“Grey’s Anatomy” Season 20, Episode 1 Recap

March 16, 2024

BY Joelle Boedecker

Welcome back to Grey Sloan Memorial Hospital and to “Grey’s Anatomy” season 20. While the actual existence of any Grey has dwindled to some Dr. Meredith Grey voiceovers and occasional visits (just four of the 10 episodes this season), we do still have the hospital, which we all know has always been like a fifth (55th?) character in the series.


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Let’s first revel in the achievement here: this show is on its 20th season. On March 27th, 2005, I was about to graduate from my undergrad and “Grey’s” launched as a mid-season replacement. We got just nine episodes of an immediately addictive, dramatic, shocking, highly quotable TV experience. Shonda Rhimes hit us all over the head with her now-signature style of writing, casting, and storytelling. Now 400+ episodes later, there’s no signs of slowing. While they are reducing Ellen Pompeo’s involvement each year, they have a fresh batch of interns, a constantly revolving door of residents, attending, and chiefs, and an open door for some of our favorite guest stars. Who doesn’t love an Addison Montgomery drop-in? And this season, rumors of a Phoenix rising, of sorts.

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In case, like me, you’re struggling to recall where we left off in Season 19, let me refresh your memory:

  1. Half the attendings headed to Boston to find out which groundbreaking medical innovation would win the Catherine Fox (formerly the Harper Avery) Award. Twist! It’s given to Dr. Miranda Bailey (who doesn’t even go here/wasn’t nominated) for her work to set up a women’s clinic in this post-Roe v. Wade American hellscape. I can always count on “Grey’s” to keep things pointed and topical. 
  2. After a classic runaway bride moment, Half-Heartedly Engaged Intern Griffith and Junior McDreamy Intern Adams have “reconnected” in the on-call room while still wearing her wedding dress. Drama ensues when the jilted groom ends up in the ER and punches Adams. 
  3. Intern Kwan violates Intern Jules’ septuagenarian bestie (Maxine)’s DNR, but it’s OK because now she loves him. Maxine is still kicking, and there’s no way he gets fired for that, right? It’s not like he CUT AN LVAD WIRE or anything. 
  4. Meredith popped in to tell everyone about her breakthroughs in Alzheimer’s research. She’s giving real “Homeland” Claire Danes vibes and they all look more worried than enthusiastic. 
  5. Jo and Link finally admit their feelings at a rather inopportune time as Sam (Joan’s terrible husband from “Mad Men”) has a cardiac episode and dies on the operating table. 
  6. Meredith and Nick (or, as I like to call him, Dr. Ben Covington—have you noticed that Scott Speedman has played the same guy on TV since the ’90s?) are reunited after a misunderstanding with the hot nanny. All is looking good for these two—except for that 3,000-mile space between them.
  7. And the big cliffhanger: Newly chiefed Teddy had a toothache all episode. When she ran into the OR to help save Sam from bumbling intern hubris, she ultimately collapsed during a critical surgery.

On to season 20, Episode 1, “We’ve Only Just Begun”

The interns are in shock, reliving the traumas from last night. Meredith is in voiceover to remind us she’s still on the payroll. Her voice is a comforting source of stability in this ever-evolving show and its ever-changing cast.

Cut to Chief Teddy Altman being rushed to surgery, interns’ bloody hands, shocked faces of Jo and Link, and then Schmitt taking the lead on Teddy’s surgery.

“So, which one of you am I firing?”

Nick walks into the Intern classroom, and he’s pissed. Through the exposition in the form of excuses and bringing Nick up to speed on the drama, we are reminded of why everyone was in the wrong places at the wrong time. Nick reminds the interns that their terrible performance reflects on him. 

Nick is definitely hating this job. I wonder what he’d rather be doing. He tells them, “Do not move, do not practice medicine.” Sure, that always works, especially at this hospital.

“You’re my patient’s husband.”

A dental infection leads to an inflammation of Teddy’s heart valve. Folks, we’re learning lessons today. Lesson #1: Don’t ignore tooth pain, or you could die unless you’re lucky enough to be surrounded by world-class surgeons when you collapse.

Ndugu is taking his new role as head of Cardio very seriously. He’s giving everyone shit—interns, residents, chiefs, husbands—no one is safe from his serious business attitude. This is likely to be a developing issue. He’s been off since Maggie left. He just got back from seeing her and NOT winning an award. He’s in a mood, and now his boss could die. That’s some emotional work to sort out. Will he? We’ll see, but this alpha male energy doesn’t tend to last long in this hospital.

“You can go back to Boston now, but not on my plane.”

In which Meredith haunts the halls of GSM Hospital all day (we know this hospital is always haunted, we just saw it on “Station 19” 30 minutes ago). Catherine is pissed at Meredith for exposing her Alzheimer’s theories too early and without approval. Catherine has her fire-red nails, cheetah-print phone case in her badass Chief of Surgery seat in the hospital, and she’s giving Meredith an ultimatum: “Shut up about your theories on Alzheimer’s, or I’ll shut down your lab.”

Meredith leaves her office seemingly with her tail between her legs. But this is Meredith; there’s always more chaos and insubordination bubbling under the surface. As she attempts to leave, she gets pulled into conversations with her mentor, boyfriend, and sister. She helps everyone and then takes one last stand. She agrees to Catherine’s terms. Remember, Catherine always wins. But Meredith has a final card: bring Amelia in on the secret research. Cool, that’ll end well for everyone.

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“The ambulance is now your trauma room.”

Adams can’t sit still following Ben’s (I mean Nick’s) orders. Enter paramedics needing doctors and engage crisis mode for Adams and Griffith. They’re now involved in a “sort of” hit and backup and hit again on repeat accident with a robot car. Lesson #2 today is about the dangers of AI. A robot car named Wayne is here to kill doctors and paramedics. Subtle.

Moving into surgery. But first, everyone, high-five the person next to you. Dr. Bailey just mentioned cutting the LVAD wire. Are there t-shirts about this? Of course!

The interns are rightfully nervous to be back in the OR so quickly after last night’s bloody death. Meredith overrules Nick yet again and allows them to scrub in. But don’t worry. Nick’s not mad at Meredith, he just doesn’t know how to move to Boston and not leave behind a failing Intern program.

“Let go of the smoothie, Owen”

Let’s check in on Owen and his feelings. 

Ndugu discovers Teddy’s right leg is blue, and it is time for an embolectomy. Owen doesn’t know how to cede control, he needs to be convinced to trust a cardiothoracic surgeon to save his wife’s life. Um, dude, you’re not operating on your wife’s heart, so maybe let him? Classic Owen.

In the waiting room, Owen is a wreck, Amelia is taking care of him, ensuring he’s not alone today, reminding him not to blame himself. I love the evolution of this relationship. Owen is truly a terrible partner to every woman he’s been involved with. But the guy means well and wants to do right in the world. He just needs friends. Amelia has turned into a friend, and I swear to Dead Derek McDreamy if they bring those two back together, I will break my TV.

Well, we have good news. With Schmitt’s help, Ndugu successfully performed the embolectomy. Chief Teddy wakes up to an emotional Owen. She looks truly scared.

“We are interns, you were supposed to be there.”

Intern Yasuda has been breaking down all day. She explodes at everyone in the classroom, shuts down during surgery, and gets kicked out of Ndugu’s OR. She spins out at Jo Wilson, blaming her for Sam’s death, for not being there to save him. She was the overworked, overtired Intern last season. But they gave her better pay and benefits. So that solves everything, right? No. Yasuda needs real help. Enter Helm for support. 

Yasuda’s moment leaves Jo feeling guilty for being happy. But don’t worry—she’s got Link’s thick arms to hold her while she feels sad. Is it bad that I’m already bored of these two?

“Today, I’m one day sober.”

Throughout the episode, Dr. Richard Webber looked rundown and definitely not okay. This is all about his almost-drink at the awards ceremony last night. He admits his challenges to Bailey and asks her to cover his surgeries while he gets his head straight. Cut to Richard at a meeting, admitting that though he didn’t drink, he feels like it’s starting over. He gets a fresh new one-day sober chip—a full-circle moment for Richard.

None of this bodes well for Bailey, who took a step back last season to remove the stress of chief from her life. Is she ready to take on this additional workload and also…

“I have five rules.”

Nick would rather live in Boston and be with Meredith than run this irritating Intern program. He’s not firing them, so here’s a better solution, he’ll step away and move across the country to be with Meredith. Is that a series wrap on Scott Speedman?

Enter Dr. Bailey. Another full circle moment, Bailey is now in charge of the intern program. Here’s hoping there’s no return to the “Nazi” nickname. That should stay behind in 2005, thank you. Bailey’s coming into Season 20 with LOTS of responsibilities, and everyone’s boss is recovering from heart surgery. 

What will happen to Bailey and our other friends at Grey Sloan Memorial Hospital? Tune in next week to find out.

Bonus: 5 points to whoever memorized Bailey’s five rules 19 years ago.

… No cheating!

  1. Don’t bother sucking up. I already hate you, that’s not gonna change.
  2. Nurses will page you, you answer every page at a run. A run, that’s rule number two.
  3. If I’m sleeping, don’t wake me, unless your patient is actually dying.
  4. The patient better not be dead when I get there.
  5. When I move, you move.
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