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Holy Sh*t, That Grey’s Anatomy Character Is Back. Here’s What It Means

Photo: Courtesy of ABC.
Warning: The most major Grey’s Anatomy spoilers ahead. 
“It feels like we were on Game of Thrones or something,” Grey’s Anatomy star Jake Borelli joked on an Instagram live video with his co-star Jaicy Elliot following the medical drama’s season 17 premiere. Borelli wasn’t wrong, since the two-hour Grey's Anatomy premiere event hid the biggest surprise of 2020 TV: the shocking return of Derek Shepherd (Patrick Dempsey) to Grey’s Anatomy
While fans may be overjoyed to see one of television’s most beloved characters back on their screens, the moment unfortunately seems to be a harbinger of even more tragedy for the halls of Grey Sloan Memorial Hospital. The reappearance of Derek — who is still very much not alive — spells medical doom for his wife, Grey’s Anatomy heroine Meredith Grey (Ellen Pompeo)
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At the beginning of Grey’s Anatomy's 2020 premiere — which was made up of episodes “All Tomorrow's Parties” and “The Center Won't Hold” — we see Meredith at a beach. She explains via voiceover the way that a tidal wave overcomes people standing on the shore. Then Meredith comes to in Grey Sloan. We’re meant to assume that beach is her daydream amid the crushing horror of the present day in the hospital. Gone are the usual melodramatic medical emergencies. In their place is the punishing reality of the COVID-19 pandemic. Meredith has been awake for countless hours trying to save infected patients. She hasn’t seen her children in days. 
Yet the closing scene of “The Center Won’t Hold” reveals Meredith’s mental beach trip wasn’t some fleeting flight of fancy. As the chapter ends, doctor Cormac Hayes (Richard Flood) finds Meredith collapsed on the ground in the parking lot of the hospital. She had just been talking to Andrew DeLuca (Giacomo Gianniotti) about how little sleep she had gotten, so it’s easy to hope Meredith is just exhausted. But Meredith is unresponsive when Cormac tries to rouse her. When we enter Meredith’s mind, she is intensely removed from reality — she’s back at that beach. As Cormac screams Meredith’s name, she sees a different handsome doctor on the beach. 
Meredith sees Derek. 
“Meredith!” Derek yells, waving his arms and sporting a wide smile. “Derek?” Meredith asks, shocked by the sight of her dead husband. Then the episode ends. 
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The promo that airs after “Center” confirms fans really did just see Derek on Grey's Anatomy after five long years away. But, that treat also suggests Meredith is in one of the most alarming medical crises of her life. In the trailer for third episode “My Happy Ending,” we see Meredith looking unwell in a hospital bed. She explains that she is terrified that if she falls asleep, she will never wake up again. Unfortunately, it’s likely Meredith will want to go back to dreaming, since the vision of her beloved late husband is waiting for her there. 
It is unclear if Meredith has contracted COVID-19 or if she is suffering from some other mysterious illness.
Despite the dark underlying meaning in Derek’s dream sequence resurgence, the Grey’s team does hope, more than anything, it brings viewers joy. Stars Ellen Pompeo and Patrick Dempsey told Deadline the idea came about when they went on a hike after the pandemic began. Showrunner Krista Vernoff had already decided she wanted to do a beach sequence in season 17, but hadn’t considered adding McDreamy to the proceedings. “Patrick and I weren’t hiking on the beach, but we were hiking in Malibu, [where] you can see the beach,” Pompeo told Deadline. “And the idea just struck me so I just said to him, 'Would you ever consider coming and being a part of the storytelling this season?'” 
Dempsey agreed, shooting more than the one scene viewers see in “Center,” according to Vernoff. He’s not against returning again. “It was fun, because I really love the message of what the dynamic is in this story,” Dempsey teased of the future of Dream Derek and Meredith. “With everything that we’re dealing with right now, and certainly we have been distracted with the election, but we’re going to get back into the reality of COVID and being in a pandemic, and all the lives that have been lost. Where are these souls going?”
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