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Pilot Inspector: Dissecting Grey's Anatomy, 10 Years Later

How does it hold up?

Joyce Eng

On March 27, 2005, Grey's Anatomy premiered and everything changed. OK, maybe not everything. But Shonda Rhimes gave us a whole new language, one of TV's best couples (Meredith and Cristina, not MerDer) and revolutionized Post-Its as the ultimate symbol of romance.

But when the pilot aired 10 years ago, was it possible to predict these lasting effects the interns of Seattle Grace Hospital would have on us? Joyce Eng, Sadie Gennis and Liz Raftery decided to find out.


Here's what you may have missed this week! TV Guide's weekend editor breaks down the week's best, worst, and weirdest TV moments.

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VIDEO: How well do the Grey's Anatomy stars know their medical jargon?

"A Hard Day's Night" synopsis: On her first day of work, Meredith Grey (Ellen Pompeo) is horrified to discover her drunken hookup from the previous night, Derek (Patrick Dempsey), is her new boss at the hospital. She joins fellow interns George (T.R. Knight), Izzie (Katherine Heigl) and Cristina (Sandra Oh) under the guidance of the terrifying resident Bailey (Chandra Wilson), aka The Nazi. The group struggles throughout their first day as surgeons, but none more than George, who earns the nickname 007 after his first patient is pronounced dead. And despite Meredith's best efforts to avoid Derek, after she and Cristina help him solve a medical mystery, Meredith winds up bonding with him over brain surgery. Maybe her talent for the "game" is genetic. Meredith's mother is famed surgeon Ellis Grey (Kate Burton). But as the final moments of the pilot reveal, Ellis is now battling Alzheimer's disease. *Cue Dido*

Liz: It usually takes me a few episodes to get really into a show, but I remember one of the things that struck me about Grey's was that I was pretty much hooked right away.
Joyce: As you know, I'm an ER disciple and while I have seen some Grey's episodes, I had never seen the pilot until now. It's a pretty solid pilot and some of the characters are sketched very vividly. I totally get why and how people got hooked; it was just never my thing. But I appreciate that it knows what it is from the get-go: a soap through and through, right from the opening frame -- a post-coital hangover. It's just set against a medical backdrop.
Sadie: I have a hard time now explaining why I love Grey's so much -- because it's basically a bunch of terrible people who occasionally save lives after freak disasters -- but the pilot reminded me why I started watching in the first place: They weren't always annoying! Karev (Justin Chambers) and Burke (Isaiah Washington) aside, everyone used to be so great. I don't think we've seen Meredith so happy and nice (especially towards her mother) ever since. And Derek is like a whole other person! He was flirty, charming, playful -- basically the complete opposite of the grade-A grumpus he's become. No wonder Meredith was once so willing to sacrifice so much for him. He really was McDreamy back in the day. And seeing how much he's changed over the past decade makes me kind depressed. Like, is no 'ship sacred anymore?

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Liz: They are all much less annoying. Maybe it's because they're young and we expect them to screw up. And Ellen Pompeo is so cute in the scene where she's saying goodbye to Derek. I forgot what pre-dark-and-twisty Meredith was like. Derek was so flirty and confident! Not to mention scrawny. It's like watching a different person. I love the scene where Meredith tells him about the high she felt after they perform their first surgery together. Look at those sparks fly!


Joyce: Well, if we're gonna talk about scrawny, hello, Meredith's arms! I know you're on a 48-hour shift (which, by the way, is now illegal. #themoreyouknow), but eat a sandwich. MerDer's insta-chemistry is disarming, and it really is sad to see how dour they've become just for melodrama's sake. What struck me the most about them was how Shonda subverted them. Meredith was the one who was kicking him out naked and forgetting his name. He was the one -- the professional superior -- who still wanted to pursue this frowned-upon affair (literally as we'd later learn). Sure, he's a cad for doing so, but his lax attitude (perhaps too casual) is a good contrast to assh--- Burke.

Sadie: Good lord, what is wrong with Burke?! I have never forgiven him for leaving Cristina at the altar (let alone for being played by Washington), but I had assumed he wasn't always that bad. And boy, I was so wrong. So very, very wrong. I get that becoming a surgeon requires a toughness George clearly didn't have, but it was so hard to watch the way Burke preyed on George like a lion attacking a baby gazelle. He should have been the one nicknamed The Nazi.
Joyce: Totes. I haven't seen enough episodes to decide if his characterization was a function of the writing or his acting, or most likely, both, but it's such a turn-off. I love villainous hardasses as much as anyone, but my biggest problem with him is that no proper doctor at a teaching hospital would demean an intern like that ("Get out of the way. Pansy-ass idiot.") You can be tough and chew out someone, and not be completely inappropriate.

Liz: Yeah, I was never a Burke fan and this episode reminded me why. Knowing what we know about Washington's on-set demeanor, I wonder how much of that was informed by him as a person. George really does seem so in over his head (and young!). Another thing that surprised me was how many references there were to things that crop up in later episodes. Cristina mentions the Harper Avery award (in reference to two-time recipient Ellis), and of course George gets called 007 after his disastrous surgery (RIP). His lack of promise gets brought up a few times, and of course we know that later on he's the only one of the interns who doesn't pass his boards.
Sadie: They mention 007, but no McDreamy! A true crime, if you ask me. But I do find it really interesting that everyone in the pilot grows and changes so much throughout their time on the show -- except George. He's the loving, bumbling underdog from his very first appearance all the way to the end.
Joyce: Womp, womp. (Side note: Grey's totally ripped off George's death from Gant's death on ER, which did it way better.) But I do like that consistency in his character. Same with Cristina's unwavering ambition. She's one of the best and most complex TV characters in the past decade and most of that is due to Sandra Oh's talents. Cristina was one of those few characters who was fully realized from the beginning.

Liz: I totally agree. Cristina's ambition and almost robotic dedication to her job/insensitivity towards others are at the forefront right from the start. Oh is really the only actor who seems to already completely own her character at this early point, and even if Cristina's not exactly likeable, she's entertaining to watch. Though, to be fair, she has a right to be pissed at Meredith for taking her spot on Derek's surgery in this episode -- even if it was Meredith who cracked the case.
Sadie: I imagine Shonda watching the scene between Cristina and Meredith in the library, where they seamlessly alternated between discussing Mer sleeping with Derek and brain aneurysms, and she was like: "Mic drop. I'm out!" Their relationship is far more interesting in the pilot alone than Meredith's relationship with Derek ever has been.


Joyce: I Liz Lemon-eyeroll at all the insane romantic entanglements Grey's has forced upon us -- many of which are shoehorned for no reason other than because these people cannot be single for an extended amount of time apparently -- but it's very clear that the relationship of the show is Meredith and Cristina. They're each other's person, BFFs, confidants, sisters -- and I think there's something maternal in their relationship, especially in hindsight, with Cristina not wanting kids and Mer's fractured relationship with Ellis. That last scene between them was bittersweet. Also, it's fun to see Kate Burton go from helpless Alzheimer's patient to this:


Liz: I completely forgot about the scene at the end where Meredith visits Ellis in the nursing home. It's easy to sometimes roll your eyes at Grey's nowadays, and all of its sentimentality, but this scene still struck a perfect emotional chord with me. It's a great reveal that Ellis has Alzheimer's, and knowing what we know now about Meredith's relationship with her mother, it's striking to see her taking an almost maternal role with Ellis.


Sadie: This was one of the only moments of Nice Meredith where I got really excited for how messy she was going to get later. I love how complicated and layered her relationship with Ellis became. Conversely, all the scenes with Alex made me so excited for how nice he became. Karev is now one of my favorite characters, but every time he popped on screen in the pilot, it was just to say some misogynistic, arrogant bull. But I do have to cut him some slack, since they had actually shot the entire pilot before casting Justin Chambers and writing in Karev. So, it's not like they had a lot of flexibility or time to give us a developed idea of his bad boy-with-a-heart-of-gold persona.
Joyce: It's kind of disconcerting how much of a cipher he is until you know the behind-the-scenes reason why. They didn't even do that great of a job mixing him into the episode, which was edited so unevenly. It was choppy and not suspenseful at all (gotta make room for those montages!), and it felt like they had no idea what kind of pace and style to go for yet. Plus, it looked hilariously cheap. Those pilot budgets, man! I do think it gave the show a more grounded feel since most hospitals don't look as clean, sophisticated and sexy as Grey Sloan Memorial Hospital does now.
Liz: It's clear that the music budget also got a significant boost as the show went on too. Other than that Rilo Kiley track in the first few minutes, the rest of the songs sound like B-sides from a lesbian folk album that was pulled out of a $0.99 bin. But in retrospect, it's interesting that the show used music in such a significant way from the first episode, even though the songs were integrated less smoothly than they were in subsequent seasons. Grey's eventually became a real touchstone for TV shows being a way for fans to discover new music, and for artists to get their music heard.

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Sadie: Yes! I felt the exact same way about the music. Though, there have definitely been times recently where I've felt Grey's was trying too hard with its music. (Can we all agree to forget the season that was scored entirely by bad '80s covers?) But that's the thing about Grey's. Even when it does something that I don't enjoy, I never consider quitting because the show is always evolving and whatever it is that annoys me will soon grow and change into something else. This is why I feel it's one of the few shows that could really survive long after its original cast members all depart.

Joyce: I'd say it already has. The list of shows that have not only survived massive cast turnover but endeared its new characters to fans is super short. So many of Grey's eventual fan favorites and couples (ahem, Calzona) won't be introduced for years, which is crazy to think about watching this. Like I said, Grey's is not my cup of tea. I like my medical dramas realistic, chaotic and visceral. Grey's traffics in the melodrama, relationships and emotional manipulation, and the medical cases veer anywhere from absurd to implausible. I think it struggles when it tries to toggle between the medicine and the personal, since the former is in service of the latter. But again, I completely understand why people fell in love with it from the start. I will never forget being forced to watch Denny's death and that hospital prom (kill me) with all the girls on my dorm floor. Grey's was arguably the last big network TV phenomenon and it's still going.

Liz: I don't know about it being the last network TV phenomenon (#Empire), but I get what you're saying, Joyce. I was also in college when it premiered and it was huge among my friends and classmates. It's also interesting for me to see the pilot from a different perspective: I was a college junior when Grey's premiered (i.e. younger than the interns), and now as a working adult (or so they tell me), I think I can look at them with a little more empathy, screw-ups and all. And it really is crazy to think that so many of the show's main characters now (Arizona, Mark, Owen, etc.) wouldn't be introduced for years. I've had an up-and-down relationship with Grey's over the years, but I think the pilot holds up. Watching it again definitely reminded me why I fell in love with the show in the first place.

Verdict: Grey's Anatomy has since had many bumps along the way, but its initial prognosis was healthy.

How well do the Grey's Anatomy stars know their medical jargon?