'Grey's Anatomy' Season 19 premiere recap: New intern's connection to Derek Shepherd revealed

This story contains spoiler details of the Grey’s Anatomy Season 19 premiere episode.

Grey’s Anatomy Season 19 (Thursdays at 9 p.m. ET/PT on CTV, CTV.ca, and the CTV app in Canada) marked the return of the residency program at Grey Sloan Memorial, but what really made us emotional in the season premiere of the medical drama was the introduction of a new character, Lucas Adams (Niko Terho), the nephew of the Dr. Derek Shepherd (Patrick Dempsey), who Dr. Meredith Grey (Ellen Pompeo) brought on as a new intern.

Lucas starts off pretty self-righteous when he first arrives at Grey Sloan but it is quickly evident that he’s the weakest link in the group, and gets himself into trouble after telling the wrong patient’s mother that her child was brain dead.

The episode ends with a triple transplant, led by Dr. Nick Marsh, played by Scott Speedman (more about where his relationship stands with Meredith coming up), with Lucas part of the procedure as well.

“Derek was a God to him,” Dr. Amelia Shepherd (Caterina Scorsone) says to Meredith as they observe the surgery. “Lucas was Derek’s favourite nephew and I do love him, so I hate to keep saying this, but I don’t think he has what it takes,...he doesn’t follow instructions, he has to do everything his way, did you hire him because he reminds you of Derek?”

“No, not Derek,” Meredith says in response. “He does need to do things his own way but he also has a stroke of the family genius and he’s a bit of a black sheep.”

That’s when Amelia finally clues in that Lucas reminds Meredith of her.

There are also little nods to Derek by Lucas in the season premiere, for example, when he says “it’s a beautiful day to save lives,” which we've heard Derek say before surgery.

Some things about 'Grey's' never change

The episode may be called “Everything Has Changed” but Grey’s Anatomy has actually shown us that some things haven’t really changed at all, with the episode filled of scenes that are mirrors of Season 1, when we first met the original group of surgical interns.

Grey’s Anatomy even has some fun with the similarities, like when Link (Chris Carmack) realizes he slept with new intern Jules (Adelaide Kane) when she shows up for her first day at Grey Sloan. Link goes to tell Meredith, who responds by telling him to go to HR and to “stay away from elevators for the foreseeable future.”

Romance is definitely in the air at the hospital (often the case in Grey’s Anatomy) and we finally get to see Meredith talk to Nick about their relationship. She says that, after she rejected his offer to move to Minnesota, she called out for him. Nick responds by saying he heard her, but he was hurt and he wanted her to do more than just call his name.

With the episode ending with Meredith offering Nick a position as the residency director at the hospital, we’re sure this isn’t the end of that love story, while we’ll also be watching to see what comes from Owen Hunt (Kevin McKidd) and Teddy (Kim Raver) returning to the hospital, as per Meredith’s request.

New interns

While it’s impossible to replicate the crew of interns that started it all, Season 19 of Grey’s Anatomy gives us an interesting group to start this new journey with, and learn more about as the season progresses, including interns played by Niko Terho, Adelaide Kane, Harry Shum Jr., Alexis Floyd and Midori Francis.

One character we’re particularly keeping our eye on after the season premiere is Simone Griffith (Floyd), who was late on her first day but seemingly the most savvy intern in the group. We leave the premiere episode with her telling Dr. Richard Webber (James Pickens Jr.) that her mother died giving birth to her at the hospital where they work, and she was late on her first day because she had a panic attack that morning.

Even 19 seasons into the show, Grey's Anatomy still knows how to suck us in and tug at our heartstrings.