Grey’s Anatomy Season 18 Ending Explained: The Shocking Truth Behind Every Twist

Grey’s Anatomy season 18’s main threat to Grey Sloan Memorial Hospital was its residency program being shut down, but that wasn’t the only development reaching a turning point in Grey’s Anatomy season 18’s finale. Meredith’s (Ellen Pompeo) decision in Grey’s Anatomy to leave the hospital to pursue a life and career elsewhere caused many problems for Grey Sloan. It proved to be somewhat contentious for Meredith herself, as she was pushed to that decision without having thoroughly thought it through. Finally, Owen (Kevin McKidd) and Teddy’s (Kim Raver) study on providing end-of-life care to veterans whose failing lungs were a result of the military mismanaging burn pits became an issue as their involvement in stealing drugs to give veterans to offer a less painful death came back to haunt them.

All these major Grey’s Anatomy season 18 storylines were carefully intertwined in the show’s season finale with the doctors’ bid to save the hospital’s reputation. Grey Sloan Memorial’s historical residency program was as much part of the fabric of Grey’s Anatomy as a show as it was fundamental for the residents’ lives, making its shutdown a colossal hardship that will need to be survived by Grey Sloan. That decision highly influenced the Grey’s Anatomy season 18 ending’s twists and turns, and it will also shape season 19’s main challenges. Here’s every question Grey’s Anatomy season 18’s ending answered.

Is Meredith Chief Of Surgery Now?

In a twist justified by everything that happened at Grey Sloan, Grey’s Anatomy season 18 ended with Bailey (Chandra Wilson) resigning as chief to Jackson (Jesse Williams) and handing her office’s keys over to Meredith. While Meredith’s decision to leave didn’t formally change from what could be seen, she did go to Bailey’s office to reflect on Jackson’s offer, and she begrudgingly accepted that she’d have a lot of work to do to save Grey’s Anatomy‘s hospital. This all pointed to Meredith effectively accepting Jackson and the Fox Foundation’s offer to be Grey Sloan Memorial Hospital’s new Chief of Surgery. While Meredith’s position as chief could be temporary, as Jackson suggested, it would still mean that Grey’s Anatomy season 19 will start with Meredith as a leader, struggling to save the hospital that shaped her, teasing a challenging but entertaining season 19.

Grey’s Anatomy All But Confirmed S19 To Be The End

Grey’s Anatomy season 18 ending with the hospital in a tough spot without a residency program, nor a Chief of Trauma or a co-Chief of Cardio, heavily hinted at Grey’s Anatomy season 19 being its last. The challenges the hospital will face next season will be even greater than those of this season, when the residency program was only threatened. Its shutdown will undermine the reputation of Grey Sloan Memorial. Meredith will have to lead the hospital through its biggest challenge yet.

In addition, Grey’s Anatomy highlighted throughout the second half of season 18 how Meredith felt she was done with Grey Sloan but was also having issues letting go. Her difficulties in leaving her colleagues and family behind resulted from how quickly she decided to resign but also from how connected she is to the place where she’s spent her whole life. The Grey’s Anatomy season 18 ending left the story open to the possibility that, while the show might end with Meredith leaving Seattle, it could also end with Meredith accepting her complicated history with Grey Sloan Memorial and permanently becoming its Chief of Surgery. The setup makes Grey’s Anatomy season 19 the perfect one to see former characters return to save the hospital and the best possible way to close out the storied series.

Is Webber Out Of The Picture?

When Jackson asked Meredith to stay in order to not utterly destroy Grey Sloan’s reputation as a hospital, he mentioned that he couldn’t “lose her and Richard at the same time.” As the Medical Accreditation Council shut down the residency program and Richard (James Pickens Jr.) was its director, it makes sense that he would no longer be in that capacity at Grey Sloan. But Richard’s roles as the Fox Foundation and Grey Sloan Memorial Hospital liaison remained, so he’d still have a role beyond just working as a surgeon there. Still, Jackson phrased his concern in a way that made it seem as though Richard wouldn’t be there at all, despite the fact a big storyline in Grey’s Anatomy season 18 revolved around Richard evaluating if he could continue as a surgeon and teacher. Jackson’s wording hinted at Richard possibly leaving, and, if that’s the case, season 19 could unite multiple Grey’s Anatomy ending theories together. Characters could easily back both to save Grey Sloan and for Richard’s retirement, making an even stronger case for Grey’s Anatomy season 19 being the show’s final season.

Grey’s Anatomy Season 19 May See Owen & Teddy On Trial

Things got worse fast for Teddy and Owen in Grey’s Anatomy season 18’s ending two-part finale. They were confronted by a man who traveled from Utah to Seattle specifically to ask them for drugs that would let his ex-Marine wife die peacefully, or he would report Owen to the authorities. With Grey’s Anatomy season 18’s final episode establishing Bailey’s knowledge of Owen’s crimes, her duty to report them to the police, and Owen and Teddy’s rushed trip outside the U.S., it’s highly likely this storyline will continue in season 19. As a result of Owen’s actions, Grey’s Anatomy season 19 might see him and Teddy standing trial. Considering that Owen stole the life-ending drugs for his veteran patients from Grey Sloan, however, it’s possible that when the news gets out, it will have consequences for Grey Sloan’s standing beyond just Owen and Teddy. Either way, season 19 will have to continue that storyline as the Grey’s Anatomy season 18 ending left off with Owen and Teddy on the run with their children.

Grey’s Anatomy’s 400th Episode Hinted At Meredith Finally Being The Sun

Grey’s Anatomy season 18’s ending set up the best challenge for Meredith yet, as Grey’s Anatomy’s latest seasons saw her grow in her professional capacity, but they often avoided her struggle to deal with her complicated past, especially living up to the legacy of her mother, Ellis (Kate Burton). Whenever her past came back to bother Meredith, such as the final visit to Thatcher Grey (Jeff Perry) in a hospice in season 15 or as nightmares about Ellis in season 18, she faced it by being present and being the bigger person. Still, Meredith suffers consequences from her inability to deal with her past. It came to a head in Grey’s Anatomy season 18’s finale when Meredith’s patient died as a result of Meredith choosing to operate on her during a blood shortage, going against Richard’s recommendations. This landed Meredith in a tight spot even with Nick, but she eventually backtracked. Realizing she was pushing her personal life aside to compartmentalize and solve her work problems was a first step in the right direction. It indicates that she will embrace not only her greatness as an innovative surgeon, but also learn how to balance her own personal desires while making peace with her complicated relationship with Ellis and Ellis’ legacy. It all proves that Meredith Grey is still central in Grey’s Anatomy and will finally be the sun in Grey’s Anatomy season 19.