika (Midori Francis) also confronts Jo (Camilla Luddington), asking where she was when they paged and called for help with Sam, since she was one of his doctors. It's very clear the interns are struggling with this loss, feeling the blood on their hands.
Simone and Lucas finally have a conversation, starting with what happened with Sam but then moving onto what happened between them. He asks if she has regrets. While she says she doesn't, she needs a minute.
The most important thing is that Nick won't be firing anyone, but they will have five new rules to follow, courtesy of Miranda.
Big decisions
Catherine (Debbie Allen) did damage control to save Meredith's career, but instructs her that she has to shut up about her theories on Alzheimer's or she'll shut down her lab. However, before Meredith leaves, Amelia shares that she went through all of her research and what's happened with Teddy has made her consider that Meredith is right. Meredith does agree to Catherine's terms, but asks Amelia to help her keep it going in secret. Plus, it turns out something good does happen for Meredith: Nick hands off the program to Miranda so that he can move to Boston and be with her.
Elsewhere, Richard (James Pickens Jr.) decides he needs to step back from the OR because he hasn't stopped thinking about the drink he almost had. When he comments that he doesn't trust himself to operate and is not sure if he ever will again, Miranda insists he will bounce back; he has made it far and he has the strength to do it again. She assures him that she will take over his surgeries until then. Before the episode ends, we see him in AA, asking for a reset and announcing he's one day sober.
Grey's Anatomy airs Thursday at 9 pm ET/PT on ABC and streaming the next day on Hulu.
