Grey’s Anatomy’s 450th Episode Featured Classic Callbacks And A Gnarly Injury, But I Can’t Get Over One Twist’s Real-Life Connection

Amelia and Maggie smile at each other on the couch in Grey's Anatomy Season 22 episode "We Built This City."
(Image credit: Anne Marie Fox/Disney)

Spoiler alert! This story contains major spoilers for the first two episodes of Grey’s Anatomy Season 22. They can be streamed with a Hulu subscription if you need to catch up.

Grey’s Anatomy hit a pretty impressive milestone Thursday night on the 2025 TV schedule, celebrating its 450th episode. “We Built This City” paid homage to past eras of the medical drama with several references to past seasons and another of its signature gnarly medical cases. We also saw a couple of familiar faces return, including Kelly McCreary, whose character Maggie was involved in a twist that has meaningful real-life connections to writer Zoanne Clack and creator Shonda Rhimes.

The second episode of Season 22 picks up in the days following the hospital explosion that resulted in the death of Monica Beltran. As expected, Caterina Scorsone’s Amelia Shepherd is taking the loss particularly hard, causing Maggie Pierce (Kelly McCreary) to return to Seattle to help Meredith Grey (Ellen Pompeo) care for their sister and deliver some exciting news.

Meredith and Amelia look at Maggie in shock in the Grey's Anatomy Season 22 episode "We Built This City."

(Image credit: YouTube TV)

Longtime Grey’s Anatomy Writer Reveals Personal Connection To Maggie’s Pregnancy Reveal

Sisterhood has always been an important part of Grey’s Anatomy, starting with “twisted sisters” Meredith and Cristina Yang back in the early days, and then Lexie Grey (who probably deserves a collective apology, particularly for her death that even Shonda Rhimes admits was “horrifying”).

Without Cristina and Lexie around, Meredith bonded with her half-sister Maggie and sister-in-law Amelia, and it was wonderful for this milestone episode to reunite them after Kelly McCreary exited the series in Season 19. Even more, Maggie announced that she’d decided to start a family and was having a baby through a donor.

Zoanne Clack, who’s been a writer and producer on Grey’s Anatomy for nearly its entire run, explained why they made this choice for Maggie, telling The Wrap:

When Maggie came back, we wanted to show that she was doing well and that she’s moving forward with her life. And in Grey’s, we always love a good pregnancy. We toyed with a bunch of different ways it could have happened. Was she in a relationship? Was she getting married? But we landed on this because it felt like something a strong, independent woman who wanted to forge forward with her life would do.

The choice to become a single mother could also be a nod to Shonda Rhimes, who has two daughters through adoption and one through surrogacy, and to Zoanne Clack, who made the same choice as Maggie and included a pretty personal easter egg in the episode. When Meredith asks who the father of Maggie’s baby is, she gives them a donor number, and Clack revealed:

Her donor number is my donor number.

What a special thing for Zoanne Clack to be able to do! She couldn’t confirm whether or not we’ll see Maggie anymore in Season 22, but we’ll definitely get updates on her pregnancy, as well as reactions from Richard Webber — James Pickens Jr.’s character is getting a grandchild! — and Maggie’s ex-husband Winston Ndugu (Anthony Hill).

Meredith and Maggie sit on a bench by the carousel in the Grey's Anatomy Season 22 episode "We Built This City."

(Image credit: YouTube TV)

“We Built This City” included several classic Grey’s Anatomy references — for instance, did you catch Lucas Adams’ “Seriously?” when finding out Simone Griffith slept with one of the new interns? (What, he didn’t like Simone taking a page out of his favorite uncle’s playbook?)

The most profound of these blasts from the past was the return of Kate Burton as Meredith’s mom Ellis Grey and her famous metaphor about life:

The carousel never stops turning, you can’t get off.

The carousel represents trauma for Meredith and her mother, which we’re reminded of in the episode’s opening scene. She’s having a nightmare about performing surgery on the carousel as her kids cry out for her to make it work. Her mom is there, too, barking at her to be faster, and we hear the words from Season 3 that clearly continue to haunt Meredith:

I raised you to be extraordinary.

But later in the episode, Meredith recontextualizes that word and the carousel, as her three kids enjoy the ride while she and Maggie talk. When her sister tells her she’s doing great with her children, Meredith says:

They have their moments, but overall they’re pretty extraordinary.

Not only did the moment show how Meredith is moving past her mom-related trauma, but Maggie is too, as she admits she's heartbroken to be having a child after her adoptive mom Diane Pierce’s Season 13 death. Meredith promises to be there to give advice, and as for Diane:

She’ll come up in ways you don’t expect.

Just as Ellis always does. I love how this episode acknowledges classic moments from Grey’s past as a way to advance the characters’ current stories, and it wasn’t just the carousel.

Kevin McKidd is shown sitting outside the trailer that used to be Derek Shepherd's in the Grey's Anatomy Season 22 episode "We Built This City."

(Image credit: YouTube TV)

Richard Is Chief Again, And Owen Finds A (Familiar) New Home

Owen Hunt and Teddy Altman (Kevin McKidd and Kim Raver) are always in turmoil, but at least with them deciding to split up in the Season 21 finale, they’ve got a good reason. After getting an assist from Richard on some paperwork, an overwhelmed Teddy admits that she wants to be a surgeon more than a suit, and the easiest transition of power ever takes place, with Richard agreeing to take over as Chief of Surgery.

This warms my heart, because that’s where he was when the series premiered back in 2005, and it’s where he belongs. Zoanne Clack admitted as much, saying:

Richard will never not be the chief. Even when he isn’t chief he is the chief.

It’s so true.

As for Owen, he’s apparently been living out of the on-call room since moving out of his and Teddy’s house. By the end of the episode, however, we see that he’s back living in Derek “McDreamy” Shepherd’s old trailer. Wow, it’s been a minute since we’ve seen that mobile marvel.

Ben and Miranda look at a man impaled by a forklift in the Grey's Anatomy Season 22 episode "We Built This City."

(Image credit: YouTube TV)

You Can’t Have A Grey’s Anatomy Milestone Without A Major Medical Emergency

One other moment from the October 16 episode reminded me of the old Grey’s Anatomy days, and that's thanks to the episode's weird medical emergency. For the 450th episode, the show seemed to draw inspiration from a past case, because the man who was impaled by his forklift was very reminiscent of Season 2’s “Into You Like a Train,” in which two people were impaled together by a large pole.

This story had a happier ending, and — like the examples above — it also moved the plot forward, with Miranda Bailey (Chandra Wilson) promoting her husband Ben Warren (Jason George) to Chief Resident after he went against her to make a life-saving call.

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Grey’s Anatomy Season 22 is off to a strong start, especially with this big milestone episode. Zoanne Clack — the credited writer on “We Built This City” — did a great job of weaving classic moments with current storylines, and I love that she was able to incorporate her own story into Maggie’s pregnancy plot.

Tune in to see how everything plays out, with new episodes airing at 10 p.m. ET each Thursday on ABC.

Heidi Venable
Content Producer

Heidi Venable is a Content Producer for CinemaBlend, a mom of two and a hard-core '90s kid. She started freelancing for CinemaBlend in 2020 and officially came on board in 2021. Her job entails writing news stories and TV reactions from some of her favorite prime-time shows like Grey's Anatomy and The Bachelor. She graduated from Louisiana Tech University with a degree in Journalism and worked in the newspaper industry for almost two decades in multiple roles including Sports Editor, Page Designer and Online Editor. Unprovoked, will quote Friends in any situation. Thrives on New Orleans Saints football, The West Wing and taco trucks.

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