‘Grey’s Anatomy’ Boss Breaks Down Season 23’s Surprise Pregnancy and That Texas Spinoff

Note: This story contains spoilers from “Grey’s Anatomy” Season 23, Episode 1.“Grey’s Anatomy” is back for Season 23, kicking things off with moral dilemmas, a doctor quitting their job and a surprise pregnancy.That’s right! The end of Episode 1, titled “Collide,” gave us one big shock after another, with Dr. Simone Griffith (Alexis Floyd) facing a positive pregnancy test from two potential baby daddies. And that was after Dr. Jo Wilson (Camilla Luddington) told her husband — who’s been over-using painkillers — that she quit her job. Meredith (Ellen Pompeo) also butted heads with Catherine (Debbie Allen) and Richard (James Pickens Jr.), after confronting them for how a patient from the new VIP floor kept her from effectively treating another patient. The VIP floor is a new hospital feature enacted by Catherine and new doctor Seth Norton (James Wolk) — Grey Sloan’s new chief of surgery after the exit of Dr. Teddy Altman (Kim Raver) and Dr. Owen Hunt (Kevin McKidd) last season. The premiere even made a quick joke about their exit at the expense of the fancy new floor. Blue (Harry Shum Jr.) was also in denial about being fired and treating his online French teacher in secret, while the actor who plays him thrives as a contestant on “Dancing With the Stars” at the same time. “What do I think people are going to be the most surprised about? Where this VIP floor goes, I’m excited,” showrunner Meg Marinis told TheWrap. “And how people come back to their, if they come back.” The VIP floor will test the doctors as they face the reality of compromising their oath of care with changing how they do things in search of the hospital’s financial feasibility. That’s been a recurring storyline on “Grey’s” Season 6, when the Seattle Grace hospital merged with Mercy West. Then Season 9 saw several doctors, including Meredith Grey, buy the hospital with the help of Catherine’s foundation and establish Grey Sloan Memorial hospital. Caterina Scorsone in “Grey’s Anatomy.” (Disney/Ser Baffo) Those changes spark the central theme of “identity” for this season of “Grey’s Anatomy,” as the show faces its own potential changes to continue producing new episodes in 2026. The show is expected to cut back on its typical 18 episodes, and already saw the exit of two long-running cast members due to budget constraints. At the same time, the “Grey’s” franchise is expanding once more. Marinis is hard at work with head honcho Shonda Rhimes on a still untitled spinoff series that will be set in Texas. Not much is known about the show just yet, but it is expected to premiere midseason in 2027 and Marinis has a title in time. Below, the showrunner tells TheWrap about Season 23’s intriguing new storylines, the next dark storyline for Jo and more about that spinoff. This conversation has been edited for length and clarity. Big changes at Grey Sloan TheWrap: Grey Sloan is opening a controversial new VIP wing to make money. What drew you to exploring this hospital storyline this year? Meg Marinis: Medicine obviously constantly changes. It’s changed so much in the 23 years that we’ve been on. I was really interested in showing that one of the ways that medicine has changed to survive is the rise of concierge care and personalized medicine, it’s popping up in private hospitals everywhere. And I love the conflict that it provides our characters. Grey Sloan has always prided itself on providing excellent care, no matter who the patient is. This new floor is confounding to many of our doctors. But it is a financial gain for the hospital when they’re in times of distress, like all healthcare institutions are right now. We’ll have to see, “Can our doctors remain who they’ve always been with this floor. The show has explored the financial impact on hospital dynamics from very early on, from two Seattle hospitals merging together to the doctors buying the hospital to keep it safe from a corporate chop shop. Now we’re meeting James Wolk as a business tycoon-y chief of surgery. Are we looking at Grey Sloan’s first adversarial chief? We’ll have to see if he’s adversarial. He will be for some people, but I’ll tell you what, Catherine Fox loves him. Meredith sees her ability to care for patients impacted by having to prioritize a VIP patient, and basically gets told to butt out because she doesn’t live there anymore. How does this set up the relationships between Meredith, Richard and Catherine this season? Time will tell, but we’ll certainly see that Meredith can’t have it both ways. She says she’s done with the leadership aspect of the hospital, but Meredith is never going to not say what she thinks. She’s the voice for all of us when we can see that something is wrong and we’re too scared to say it, she says what we’re too scared to say. That’s why we love her. And I think that probably deep down, Richard has probably some question about whether or not this is a good idea. But also it’s like, what do you do? Do you close your doors, or do you turn to methods that you might not have done in the past to keep them open? Harry Shum Jr. In “Grey’s Anatomy.” (Disney/Raymond Liu) Blue is still fired, but practicing medicine in secret and in a way enjoying the time away from the hospital. It’s not like the usual doctor break where they go to a really dark place before pulling themselves back to the OR. How can he make his way back? I think he’s probably in denial. There’s a road to earning back Richard’s trust, and it’s not easy. Richard, uncharacteristically, dug his heels in on this one. But I think he’s trying to make a statement and protect this hospital and residency program. So Blue’ll be put through his paces. And who knows? It may not be Richard who lets him back on the door. It may be somebody else. This storyline is happening as Harry Shum Jr.’s been killing it on “Dancing With the Stars,” and it was fun to see him practicing on set as he balances both gigs. How is it to have that crossover of sorts right now? When they came to us about it, we were so excited for him. Obviously, our whole staff and crew, everybody’s voting and rooting for him every week. And we’ll watch, we’ll put up a TV screen in between the stages on Tuesdays, and watch them while we’re filming. It’s funny because you’ll be just like walking through, and you’ll see, “Oh, there’s Jenna Johnson and Harry dancing in the breezeway.” It’s fun. She has a parking spot! Have you given Jenna a part yet? Not yet. They’re too busy. We’re already juggling one of them. But it’s very fun. We’re very excited, and some of us have gotten to go watch it live, which is nice. Doctor drama One person who is seemingly done is Jo, who quit at the end of the episode. And just as Link is definitely hiding his painkiller use. How dark are things going to get in this next chapter for this couple? Her traumatic health scare really impacted her. PTSD after birth trauma affects so many people, not that many people talk about it. It takes time to process, and I wanted to play the reality of that. She’s questioning her career. She’s questioning how she wants to parent. It’s a time of personal discovery for her, and there’s going to be ups and downs to that.I wanted to not gloss over it. We don’t take care of our postpartum moms very well here, and I wanted to at least acknowledge that. More attention needs to be paid to support them. Camilla is crushing it this season. I can’t wait for y’all to see one of the things that she’s done. There’s the added layer of Link, and he’s going through what he’s going through. Last year, we were talking about how Link has always been this protector, making sure that other people are OK but not being good about taking care of himself. What about him? You’ll have to wait and see. But he hasn’t been able to come up for air, and he’s been pushing his own health and needs aside. How long can they go with keeping this from each other, and how long can he go with keeping that to himself? Keeping his use of the painkillers to himself. He’s going to think he’s doing a great job for a while, but then that will obviously explode in storytelling. It’s one thing for him to take it for pain, but I think where it gets dicier is when we see that it might not just be for pain anymore. There might be a dependence there, and we’ll see what happens when he doesn’t take it and things like that. Jen Landon, Chris Carmack and Camilla Luddington in “Grey’s Anatomy.” (Disney/Ser Baffo) Winston and Jules are official, and now he is her direct supervisor after Bailey delegated residency director to him. Fans have had their reservations about this pairing from the start, how do you think they’re going to take that twist? People either love that couple or people are like, “What are you doing? I think that probably some people are going to think, “Oh, this is a trainwreck waiting to happen?” And I think some people are going to think, “Oh, maybe this means more sneaking around,” which is kind of a fun dynamic to watch. Everyone always loves a romance that feels like a forbidden love. I think people will be split on it. There’s always a couple that people are split on. But also, as we’re seeing Jules get more autonomy as a second-year resident, it’s going to be really interesting to see when she does make decisions on her own now that her boyfriend is the residency director, and what that looks like. Amelia and Toni reconciled after some classic “Grey’s” passive aggression and quarreling. What are you excited to explore with them this season? We love Jen (Landon), so we’re so happy that she’s back here, she fits right into the family. Right from the beginning, we’re seeing whether or not they can repair things after that cliffhanger. It’s been a month, Amelia wasn’t going into that thing with Cass to cheat on Toni. It was out of pain that she slept with Cass. She really thought that Toni was going back to her ex, so that’s what made all this even more painful. At the end of the day, for Toni, those feelings never disappeared. They’re quite perfect for each other, and a lot of the things that Amelia struggled with in her last relationship with Kai, those challenges don’t exist with Toni. SoI’m excited for them. They have great chemistry, and we’ll see, “Can they be happy for long.” It’s “Grey’s,” so probably not. Toni’s son is on the other side of the door when they have their big reunion. So I’m sure that family dynamic will play into things at some point. Obviously, Amelia has her kids. So family chaos, is that part of the equation? Will we meet Toni’s ex? That’s always a possibility. Caterina Scorsone and Jen Landon in “Grey’s Anatomy.” (Disney/Raymond Liu) Simone gets huge news with a positive pregnancy test, as she doubles down on her relationship with Wes and asks Lucas for space. What’s next for them? For Simone, it’s whether or not she involves anyone in that piece of news. Will we ever find out who is in this with her and who’s not? But I think her saying to Lucas that she needs space is her doubling down on trying not to go back there again. When she says that, it still looks slike she still has lingering feelings, then we realize why. Showrunning and the new spinoff This is your fourth season as showrunner and it’s been a privilege to get to speak to you throughout your evolution of the show. What are some of the things you know now that you wish you could’ve told yourself on Day 1 of being in charge? Maybe to give myself some grace. We’re all valuable here. Yeah. Let’s see. And to ask for help more. I’ve got a great team here, and everyone’s always willing to step up and move mountains to help create the best story possible, so just to trust that. Alexis Floyd in “Grey’s Anatomy.” (Disney/Raymond Liu) This year you’re adding another show into the mix with the Texas-set “Grey’s” spinoff, which as a fellow Texan I am very excited about. How has it been to balance producing one show while developing and now co-creating another from scratch? It’s one day at a time. It’s a little nutty, and I have to really be on top of my schedule about which hat I’m wearing. But I’m just grateful. To create a show with Shonda Rhimes. I mean, it’s one thing to be able to work for her, but to be able to do this with her, it’s a dream come true. And also for it to be about Texas, which is so dear to my heart, we’re just quite excited. I can’t wait for people to see the characters and the stories that we’re going to share. Where are you in filming for Grey’s? Will it be 18 episodes or is it going down to 13? We’re filming Episode 7. The schedule right now is still being figured out. We don’t have a final number to release yet. Where are you in the process of getting the spinoff out? Will we start hearing about the cast soon? It’s coming out midseason. Shonda and I are working away. Do you know the name yet? I have an idea, yes. “Grey’s Anatomy” airs Thursdays on ABC and streams the next day on Hulu.