Grey's Anatomy is back and things got messy in the Season 16 premiere. The episode picked up shortly after the Season 15 finale, with Jackson (Jesse Williams) lost in the fog and Grey Sloan Memorial in turmoil after Meredith (Ellen Pompeo), Karev (Justin Chambers), and Webber (James Pickens Jr.) got fired for their part in Meredith's insurance fraud, but things moved quickly from there.

Jackson was found alive, thank goodness, helping a hiking couple that was (literally) hanging by a thread when Maggie (Kelly McCreary) and Vic (Barrett Doss) from Station 19 showed up to help. The couple was saved, but Jackson and Maggie's tenuous relationship was not. The two are officially done-zo, and after a time jump the Station 19-Grey's Anatomy romance that showrunner Krista Vernoff teased ahead of the premiere officially kicked off between Jackson and Vic. Maggie definitely has feelings about that and they aren't pretty — which means things are going to get awkward around the hospital sooner rather than later.

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Meanwhile, Webber and Karev found new jobs at Pac North, a hospital with a much less illustrious reputation than Grey Sloan, and their new mission will be turning it into a premiere destination for medical care. Karev also managed to push through his fears of Jo (Camilla Luddington) going crazy and leaving him and was really there for her after her 30-day stint at Grey Sloan and her time in rehab. She's doing much better than she was at the end of Season 15, but there's still a long road to go. Karev proposed once more so they could make their marriage official (turns out they never actually filed a license, which seems like a big oversight?)

Meredith had less luck on the new job front. She turned herself in to get DeLuca (Giacomo Gianniotti) out of jail. Thanks to her clean record and being an award-winning surgeon, she was only given community service. However, the premiere episode ended with the medical board deciding to pursue action against her medical license, which means that we could see Meredith stripped of the ability to be a doctor.

TV Guide spoke to showrunner Krista Vernoff about the jam-packed premiere and where the doctors of Grey Sloan (and now Pac North) go from here.

Meredith got the bombshell that her license is in jeopardy, and she seemed calm in that moment. Is she going to stay that way, or are we going to see a bigger reaction to the news once she processes it?
Krista Vernoff: Meredith is, sort of, stunned in that moment and taken off guard. As the reality of the stakes escalate and become more real for her, for sure, this is not an easy journey for her.

What does the season of Grey's look like if Meredith can't actively practice medicine?
Vernoff:
Well, it's a complicated question. It's hard to answer without giving away too much. For sure, there's a period of time, here, where Meredith can't practice medicine, and... She's got a lot of community service hours to work off.

It's been a minute since we've had such a contentious breakup on the show. How bad is it going to get between Jackson and Maggie as we move deeper into the season?
Vernoff: I realized, in watching it, how long it's been since we've had a really contentious breakup and it excited me. It felt exciting and really alive. There's so much energy that runs between those two actors and when you go from loving someone to kind of hating someone, that's not an easy thing to move through when you have to work with that person. I thought that was a really interesting story to tell.

<p>Jesse Williams and Kelly McCreary, <em>Grey's Anatomy</em> </p>

Jesse Williams and Kelly McCreary, Grey's Anatomy

Obviously there are some sparks happening between Jackson and Vic already. How slow are you planning to take that, considering the precarious emotional position both of them are in when they meet each other?
Vernoff: It's a little bit of a slow roll, for sure. As they acknowledged, one of them is coming out of a difficult breakup. One of them is coming out of something even more difficult than a breakup. And yet, life happens. I love Vic's acknowledgement that society really judges us if we don't just feel miserable for as long as humanly possible, but there's something there between them, and so it'll be interesting to see how it unfolds.

Amelia finds out that she's pregnant in this episode and her track record with being pregnant is terrible, to put it lightly. Will this revelation send her through another tailspin? How will she deal with this news, considering her traumatic past with pregnancy?
Vernoff: Amelia has a terrible history with pregnancy, it's true. This news is really complicated for her. I don't think it has to send her into a terrible tailspin, but she definitely has complicated choices to make, choices that are even more complicated than for someone without her particular history.

Karev and Weber seem to have found new jobs at a new hospital. What made you want to expand and go to a new place rather than have them campaign to get their jobs back at Grey Sloan?
Vernoff: I felt like we needed to be authentic to the consequences of the story that we told at the end of last season. I didn't want Bailey's firing of them to be like a bait-and-switch. I wanted to play it through. It felt, to me, like Richard's pain around what happened in that room, with both Catherine and Bailey, felt palpable in a way that I didn't believe he would go campaign to work for them or with them again immediately.

The idea of this other hospital felt like the authentic way to play that story through. I thought it was really fun and exciting, the idea of of them taking over a shitty hospital, a crappy hospital... The idea of, like, "Oh, they've got to turn this place around." We've always seen these doctors working in a great hospital, with great resources, and great support, and a great staff. What is it for those two doctors to go try to turn around a sinking ship, felt like really ripe storytelling.

There's a Light at the End of the Tunnel for Jo on Grey's Anatomy

Karev was stressed out as chief when he was in charge of a working hospital. What are his growing pains going to be like when he has to be all hands on deck to turn this new hospital around?
Vernoff: Well, he was stressed out, but he was also excellent at it. That was the reveal at the end of the day, was that Bailey and Richard said, "He was better at this than we were." He had some really good ideas as chief. So, in a strange way, because of his upbringing, he's pretty comfortable in a chaotic environment and he has an opportunity to shine even more. But yes, it's a challenge, for sure.

He proposes to Jo again in the premiere. Does that mean that there's potential for another Alex and Jo wedding, or will that be more of an off-screen situation?
Vernoff: I'd say there's potential in that proposal.

Koracick is ticking around to wait for Teddy. Should we be rooting for him over Owen?
Vernoff: Everything is complicated on Grey's Anatomy this season! It's hard for me to say who anyone should root for or against. I think it's a human, messy, complex season. Who I'm rooting for in general changes from week to week and I suspect it may for you as well.

Grey's Anatomy continues Thursdays at 8/7c on ABC.