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.
4. 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.
3. 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.
2. 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.
1. 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.
