The season nine premiere of Grey’s Anatomy threw viewers straight into an altered reality, a stark contrast that initially felt disorienting, much like the show’s own “What If?” episode from the previous season. For long-time fans accustomed to the familiar rhythm of Seattle Grace Mercy West, the episode delivered a series of jarring changes right from the opening scene.
Lexie Grey was gone, a painful absence hanging heavy in the air. The hospital corridors buzzed with unfamiliar faces – new interns and residents navigating their first days. Cristina Yang was across the country in Minnesota, pursuing her career. Alex Karev was on the verge of leaving for Johns Hopkins. April Kepner and Arizona Robbins were nowhere to be seen. Even Miranda Bailey, usually a picture of controlled intensity, was radiating unexpected happiness. Meanwhile, Derek Shepherd and Callie Torres were visibly consumed by grief. Meredith Grey, now bearing the weight of responsibility, was navigating the hospital with a newfound sternness, earning the moniker “Medusa.” And then there was Mark Sloan, McSteamy himself, lying on life support, his fate hanging precariously in the balance. This was not the Seattle Grace they knew.
Meredith’s opening monologue, a Grey’s Anatomy staple, immediately set the somber tone for the episode. “Dying changes everything,” she began, a stark statement of fact that resonated deeply. “The world just keeps on going…without you.” Her words were a direct echo of the gaping hole left by Lexie’s death in the plane crash finale, and a foreshadowing of the impending loss of another beloved figure: doctor Mark Sloan.
The episode centered around the agonizing farewell to doctor Mark Sloan, lovingly known as McSteamy. In true Grey’s Anatomy fashion, creator Shonda Rhimes orchestrated a poignant and melodramatic exit for the character who had first steamed onto screens in season 2. A ticking clock was introduced early in the episode – 5 p.m. – an ominous deadline that initially remained unclear. It soon became apparent that this deadline was tied to Mark’s living will. Richard Webber somberly explained that per doctor Sloan’s directive, if there were “no signs of recovery after 30 days,” he was to be let go. The decision was framed as an act of honoring his wishes, a final act of respect for a dying man.
The narrative carefully avoided explicitly detailing how doctor Sloan’s condition deteriorated to this critical point after the plane crash. Viewers were left to infer that his internal injuries, initially severe, had worsened in the aftermath, succumbing to complications in the wilderness. The ambiguity amplified the tragedy, leaving a lingering question of “what if” and underscoring the brutal randomness of the plane crash’s aftermath.
Callie, heartbroken and desperate, refused to accept the inevitable. Sitting vigil at his bedside, she desperately tried to elicit a response from the unresponsive doctor Sloan. “I keep thinking if I say something big enough or shocking enough he’ll open his eyes,” she confided in Derek. In a moment of dark humor amidst the grief, she even resorted to a playful, albeit futile, attempt to shock him awake, a brief moment of levity that highlighted the depth of her despair and affection for Mark.
Doctor Sloan’s impending death cast a long shadow over the entire episode, touching each character in different ways. Callie and Derek grappled with their grief openly, while Jackson Avery, in a more understated tribute, sat with his former mentor, updating him on cases and seeking his absent guidance. Avery’s quiet goodbye, “You’ve taught me a lot, but I really think I know what I’m doing now, so I’m good,” served as a poignant passing of the torch, acknowledging Sloan’s profound impact on his protégé.
In a respectful and touching manner, the episode honored doctor Sloan beyond his “McSteamy” persona. Interspersed throughout the episode were flashbacks, “home videos” showcasing different facets of Mark Sloan’s life. These vignettes revealed Sloan as Derek’s supportive best friend on his wedding day to Addison, Sloan attempting a comical sex tape with Callie, Sloan in surgery with Avery, Sloan declaring Lexie Grey as his greatest love, Sloan with baby Sofia, and Sloan surrounded by his family, Callie and Arizona. These memories painted a portrait of a complex man – beyond the flirtatious exterior, he was a father, a mentor, a friend, and a dedicated surgeon. The episode served as a celebration of doctor Mark Sloan’s life, recognizing his multifaceted contributions to those around him.
When Richard Webber finally carried out doctor Sloan’s wishes, disconnecting life support, it was done with solemnity and respect. Webber’s words were measured and deliberate, quoting Sloan’s living will and emphasizing the act as honoring his final requests. The song accompanying Sloan’s passing, with the poignant lyrics “How’s my heart supposed to be without you?”, amplified the emotional weight of the scene, underscoring the profound loss felt by those who loved him.
Initially, the decision to kill off another beloved character, so soon after Lexie, felt like another blow. However, there was a sense of tragic symmetry to Mark following Lexie, both victims of the same devastating plane crash. The episode subtly echoed a Romeo and Juliet tragedy, suggesting that even in death, they were together. While not a desired outcome, it reinforced the show’s established narrative that no character is immune to heartbreak and loss.
Beyond the central storyline of doctor Sloan’s death, other plot threads were woven into the premiere. Miranda Bailey’s blossoming romance with Ben Warren provided a welcome contrast to the pervasive grief. Her new nickname, “Booty Call Bailey,” offered a moment of levity, a stark departure from her previous “Nazi” moniker and highlighting her personal growth. Alex Karev’s near-departure and subsequent return, spurred by Meredith’s emotional plea and his commitment to his orphan program, reaffirmed his ties to Seattle Grace.
Cristina Yang’s storyline in Minnesota showcased her clash with a different hospital environment, contrasting her direct and competitive nature with the Midwest’s more polite culture. Her interactions with her new colleagues, played by recognizable actors, hinted at future conflicts and her eventual, inevitable return to Seattle. April Kepner’s storyline on her family farm served to emphasize her displacement and Hunt’s efforts to bring her back to where she belonged – in the operating room.
The episode’s final major reveal concerned Arizona Robbins, whose absence was initially ominous. The subtle hints throughout the episode led viewers to believe the worst, but the truth was revealed to be equally devastating – Arizona had survived the plane crash but lost a leg. Her confrontation with Callie, filled with raw emotion and pain, set the stage for exploring the profound impact of this life-altering injury.
The season nine premiere, while emotionally heavy, effectively set the stage for a season grappling with the aftermath of profound loss and change. The episode raised numerous questions, leaving viewers eager to understand the full repercussions of the plane crash and the future trajectories of their beloved characters. Meredith’s closing voiceover, reflecting on loss, memories, and the enduring impact of those we’ve lost, served as a fitting elegy for doctor Mark Sloan. The final screen displaying “Mark Sloan, 1968–2012” provided a definitive and heartbreaking farewell to a character who had become an integral part of Grey’s Anatomy.
