Sex dreams and explosive rectal surgeries—it must be the Grey’s Anatomy season 15 premiere

After fifteen seasons on the air, longtime fans know the world of Grey Sloan Memorial and the lives of Grey’s Anatomy’s characters inside and out. With that shorthand and context firmly in place, Grey’s can be remarkably efficient in its storytelling. Tonight’s two-hour season premiere crams in half a dozen major storylines, even more subplots, and a whole bunch of different medical cases. Plus it finds time to introduce some major new characters, shake up the hospital’s structure, and set a clear season-long focus for its long-running protagonist. A newer show still fleshing out its world wouldn’t be able to do all that in just two hours, but by this point Grey’s Anatomy is a well-oiled machine. And there’s a lot of comfort in watching a show confidently do what it does best.

For longtime Grey’s fans, this two-hour premiere is a big ol’ plate of comfort food. Only in this case “comfort food” means a medical subplot that doubles as a PSA encouraging straight men not to feel ashamed of (safely) involving their anuses in sexual intimacy—a subplot that ends with a man dying in surgery when a can of hairspray lodged in his rectum explodes into a fireball. It’s perhaps the most Grey’s Anatomy storyline to ever happen in the history of Grey’s Anatomy. Really the only surprising thing about it is that we don’t get a tearful scene of his widow hearing the news and grappling with what’s happened. Actually, most of tonight’s medical storylines feel a bit underbaked and unfinished, which has been a pretty common problem in this latter era of Grey’s. The show simply has too many doctors to give the patients much screentime anymore. But tonight’s premiere echoes a more patient-focused time in Grey’s life with the story of matchmaker Cece and car accident victim Neesha. Cece’s insistence on looking out for Neesha calls to mind any number of past episodes in which two strangers form a close friendship while under the care of our intrepid doctors (the two people stuck on a pole in “Into You Like A Train,” the burn victims in “She’s Leaving Home,” etc). Neesha is the less developed of the two characters, which undercuts the tragedy of her ultimate death. But Cece is a welcome addition to the roster of memorable, instantly likable Grey’s patients. Even better, it looks like she might be sticking around for a bit.

Cece’s occupation as a professional matchmaker firmly establishes a major theme of the season, which showrunner Krista Vernoff has dubbed “the season of love.” And there’s plenty of that to go around. Amelia and Owen decide to give their on-again, off-again relationship another go. Maggie and Jackson strengthen their relationship, even as Jackson seems to be going through an existential crisis. Glasses-wearing intern Schmitt gets hit on by angelic ortho doc Nico Kim (new castmember Alex Landi). And Jo and Alex have a successful, if slightly unusual, start to their marriage as she spends most of their honeymoon working on a new medical idea. But the biggest area in which the “season of love” theme emerges is with Meredith Grey herself.

The best thing about late stage Grey’s is the way Meredith has totally blossomed as a character following Derek’s death. But as great as post-McDreamy Meredith has been, the show has struggled to figure out what to do with her love life since Patrick Dempsey exited the series back in season 11. There have been some weird false starts like Riggs and that random eyeliner-wearing military doctor, and the show has also occasionally toyed with the idea of just not giving Meredith a love life at all. But tonight’s premiere offers a soft reboot of Mer’s life goals. She’s ready to find love again (and ready to have sex again, according to her overpopulated sex dreams), and she wants to start actively looking for it. Having Meredith take real agency over her love life feels like the right way to bring romance back into her world. Personally, I’m hoping Cece’s matchmaking will lead Meredith right back to that dreamy transplant surgeon Nick (Scott Speedman) from last season.

At least for now, however, Grey’s wants to leave open the idea that Meredith might hook up with new “ortho god” Atticus Lincoln (The O.C.’s Chris Carmack), otherwise known as Link. It’s not a romance I’m particularly rooting for (nor one I’m sure the show is actually going to go through with), but Link does bring an enjoyable new energy to the series. Carmack is great at playing obnoxious, entitled characters who are nevertheless kind of inherently likable (again, see The O.C. for more of that). And I do think there’s a value in continually adding new characters to the series so that its world doesn’t become too incestuous. Plus the slow motion shots of Link and Nico definitely feel like a nod to old school Grey’s.

Elsewhere, tonight’s premiere continues to explore cutting edge medicine, which is another thread Grey’s has been pushing harder and harder over the past few seasons. Jo—whose decision to stay in Seattle rather than move to Boston is the least surprising thing in the world—is planning to change the future of medicine by pioneering a way to target cancer cells on a genetic level. In addition to supporting that project, Bailey has also invested in a hyperbaric chamber (a.k.a. a basement submarine, a.k.a. a moon spa) in the hopes of using Hyperbaric Oxygen Therapy to help patients heal quicker. And since this is Grey’s, the chamber immediately gets used for a dangerous emergency surgery rather than as a space for healing. As with the other medical storylines, Jackson’s surgery on Neesha feels a bit rushed; I would’ve gladly watched a whole bottle episode just about that procedure (the shots of the doctors trapped in the chamber with Neesha’s dead body were some of the episode’s most compelling). But for a show that can sometimes feel like a relic from another age, Grey’s has at least led me to some really interesting Google searches about medical innovations.

Tonight’s premiere doesn’t reinvent the Grey’s Anatomy wheel, but it does play like an enjoyable greatest hits montage of the past 14 seasons. At this point, that’s pretty much exactly what I want from this series. So welcome back, Grey’s and long may you reign.

Stray observations

• The A.V. Club isn’t planning to regularly cover Grey’s Anatomy this season, we just wanted to check in on the premiere. I, however, will happily talk about the series anytime on Twitter.
• The reveal that Bailey chose Alex to be Interim Chief is maybe my favorite reveal in Grey’s Anatomy history. It’s also a smart way to give Alex a new storytelling lane for the season.
• After her big appearance in the season 14 finale, Teddy was used really bizarrely in this episode. I’m curious where her character goes from here.
• This episode was the most likable I’ve ever found DeLuca, but I’m still not sure he needs to be on this show.
• I really enjoyed the dynamic between Maggie and intern/former Air Force Lieutenant Casey Parker. I’d love to see Grey’s do more with the interns beyond just having Glasses be overly anxious all the time.
• Between lying about eating the weed cookies last season and now ignoring Webber’s direct instructions during surgery, thereby causing a patient to literally explode—it definitely feels like intern Vik should be fired.
• I know Amelia and Owen are divisive characters, but I like both of them and I especially like them as a couple. On the other hand, I’m supremely bored by Maggie and Jackson as a couple, even though I like them individually.
• I’m still mad at Grey’s for unceremoniously getting rid of April Kepner (and unceremoniously dumping Sarah Drew) after last season was her most compelling yet. Especially when it seems like they’re now just giving her faith storyline to Jackson.