ABC’s hit primetime medical drama, Grey’s Anatomy, premiered in March of 2005 as a mid-season replacement series for the network. Fifteen years later, the series is still going strong having just wrapped its sixteenth season and already renewed for at least one more year.

The series is now the longest-running medical drama in television history, having surpassed E.R.‘s episode count two years ago, and its star, Ellen Pompeo is the highest-paid actress on TV. The success of this series was evident from the start and even from the first episode, it’s clear something special is about to take off.

10 The Title

Most series first episodes are simply titled, “Pilot”, but not the premiere episode of Grey’s. With the exception of one, every episode in the series is named after a song. The first episode is titled, “A Hard Day’s Night,” after the hit song from The Beatles.

The title of this episode plays into the storyline of Meredith and the other new surgical interns at Seattle Grace Hospital as they embark on their first forty eight hour shift at their new job.

9 The Voiceovers

Another key component to a classic episode of Grey’s Anatomy is the beginning and ending voiceovers. As the series progresses, different characters do the voiceover for different episodes, but for the first episode, viewers get to hear the inner thoughts of Meredith Grey, which is appropriate considering she is the central character for the series.

The show’s creator, Shonda Rhimes revealed in an interview recently that these voiceovers were never part of her original plan, but something added in post once the pilot was shot because upon viewing a cut of the episode, Shonda thought something was missing and a voiceover was the perfect way to tie everything together.


8 The Elevators

There aren’t many shots of or any scenes taking place inside the elevators in this episode, which seems a little off considering how many big moments take place in the hospital episodes as the series progresses.

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Derek proposes to Meredith in an elevator, George does major heart surgery in an elevator, and Alex almost dies in an elevator, but in this episode, we only see the elevator once, when Meredith is moving Katie to get a CT and gets lost, and these elevators don’t look anything like the elevators in future episodes.

7 Alex Isn’t One Of The Main Interns

The character of Alex Karev was added after principal photography wrapped on the pilot. The show’s creators thought there needed to be another male intern to balance out George’s character, which is how tough, snarky, sometimes rude, Alex came to be.

Alex shot his scenes later on and was edited into other scenes in post, which is why we don’t see much of him in the first episode.

6 The Cafeteria

Halfway through their first day of work, the interns meet up for lunch in the hospital’s cafeteria, but this location does not look like any of the other places fans are used to seeing the main characters meet and eat.

This cafeteria looks dated and a little blander. In future episodes, we see the gang meet in the basement or outside or if they are in a cafeteria, it seems a lot nicer than this one.

5 Meredith And Cristina

It really was love at first sight for these two best friends. From the moment they meet, Meredith and Cristina seem to have an instant connection and they team up to solve the mystery of Derek’s patient’s seizures.

In the library, Meredith opens up to Cristina about her one night stand with Derek, trusting Cristina to keep her secret. The two seem to have an easy rapport and they understand each other very well, which makes both secret sharing and making up after their first fight, very easy.

4 The Storyline

The biggest twist in the pilot episode is that the man Meredith sleeps with the night before her first day as a surgical intern, is now her boss. This storyline could have not aged well in a post Me Too Movement era, but it’s handled so well and the women are written to be empowered so that they are equals to their male co-workers.

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The writers don’t shy away from addressing the inherent issues of a male superior sleeping with a female intern and they do so in a way that never victimizes Meredith or makes Derek seem like a predator.

3 Derek’s Catchphrase

Any Grey’s Anatomy fan knows that Derek has to say “the thing” before every surgery, but most don’t know that this originated in the pilot episode. Derek is about to operate on Katie Bryce after Meredith and Cristina are able to diagnose her.

In the operating room, as he gets suited up, Derek asks for everyone’s attention and states, “It’s a great night to save lives, people.” From that moment on, every time Derek is about to operate he has to say it, and if he doesn’t there’s a superstition that the surgery won’t go well.

2 Derek And Meredith

Another example of love at first sight is the relationship between Derek and Meredith. Derek is clearly smitten with Meredith when he wakes up on her living room floor after a one night stand, but more feelings develop in this first episode.

After their first surgery together, Meredith expresses to Derek how exciting it was and she’s clearly attracted to his skill and talent. Derek listens to Meredith’s excitement and when they lock eyes it’s clear these two are meant to be.

1 Diverse Casting

At the time of Grey’s Anatomy‘s premiere, Hollywood was not considered very diverse, especially when it came to casting a series. This series broke a lot of molds and challenged a lot of traditional casting beliefs and stereotypes and that is evident in the very first episode. It’s important to note that three of the four bosses these new interns meet are black and one is female.

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From the very first episode, creator Shonda Rhimes put out a call for more diverse talent both in front of and behind the camera and this show paved the way for so many other series to start doing the same.

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