How ‘Grey’s Anatomy’ Revolutionized Pop Culture — and Why It’s Not Done Yet

She might change her mind; she certainly has before. But midway through an interview, Ellen Pompeo casually drops the bomb that after more than 360 episodes, the upcoming 17th season of “Grey’s Anatomy” may be its last.

“We don’t know when the show is really ending yet,” Pompeo says, answering a question that was not at all about when the show might end. “But the truth is, this year could be it.”

Pompeo has played Meredith Grey — the superstar surgeon around whom “Grey’s Anatomy” revolves — since its start. The show, created by Shonda Rhimes, premiered on ABC on March 27, 2005, and became an immediate, noisy hit. Since then, for a remarkably long time in Hollywood years, the drama has been among the most popular series on TV, even as the landscape of television has changed seismically. At its Season 2 ratings height, the program drew an average audience of 20 million viewers. And all these years later — in a TV universe now divided by more than 500 scripted shows —“Grey’s” ranks as the No. 1 drama among 18- to 34- year-olds and No. 2 among adults 18 to 49. In delayed, multiplatform viewing, Season 16 averaged 15 million viewers.

Strikingly, technology is such that teenagers who were born when the show premiered, and later binged “Grey’s” on Netflix, watch new episodes live with their parents. The series has spawned two successful spinoffs for ABC, “Private Practice” (which ran from 2007 to 2013) and “Station 19” (which enters its fourth season this fall). “Grey’s Anatomy” has been licensed in more than 200 territories across the world, translated into more than 60 languages, and catapulted the careers of music artists — from Ingrid Michaelson and Snow Patrol to Tegan and Sara and the Fray — whose songs have played during key emotional sequences.

In its explosive initial success, “Grey’s Anatomy” was an insurgent force in popular culture. The Season 1 cast featured three Black actors — Chandra Wilson, James Pickens Jr. and Isaiah Washington — as doctors in positions of power at the Seattle hospital where the show is set, and Sandra Oh played the ambitious intern Cristina Yang, who would become Meredith’s best friend. For the women characters, the “Grey’s” approach to sex was defiant and joyful, starting in the pilot with Meredith’s one-night stand with Derek (Patrick Dempsey), who turned out to be one of her bosses at the hospital.

Rhimes presented these images to the world like they were no big deal, when in fact, nothing like “Grey’s” had ever been seen on network television. Krista Vernoff has been the “Grey’s Anatomy” showrunner since Season 14, as anointed by Rhimes, and was the head writer for the first seven seasons. She remembers the moment she realized how radical “Grey’s” was — a medical show driven entirely by its characters instead of their surgeries — as she watched an episode early in Season 1. “My whole body was covered in chills,” Vernoff recalls. “I was like, ‘Oh, we thought we were making a sweet little medical show — and we’re making a revolution.’”

Still, no one expected “Grey’s Anatomy” to become the longest-running primetime medical drama in TV history, outlasting “MASH” and “ER,” the previous record-holder. Since 2005, “Grey’s” has inspired countless women to become doctors, and along the way, its depiction of illness has even saved a few lives. The show has remained popular through three presidential administrations, the Great Recession, tectonic shifts in how people watch TV and two cultural reckonings — one feminist, one anti-racist — that demonstrate how ahead of its time “Grey’s Anatomy” has always been.

And they’re not done yet. When Season 17 premieres on Nov. 12, “Grey’s Anatomy” will tackle the subject of the coronavirus as experienced by the doctors at Grey Sloan Memorial, all while filming under strict COVID-19 protocols. The season is dedicated to frontline workers. And Pompeo, a producer on “Grey’s” — whose Meredith has removed a live bomb from a patient’s body, was in a plane crash, was widowed after Derek died in a car accident, was beaten nearly to death by a patient and, in a separate incident, actually did die briefly after a ferry accident — is intent on making the show top itself once again.

“I’m constantly fighting for the show as a whole to be as good as it can be. As a producer, I feel like I have permission to be able to do that,” Pompeo says. “I mean, this is the last year of my contract right now. I don’t know that this is the last year? But it could very well could be.”

Pompeo has been refreshingly transparent about her fight to become the highest-paid female actor on television, having detailed a few years ago how she negotiated a paycheck for more than $20 million a year. She clearly knows what she’s doing with these frank pronouncements as well.

As Pompeo laughs over the phone from her car, she says in a near shout: “There’s your sound bite! There’s your clickbait! ABC’s on the phone!”

The “Grey’s Anatomy” team — led by Rhimes and executive producer Betsy Beers — created the first season in a vacuum, because the show did not have an airdate. The 2004-05 season was a comeback year for ABC because “Desperate Housewives” and “Lost,” both of which debuted that fall, became phenomena — not only ratings successes but also watercooler events.

But at “Grey’s,” Rhimes was getting noted to death by network president Steve McPherson. According to Vernoff, McPherson — who resigned in 2010 under a cloud of sexual harassment allegations — stonewalled with “pushback every step of the way,” as ABC’s then- head of drama, Suzanne Patmore Gibbs, fought for the show. Vernoff was close with Patmore Gibbs, who died in 2018, and recalls her talking about her clashes with McPherson.

“He just didn’t get it; he didn’t like it,” Vernoff continues. “Honestly, I’m going to say, I don’t think he liked the ambitious women having sex unapologetically.”

Wilson, when she was cast as Miranda Bailey on “Grey’s,” was a New York theater actor (“Caroline, or Change”) relatively new to series television. But she was well aware of the network’s issues. “We took a creative break around the Christmas holiday, which to me meant ‘Oh, we’re out of a job.’”

Pompeo was frustrated: “Once we finally got an airdate, two weeks before that airdate they wanted to change the title of the show to ‘Complications.’”

In an email to Variety, McPherson disputed these assertions, saying, “I made the original deal with Shonda. I developed ‘Grey’s Anatomy’ at the studio. I picked it up at ABC.” He praised Patmore Gibbs, and added, “As for defaming me again and again, I don’t know what to say other than it’s sad that anyone feels the need to spread lies about me.”

Yet there was so little faith in the show that the writers were asked to clear out their offices when they finished the season. But to Vernoff, who had clicked right away with Rhimes, the early episodes had “felt like a labor of love.”

And it was worth the battle. “We fought for the right for Meredith and Bailey to be whole human beings, with whole sex lives, and not a network TV idea of likable,” Vernoff says. “You might not have been likable, but now you’re iconic.”

As far as the medicine went, the cases were often ostentatious. “Every kind of crazy accident that had ever caused terrible harm to any human ever, that was our homework at night,” Vernoff says. It was up to Zoanne Clack, an emergency room doctor-turned-writer, to be a sounding board in the writers’ room. She began as the only doctor on staff during the first season, and is now an executive producer. “What was interesting was that the writers don’t have those boundaries because they don’t know the rules, so they would come up with all of these scenarios, and my immediate thought was like, ‘No way!’” Clack says. “Then I’d have to think about it and go, ‘But could it?’”

When the program finally premiered — on a Sunday night after “Desperate Housewives” — to massive ratings, it was a shock to the cast and crew, given that they had shot the first season under a cloud, Pompeo says, adding, “So the fact that the numbers were that huge the first time we aired was a big fuck-you to McPherson!”

With Season 2 now a given, everything changed, Vernoff says: “It was like a hurricane-force gale, and everyone was just trying to hold on.” They had made 13 episodes for Season 1, airing nine of them and holding the final four for Season 2 — Meredith finding out that Derek was actually married (to Addison, played by Kate Walsh) had felt like the perfect finale. But upon the writers’ return, Vernoff says, the feeling was “Holy shit. We have to make 22.”

The entire cast — mostly unknown actors like Katherine Heigl as the sunny Izzie Stevens, T.R. Knight as the chummy neurotic George O’Malley, and Justin Chambers as the troubled, secretly vulnerable Alex Karev — had become famous overnight. For Wilson, whose Bailey was the stern teacher the interns called “the Nazi,” it was a new experience. “Folks were scared to talk to me, like in the store or in the Target — people would just kind of leave me alone,” she says. “It was like, ‘What’s going on?’”

According to Vernoff, “Paparazzi were following the cast to work — it was wild.”

The mid- to late-2000s were the height of glossy gossip magazines such as Us Weekly (and its copycats), as well as the inception of TMZ and Perez Hilton as celebrity-hounding, news-breaking forces that fueled (and soiled) the fame-industrial complex. The cast of “Grey’s Anatomy” was firmly in the sights of these new, often toxic forces in media.

Pompeo says the cast was so talented that it “was all worth it” — but yes, the transition to stardom was hard for the group: “At the time, it was just a real combination of exhaustion and stress and drama. Actors competing with each other — and envious.”

Heigl, Knight and Isaiah Washington all went through press cycles that made the show seem scandal-prone. To rehash it all now seems pointless; you can look it up. Washington was fired in June 2007. Knight and Heigl asked to be written out of the show preemptively, in Seasons 5 and 6, respectively.

Vernoff and the other writers were watching the internal messes unfold. They had to deal with how the fallout affected the show’s plot, as when Washington was fired just as Burke, his character, was about to marry Cristina. “When word comes down that an actor is leaving the show, and what you’ve got scripted is a wedding …” Vernoff trails off, laughing.

“There was a lot of drama on-screen and drama off-screen, and young people navigating intense stardom for the first time in their lives,” she continues. “I think that a lot of those actors, if they could go back in time and talk to their younger selves, it would be a different thing. Everybody’s grown and changed and evolved — but it was an intense time.”

Pompeo doesn’t want to talk about what happened with individual actors from the show, because when she has in the past, “it doesn’t get received in the way in which I intend it to be.” But she does make a point about the way television is produced. “Nobody should be working 16 hours a day, 10 months a year — nobody,” she says. “And it’s just causing people to be exhausted, pissed, sad, depressed. It’s a really, really unhealthy model. And I hope post-COVID nobody ever goes back to 24 or 22 episodes a season.

“It’s why people get sick. It’s why people have breakdowns. It’s why actors fight! You want to get rid of a lot of bad behavior? Let people go home and sleep.”

Debbie Allen would eventually be Pompeo’s savior in that regard, but that was years away. Allen — an actor and a dancer — began her directing career when she was on the 1980s TV series “Fame” as a “natural progression” because, she says, “I was in charge of the musical numbers, and so many directors didn’t really know how to shoot them.” She went on to be a prolific director and producer, most notably overhauling NBC’s “A Different World” after a tumultuous first season. As a fan of “Grey’s Anatomy,” Allen wanted to work on the show, and in Season 6, she was hired to direct. To prepare for it, Allen shadowed Wilson, who had been tapped to direct by executive producer-director Rob Corn. (“He came to me and said, ‘You should direct,’” says Wilson, who has now helmed 21 episodes. “And I said, ‘OK.’ Because I didn’t know what else to say.”)

Directing that sixth-season episode led to Allen’s fruitful relationship with “Grey’s.” In Season 8, Rhimes wrote Allen into the show to play Catherine, a star surgeon, a love interest for Richard Webber (Pickens) and the mother of Jackson Avery (Jesse Williams). Ahead of Season 12 in 2015, Allen became the show’s EP/director. Her duties included hiring all of the directors, weighing in on scripts and casting, and, as Allen puts it, “minding that people feel good about themselves.” Several years before the revived #MeToo movement would lead to calls for systemic changes behind the camera in Hollywood, Allen set a goal of hiring 50% women directors. She also increased the number of Black men who directed “Grey’s” during her first season as executive producer, among them Denzel Washington. (When she sold him on it, she recounts, he said to her, “I’m going to say yes, Debbie Allen.”)

Pompeo and Allen are close. Allen began her new role the year after Dempsey left, “at a time when we were really broken,” Pompeo says. “And so much of our problems were perpetuated by bad male management. Debbie came in at a time when we really, really needed a breath of fresh air, and some new positive energy.”

Pompeo continues with a laugh: “Debbie really brought in a spirit to the show that we had never seen — we had never seen optimism! We had never seen celebration. We had never seen joy!”

According to Pompeo, Allen began advocating for her to have more humane hours — Fridays off (Pompeo: “And I was like, ‘What? What? Fridays off?’”) — and for the show to shoot 12-hour days maximum, and ideally no more than 10 hours (Pompeo: “And I was like, I love this woman.”).

Allen speaks affectionately about her bond with Pompeo. “Coming out of Boston, she’s so earthy and real in a way that you might not know,” Allen says. “There’s a sisterhood between us — I guess you would say it’s almost a Blackness that exists between us. And she’s part of our tribe.”

Allen has been a key member of the “Grey’s Anatomy” brain trust since Season 12, and two seasons later, Vernoff returned to run the show. She’d left at the end of Season 7, consulted on “Private Practice” for a few years, and then went to Showtime’s “Shameless” for five seasons. As her contract was set to expire, Rhimes asked Vernoff to lunch, and told her she wanted her to take over. “It felt like she was saying, ‘Hey, our kid needs you,’” Vernoff says.

Before accepting the offer, Vernoff had to catch up on the show. She had always written “Grey’s” as a romantic comedy, and what she saw on-screen during her binge was dark as hell — especially after Derek’s death. “If this show that you are currently making is the show that you want ‘Grey’s Anatomy’ to be,” she recalls telling Rhimes, “I am, in fact, not the right writer for it.” But Rhimes was insistent, saying it was time for a change after the mourning period for Derek.

Vanessa Delgado, who started as a production intern during the seventh season and has worked her way up to being lead editor and co-producer, says the show’s trajectory shifted when Vernoff came back — it was a return to the original, saucier tone of “Grey’s.” “We changed the music completely,” Delgado says. “The dialogue felt lighter and more fun, and we were having fun again.”

That lightness will be difficult to maintain this year, of course, when, as Allen puts it, “COVID is No. 1 on the call sheet right now.”

Vernoff at first wondered whether “Grey’s” should ignore the coronavirus, thinking the audience comes to the show “for relief.” But the doctors in the writers’ room convinced her this wasn’t the time for escapism, saying to her, “This is the biggest medical story of our lifetime, and it is changing medicine permanently.”

When they’ve had doctors and nurses come speak with them this season, Vernoff says, “they were different human beings than the people we’ve been talking to every year. And I want to honor that, tonally. I just want to inspire people to take care of each other.”

Pompeo, who is not shy about offering criticism, sounds positively enthusiastic: “I’ll say the pilot episode to this season — girl, hold on.

“What nobody thinks we can continue to do, we have done. Hold on. That’s all we’re going to say about that!”

Pompeo has a few more months before she decides whether she wants to continue — and as Rhimes and ABC have made clear in recent years, the show will likely end when she leaves. “I don’t take the decision lightly,” Pompeo says. “We employ a lot of people, and we have a huge platform. And I’m very grateful for it.”

“You know, I’m just weighing out creatively what can we do,” she says. “I’m really, really, really excited about this season. It’s probably going to be one of our best seasons ever. And I know that sounds nuts to say, but it’s really true.”

Vernoff doesn’t worry about the creative well drying up. “We’ve blown past so many potential endings to ‘Grey’s Anatomy’ that I always assume it can go on forever,” she says.

And Wilson knows how important “Grey’s” is to its audience, in that the characters have essentially become people who “live in their house.” As one of only three actors who’ve been on “Grey’s” since the beginning — the other is James Pickens Jr. — Wilson is in it until the end: “In my mind, Bailey is there until the doors close, until the hospital burns down, until the last thing happens on ‘Grey’s Anatomy.’ That is her entire arc.”

Whenever the show does conclude, part of its legacy will be about the talent it launched into the world, beginning with Rhimes, who will soon release her first shows for Netflix, after her company, Shondaland, made a lucrative deal with the streamer in 2017.

But it will also be about the characters of “Grey’s Anatomy”— mostly women and people of color — who are trying to make the world a better place as they find friendship, love and community.

“The show, at its core, brings people together,” Pompeo says. “And the fact that people can come together and watch the show, and think about things they may not have ordinarily thought about, or see things normalized and humanized in a way that a lot of people really need to see — it helps you become a better human being. If this show has helped anybody become a better human being, then that’s the legacy I’d love to sit with.”