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Grey’s Anatomy’s Ellen Pompeo Reveals Big Season 18 Change For Meredith That Honors Derek Shepherd

Meredith and Amelia look at her lab on Grey's Anatomy.
(Image credit: ABC)

The surgeons of Grey-Sloan Memorial Hospital have a lot going on in this season of Grey’s Anatomy so far. Richard is revamping the residency program, Addison Montgomery has her eye on a Catherine Fox Award with her uterine transplant surgery, and Amelia is working is with David Hamilton and Kai Bartley to cure Parkinson’s. But it sounds like Meredith’s got something cooking as well, as she feels the post-COVID pressure to do something monumental. 

Ellen Pompeo spoke to Dr. Sanjay Gupta on her podcast Tell Me with Ellen Pompeo, where she discussed her interest in the microbiome, and the role that gut health plays in being able to fight disease. Pompeo’s personal interest is going to bleed into her character’s plot, as it were, with Pompeo revealing that Meredith is about to take her ferry boat scrub cap in a direction that her late husband, Derek “McDreamy” Shepherd, would likely approve of. In her words:

On Grey’s Anatomy this season — I’m giving away a spoiler here — Meredith is about to change her specialty and go back to neuro, because we want to address these findings that our microbiome and our gut, our second brain, are as important as our first brain, and we should start treating them as such. So that’s going to be my storyline this season, and I’m absolutely fascinated with it, so I’m pretty excited about that.

Meredith’s upcoming change of specialty from chief of general surgery back to neurosurgery satisfies two purposes. The study of “our second brain” will be her way of contributing something significant to the medical community in the show's fictional aftermath of the pandemic. And switching back to neurosurgery is also way to bring part of star neurosurgeon Derek Shepherd back into the hospital. 

Longtime Grey’s Anatomy fans might remember that Meredith’s first preference was neuro — and certainly Derek had something to do with that — but after she was caught tampering with Derek’s Alzheimer’s trial, she switched her focus to general surgery. Perhaps Addison’s presence in Seattle sparked something in Meredith? Derek’s ex-wife broke down in an elevator upon her return, saying that being in the hospital without Derek made his death feel real. 

But along with any motivations related to McDreamy, we know Meredith feels the pressure about what her next move will be professionally. In the Season 18 premiere “Here Comes the Sun,” Ellis Grey appeared in Meredith’s dream asking what she was going to do now that she survived COVID. The surgeon confided to her friend (and potential love interest) Nick Marsh — who survived his own medical trauma — that she was afraid to fail in her first venture since being sick. 

Does Meredith’s big change also mean she’ll have a bigger role in David Hamilton’s Parkinson’s research? Meredith brought in Derek’s sister Amelia — a star neurosurgeon in her own right — who’s already hit the ground running. Since this new storyline for Meredith hasn’t yet been addressed on Grey’s Anatomy, we’ll just have to wait and see what all of this means, and whether it'll include another surprise cameo from Patrick Dempsey.

Grey’s Anatomy airs at 9 p.m. ET Thursdays on ABC. Check out our 2021 Fall TV Schedule for all of the upcoming premieres. 

Heidi Venable

Mom of two and hard-core '90s kid. Unprovoked, will quote Friends in any situation. Can usually be found rewatching The West Wing instead of doing anything productive.