Given the ongoing WGA and SAG-AFTRA strikes, fan theories about Grey’s Anatomy season 20’s story won’t go answered for some time. Shonda Rhimes’ enduring medical drama is notably absent from ABC’s fall slate. While a mid-season premiere seems more likely, that also means a shorter season 20. However, at Grey Sloan Memorial Hospital, fewer episodes don’t equate to less drama, and the season 19 finale certainly set up several compelling threads.
Despite Ellen Pompeo’s departure from the series, it looks like long-time protagonist Dr. Meredith Grey has a reason to crop up during season 20. Meanwhile, Dr. Teddy Altman (Kim Raver), the hospital’s current Chief of Surgery, may be incapacitated — if not worse. From blossoming new relationships to messy endings, Grey’s Anatomy season 20 has a lot to explore both instead and outside the hospital’s operating rooms.
Richard Didn’t Take A Drink
In the Grey’s Anatomy season 19 finale, Richard Webber (James Pickens Jr.) attends the Catherine Fox Awards alongside his wife (Debbie Allen), for whom the awards are named, along with attendee Amelia Shepherd (Caterina Scorsone) as well as nominees Winston Ndugu (Anthony Hill), Maggie Pierce (Kelly McCreary), Nick Marsh (Scott Speedman), and award-winner Miranda Bailey (Chandra Wilson). On the plane ride from Seattle to Boston, intense turbulence strikes.
Thinking the plane is going down, a panicked Richard, who has been sober for years, reaches for Catherine’s drink. Thankfully, Bailey knocks the glass out of his hand before he can take a sip. But it’s not a passing temptation. After the award ceremony, Amelia, who’s also sober, suggests they find a meeting. After Amelia leaves, a waiter delivers a drink to Richard. He considers the glass, but the show doesn’t reveal if he broke his sobriety or not. Given Richard’s years of dedication to his sobriety, it’s hard to imagine Grey’s throwing that away to rehash a familiar plot.
Meredith’s Alzheimer’s Research Will Be A Recurring Storyline
Grey’s Anatomy season 19 sees Meredith Grey finally leave Grey Sloan Memorial behind. While viewers found her departure episode disappointing, Meredith clearly isn’t being written out of the show entirely. After her eldest daughter, Zola (Aniela Gumbs), experiences chronic panic attacks, Meredith deduces that Zola is afraid of a looming threat: that her mother, like her grandmother, will develop Alzheimer’s disease. Passionate about medicine, Zola knows there’s no cure.
On a trip to visit schools for Zola, Jackson Avery (Jesse Williams), who’s heading up a Boston-based branch of his mother’s Catherine Fox Foundation, suggests Meredith move her family to the East Coast so that he can fund her research into Alzheimer’s. Meredith agrees, believing she can assuage Zola’s fears and make groundbreaking contributions. On the eve of the Catherine Fox Awards, Meredith reveals that her research has debunked the leading theories about the disease, which means Meredith’s Alzheimer’s story gives her a reason to return to Grey’s Anatomy for season 20.
Sam Dying Will Put A Strain On Jo & Link’s New Relationship
Jo Wilson (Camilla Luddington) and Atticus Lincoln (Chris Carmack), a.k.a. Link, have been best friends for years. Long before they met up again at Grey Sloan, they’d worked together as teenagers, and as Link later reveals, he’d always had a massive crush on Jo. When Link’s relationship with Amelia, the mother of his son, deteriorates, he moves in with Jo and her adopted daughter, Luna. What starts out as a found family/roommate scenario turns much more complicated.
After sleeping with Link, Jo pushes him away as she’s afraid of ruining their friendship. However, the introduction of a patient, Sam Sutton (Sam Page), throws another wrench into things. Sam, who has a penchant for risk-taking and thrills, breaks all of his limbs, leading Link to perform some serious surgery. Afterward, Sam becomes Jo’s quasi-love interest, which infuriates Link. In the end, Jo and Link confess their love for each other — in the rain, no less — but Sam dies of complications. Undoubtedly, the friction over Jo and the late Sam’s relationship will complicate the couple’s would-be fresh start.
Teddy Will Survive Her Season 19 Fate
In the last few episodes of Grey’s Anatomy season 19, Teddy complained of a toothache, all while refusing to see a dentist. As the newly named Chief of Surgery, Teddy had a lot on her plate, especially with various doctors leaving the hospital to either attend the Catherine Fox Awards or Simone’s ill-fated wedding. Needless to say, Teddy pushed her own health aside for the sake of work, despite her colleagues’ words of warning. In the finale episode, Teddy suddenly collapses.
Clearly, whatever is going on is connected to the toothache. Ironically, toothaches and jaw pain can be symptomatic of heart attacks in women or signs of heart spasms. As an attending cardiothoracic surgeon, who was once head of the department, it’s a fittingly wild turn that Teddy was unable to detect her own heart issues. This also opens the door for Winston, the newly appointed Head of Cardio, to perform a life-saving procedure on Teddy.
Amelia’s Sister Will (Somehow) Blame Her For Lucas’ ADHD Diagnosis
While Amelia may have been close with her brother Derek Shepherd (Patrick Dempsey), she has a much more complicated relationship with the rest of her family of doctors. In fact, her sisters didn’t even attend her ill-fated wedding to Owen Hunt (Kevin McKidd). In season 19, viewers learn that one of the new surgical interns, Lucas Adams (Niko Terho), is Amelia’s nephew. So far, it’s not clear which Shepherd sister is Lucas’ mom, but some signs point to Nancy Shepherd, a Connecticut-based OBGYN.
Later on in Grey’s Anatomy season 19, Nick has a heart-to-heart with Lucas. Nick not only notices that the intern is neurodivergent, but that Lucas exhibits signs of undiagnosed ADHD. As someone who also has ADHD, Nick is able to clock it; Lucas, however, can’t believe his family of doctors never noticed, and that they blamed him for never being “good enough.” One of Amelia’s sisters, Kathleen, is a psychiatrist — it would be quite the turn if Kathleen is Lucas’ mother, and she missed diagnosing her own son. Suffice it to say, all of this would somehow come back to bite Amelia.
Winston & Maggie Will Divorce
Winston and Maggie had an incredibly tumultuous season 19, to say the least. Friction in their marriage turned to friction in the OR, especially when the pair realized they had some fundamental differences in how they viewed work and love. At one point, Winston thinks about quitting cardio: he believes working in a different department from Maggie will save their marriage. The ever-driven Maggie, however, tells Winston she can’t respect him for that choice.
Later on, the pair puts aside their differences to perform an incredibly complicated surgery. At first, Maggie gets all the credit for the procedure — even though she doesn’t want that — and Winston blames her, frustrated that he’ll always be living in her shadow. Maggie ends up leaving the hospital for other pursuits, but the still-married couple meet up in Boston ahead of the Catherine Fox Awards. Given their joint nomination, the two realize they might have chemistry in the OR (and the bedroom), but that marriage isn’t for them, meaning season 20 will likely feature a (mature) divorce.
Trey’s Life-Threatening Crash Will Complicate Lucas & Simone’s “Happy Ending”
In the penultimate episode of season 19, Simone Griffith (Alexis Floyd) seems to be forging ahead with her marriage to long-time beau and fellow surgeon Trey (William Martinez). On the morning of her wedding, Simone heads to Grey Sloan to see Lucas; although it’s under the guise of asking him a work-related favor, the romantic tension between the two is palpable. After seeing multiple omens ahead of her nuptials, Simone jilts Trey.
Someone fleeing their wedding while walking down the aisle isn’t the episode’s most dramatic turn, though. After leaving, Simone rushes to the hospital to confess her feelings to Lucas — and grab an on-call room, in true Grey’s Anatomy fashion. Lucas is later called to help with a trauma case: the doors of the ambulance open to reveal Trey, who’d gotten into a car accident while chasing after Simone. Trey’s ability to operate hangs in jeopardy too. Although Lucas and Simone are mirroring a legacy couple from the series, this development will no doubt mar their seemingly happy ending.