Anniversary
Even After 20 Years, the ‘Grey’s Anatomy’ Pilot Proves Meredith & Derek Had TV’s Best Chemistry

Twenty years later, the opening scene of Grey’s Anatomy remains a blissfully romantic dance of intimacy and awkwardness that set the tone for the series — and its greatest love story.
For those who haven’t checked in on the ABC series’ first episode since it premiered on March 27, 2005 (or whenever you watched it for the first time on Netflix), it opens with the signature narration of Meredith Grey (Ellen Pompeo) played over the hazy images of an operating room. Then, her own inner monologue crashes down to earth with a cut to a naked Meredith passed out on the couch and her intended one-night-stand, Derek Shepherd (Patrick Dempsey), lying equally naked on the floor next to her.
What follows is the always-awkward parting of two people who filled each other’s needs physically in the fever dream of alcohol and lust and are now suddenly having their first real conversation in the broad daylight of those decisions. But Grey’s Anatomy couldn’t start with just any one-night-stand goodbye. Somewhat miraculously, even with two decades of foresight, the chemistry is instantaneous between these two people, and a few things contribute to this.
First, when Meredith wakes up, she pulls off the blanket covering Derek, briefly exposing Dempsey’s backside (a flash of nudity you rarely got on broadcast TV in 2005). She then drops a pillow over said backside to give him some sense of modesty. Awakened by the thud of fabric on him, Derek hops up and almost immediately starts tempting Meredith back to the previous night’s activities. Between the nudity and the playfulness, there’s a sexually charged entangling of intimacy and vulnerability on display, and despite the clumsy nature of the morning, Pompeo and Dempsey lock into it automatically. In short, it’s hot, and you can feel their pull to one another and how much at least Meredith is barely fighting.
She playfully pivots away from his advances by acknowledging she’s already late for her first day, and he should dip out while she runs upstairs to shower. Then there’s an embarrassing bit where they realize they don’t remember each other’s names, and she almost reveals too much personal information when talking about moving into her mother’s house. Every one of their guards are down in this moment as they try to stumble through with as much dignity as possible, and they succeed to some degree. But the meandering conversation to that conclusion is unabashedly adorable and downright romantic because Pompeo and Dempsey had chemistry to spare from the jump.
His dashing yet horny smile. Her bumbling but confident take-charge resolve. It is all charming enough that you want her to stay, despite the fact that this is the first day of the rest of her life — professionally speaking. It feels bigger than a drunken night (one we don’t even see until Season 3), and anyone who has watched even a fraction of the show’s 21 seasons knows it was.

Ron Tom ABC / Everett Collection
Across the rest of the premiere, some of the most important Meredith-Derek moments fall into place. She realizes that the naked charmer on her floor is actually the chief of neurosurgery at Seattle Grace Hospital, where she is a new resident. They duck away for the first of many stairwell chats (where he again makes a pass at her that she struggles to deflect), and they get into their first fight when she messes up treatment on a patient. But in the end, he invites her to scrub in for surgery, something that changes her life forever.
Their story, in the pilot at least, ends with the same smiles they gave each other that morning. She can barely come down from the high of saving someone’s life, something he knows all too well. She questions why people do drugs when they could just go to medical school, while he looks on, unable to find the words to express the real high he feels looking at her.
Unlike their morning balancing act, which they filled with overly intimate banter to move the moment along, their connection has already developed into something deeper. Something richer and more mature. One of mutual respect, fascination, and desire — and it all happens in one episode. There’s a reason why creator Shonda Rhimes is such a force. Between her writing and their acting, such instant onscreen perfection is rare.
In fact, very few shows can establish this in a pilot, which already has the colossal responsibility of laying the foundation for the show ahead. But Grey’s Anatomy had two romantic leads, cast with surgical precision, at its disposal from its first scene. For everything that will happen to Meredith and Derek — babies, a plane crash, a secret wife, dream houses and his eventual death — none of it would ring as true or as seismic if not for the two people awkwardly smiling back at each other that morning.
Two decades later, Meredith and Derek still have the best chemistry of any TV couple because Pompeo and Dempsey were exactly what the doctor ordered for these roles.