How the 'Grey's Anatomy' Season 19 Premiere Serves as a Nod to Season 1

Sometimes a new beginning is just what the doctor ordered. The key parallels from Thursday's premiere to the early days of 'Grey's.'

Spoiler alert! Do not proceed if you have not watched the season 19 premiere of Grey's Anatomy.

Grey's Anatomy officially started a new chapter with the season 19 premiere, introducing a new class of interns and navigating a slew of major changes at Grey Sloan Memorial Hospital -- from restarting the residency program to bringing Grey Sloan back to its glory days.

In the lead-up to Thursday's opener, appropriately titled "Everything Has Changed," the latest season of ABC's medical drama was being called a "rebirth" for the long-running franchise amid news that longtime leading lady (and the center of the Grey's universe) Ellen Pompeo was stepping back and only appearing in only eight episodes. A combination of the old, along with the new. As the first episode unfurled, it was clear that Grey's was entering a new era as it harkened back to its storied past -- more specifically season 1 -- as it forged ahead on a different path.

With Meredith at the helm of Grey Sloan as the permanent interim chief of surgery, the once bright-eyed intern everyone fell in love with in season 1 has risen to the very top, calling the shots and being tasked with rebuilding the hospital to what it once was after the fallout of last season. Though her impending absence lords over the first episode, it's unclear the circumstances that will take her away from being as present as she has been over the last 18 seasons.

Either way, as the new group of medical residents hit the ground running on a complicated case involving multiple organ donors and transplant surgeries and Meredith navigated the complicated waters of trying to get the gang back together following a mass doctor exodus last season, there were several key callbacks and scenes that felt familiar for Grey's fans who have been there since the beginning. Sure, the colors of the hospital walls might be different and it may no longer be known as Seattle Grace, but the signature feeling of what makes Grey's timeless remains at the heart.

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"I think we have something really special happening this year. I think we know the show and we're all so familiar with all of the characters and some of the crazy storylines that we've had, but this year feels like a really defining moment," series star Caterina Scorsone told ET. "I feel like we're moving into a new chapter and a new era of the show that it really feels fresh and energizing for everybody on set."

Here are a few of the season 1 parallels in the season 19 premiere.

The Passing of the Baton...

At the start of the Grey's pilot, it's Richard Webber, then chief of the hospital, saying his famous speech to the first-year interns. Nineteen seasons later, it's Meredith giving that same famous speech in the OR. It's rare, as OG star Chandra Wilson noted, to have a show go as long as Grey's has and be able to successfully chart a character's evolution from intern to doctor to the top dog. That's, in any effect, what's happened here with Meredith. 

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"I think when we pass the baton, it's never about passing the baton and then you go away. If you pass the baton, then you move on to the next thing that's in store for this human being. And that's what we do in life. We teach our lessons, but then we're still learning our own life lessons at the same time," Wilson said. "And that's also something that I love that we give that to the audience to say, 'You can reinvent yourself multiple times over your life.' And in real-time, our audiences have gotten to see our characters reinvent themselves and move forward."

"For Richard, it's a chance to push the restart button and the new interns are going to help him do that," original cast member James Pickens Jr. told ET. "They're going to bring a new type of energy in there. Obviously, as Chandra said, his impetus is to get our accreditation back. That's what's made the hospital what it is and that's what helps to fuel these journeys and these stories. It's because we teach, and that's what he wants to get back, teaching these students. He likes the energy that they bring to him; it energizes him as well."

The New Interns Remind You Of...

Grey's has introduced dozens and dozens of new residents over the seasons, but season 19 puts them back in the spotlight as they go back to basics, refocusing the story on an intern's topsy-turvy journey. Fans quickly met Benson "Blue" Kwan (Harry Shum Jr.), Jules Millin (Adelaide Kane), Simone Griffith (Alexis Floyd), Lucas Adams (Niko Terho) and Mika Yasuda (Midori Francis) in the premiere, it may seem like deja vu for many viewers -- from their locker room banter to the same deserted hospital wing Meredith, Cristina, George, Izzie and Alex claimed as they lamented over their day's hardships. As the newcomers to the franchise recently revealed to ET, all of that was by design and meant to bring a sense of nostalgia to viewers.

"Having just refreshed my memory on the first couple of seasons, we all discussed it on set where we were like, 'Oh yeah, this scene is really similar to this one from season 1. And this scene is really similar to this one from season 2 and there's a lot of commonalities drawn,'" Kane said. "They're making a very clear effort to harken back to the beginning of the series, which I think is really cool. And inject a fresh sense of humor and fresh sense of fun just like those first couple of seasons and that's really wonderful."

Liliane Lathan/ABC

On paper, many of the new interns have similar personality traits to past memorable first-year residents. There's Blue, who's so cutthroat and zeroed in on being the absolute best, he's even willing to lie about having a brother who died to get what he needs from a patient's mother. (Elements of early Cristina.) Then there's Simone, who reveals her heartbreaking tie to Grey Sloan is by way of her mother dying while giving birth to her at the very same hospital. Of course, Jules finds herself in a storyline set up to parallel Meredith and Derek's early days of their love story after she has a one-night stand with an attending in Link. Even Lucas, whom Meredith later compares to what Amelia was like in those early years, has elements of Alex's early-day brashness.

"I think people will feel a huge sense of nostalgia when watching it this season," Terho promised, whose character's dynamic between Amelia gets a whole lot more interesting as the season unravels, Scorsone hinted: "They have some moments, but it's going to be a journey."

And That Iconic Line...

The episode really hit deep in its final minutes, as transplant surgeon Nick Marsh (Scott Speedman) -- who may or may not take the well-paid residency director position Meredith offers him on the spot -- uttered the iconic words once frequently said by another beloved Grey's doc: Derek Shepherd.

As they prepared for another surgery in one of the Grey Sloan ORs, he looked around the room and said, "It's a beautiful day to save lives."

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"We like touching back on nostalgic moments for our audience because we love to tease that, and it really kind of ingratiates them in a way to the show," Wilson told ET. "They really appreciate that."

The line was made famous by Derek, who said a variation of it in the 2005 pilot episode, and soon became a mantra for the show as his character regularly said it before surgeries. With those familiar words echoing through the OR once more, it was a sweet reminder that even amidst all the changes -- at Grey Sloan and behind the scenes with the show -- it's going to be just fine.

Here is the scene from the first episode of Grey's Anatomy.

Recapturing That Magic...

"The people who still pine for that energy of the first three seasons are going to be really happy because they're going to feel that at a certain point," Scorsone promised, explaining why Grey's is going back to the beginning in a sense. "Once the characters have learned all this stuff, it's hard to have that same dynamic between the upstarts and the mentors. And so you just can't recapture that once everybody has learned the medicine. To bring in this new group, it creates the possibility of more of those hilarious and tragic circumstances that they're trying to navigate with really high stakes."

Liliane Lathan/ABC

Wilson added that season 19 will serve as a reminder that, ultimately, "the lessons don't ever change" even if the people do. 

"Time marches forward, but the lessons are always there to get learned," she noted. "It talks about how the show stands the test of time. Time marches forward, but the way we deal with situations. First-year interning is first-year interning, regardless. We can change the color of the hospital I don't know how many times, in order to start things anew. But the work is the work. And either you have the passion for it as a surgeon, or you burn out and you're not going to make it. It's the same speech that Webber's been giving since the beginning, that Meredith is giving now."

Grey's Anatomy airs Thursdays at 9 p.m. ET/PT on ABC.

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