"Pick me, choose me, love me:" How Grey's Anatomy found its voice

Twenty years back, the ABC phenom became the ultimate Emotional Catharsis Show.

By Caroline Siede  |  August 13, 2025 | 3:00pm
Screenshot: Netflix/Grey's Anatomy
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In an era when we’re increasingly expected to wait two years for 10 new episodes of television, it’s remarkable to think about how much network TV we used to get back in the day. In 2005, for instance, ABC aired not just the nine-episode first season of Grey’s Anatomy in the spring, but almost half of its 27-episode second season in the fall as well. In that way, Grey’s (which, yes, is still running to this day) is a show that both took a minute to find its feet and also one that emerged as an instant cultural phenomenon—all in one year.  

Grey’s second season is filled with iconic moments that made it the watercooler show of the moment: the post-Super Bowl bomb episode with Christina Ricci and Kyle Chandler, the introduction of Eric Dane’s “McSteamy,” the devastating Denny Duquette arc featuring guest star Jeffrey Dean Morgan, and that infamous LVAD wire. But all of those storylines stand in the shadow of the first true signature Grey’s Anatomy installment, “Into You Like A Train” (season two, episode six), a.k.a. the one where two patients are impaled on the same pole and only one of them can survive. 

Before that, the show’s evolution had come in fits and starts. Initially launched as a mid-season replacement for Boston Legal, the shortened first season of Grey’s Anatomy feels like a sexier, female-driven riff on ER. Though the pilot opens the morning after surgical intern Meredith Grey (Ellen Pompeo) and attending neurosurgeon Derek “McDreamy” Shepherd (Patrick Dempsey) hook up, there’s still a muted maturity to the overall tone. While the first season of Grey’s Anatomy indulged in playful comedy, sexy on-call room antics, and some heavy drama, it hadn’t yet found the acerbic sense of humor and unabashed melodrama that would soon become creator Shonda Rhimes’ signature.  

In fact, the first season is downright wholesome at times, with Dempsey’s charming, carefree attitude lending the show’s central relationship a flirty, breezy vibe (and lacking the roller-coaster drama that would come to define it). The series debuted to high ratings, positive reviews, and several Emmy nominations. But it wouldn’t deliver its first truly iconic moment until the final few seconds of the season-one finale, as a glamorous redhead named Addison Montgomery (Kate Walsh) strides into the lobby of Seattle Grace Hospital, shakes hands with Meredith, and smiles, “You must be the woman who’s been screwing my husband.”

That spiky energy carries over into the start of season two, the defining and best one of the show’s run. (That said, season 12 was unexpectedly strong too.) The sophomore season introduced an after-hours bar hangout spot, Cristina Yang (Sandra Oh) calling Meredith “her person,” and more tense interpersonal dynamics at the hospital, particularly between Meredith, Derek, and Addison—the wife who cheated on him but now wants him back. And that all culminates in the fifth and sixth episodes, where Meredith famously begs an indecisive Derek to “pick me, choose me, love me” only to see her doomed side of the love triangle echoed in the impaled patient who gets sacrificed so the other can live.

Interestingly, the show had originally planned to end season one with the “pick me” cliff-hanger, but shifted to a shorter debut season to align with the Desperate Housewives finale schedule instead. Production held back four episodes that had already been shot for season one to air as the start of season two instead—rounding them out with some reshot material as well as a brand-new second episode. And Addison’s arrival became the makeshift season-one cliffhanger instead. So part of the reason Meredith’s speech and the subsequent impalement episode feel so memorable is because they were written to be a season finale and premiere, respectively. 

Pompeo hated performing the “pick me” line and at various points over the years (including in this most recent season finale), Grey’s has tried to refute it by having female characters “choose themselves.” But in context, it’s an undeniably great bit of rom-com writing from Rhimes, up there with the “I’m just a girl, standing it front of a boy” speech from Notting Hill or the New Year’s Eve one from When Harry Met Sally. It’s also beautifully performed by Pompeo, who gives Meredith such a sardonic, aloof baseline that it hits harder when she gives over into full openhearted vulnerability. 

Plus, one of the great things about a show filled with so many women is that Meredith doesn’t have to represent the entirety of the female experience. This is the same episode where Miranda Bailey (Chandra Wilson) happily skips off to a 10-year anniversary date with her husband; Meredith’s mom Ellis (Kate Burton) longingly recalls leaving her husband for a married man; Izzie Stevens (Katherine Heigl) bemoans not getting kissed on a first date; and Cristina takes things to a new level with her boyfriend with a casual, “Okay. We’re a couple. Whatever. Don’t make a big deal about it.”

Romanticism is a cornerstone of the Grey’s Anatomy world, but the show doesn’t treat romance like a one-size-fits-all proposition. Rhimes is a character-driven writer and even if her heightened characters don’t exactly act like real people most of the time, they’re allowed to have a diversity of viewpoints and personality types that make them feel distinct and dimensional. 

If the speech gave Grey’s a core romantic ethos, “Into You Like A Train” locked into how the show wanted to use its medical cases moving forward. Before the pole incident, Grey’s patients were mostly medical mysteries, technical challenges, or emotional touchstones to awaken something in our heroes. But with “Into You Like A Train,” the show realized it could deploy big, over-the-top medical set pieces as overt metaphors for what its characters are feeling too. What if your breakup felt like getting sacrificed at the altar of surgical medicine? 

Meredith opens the episode at Joe’s Bar, waiting to see if Derek will “choose her,” only to get called into one of the wildest medical cases of her career: a human shish kebab caused by a massive train wreck. There’s a freak show element to the impalement case—something the show has tried to top over the years with ferry crashes, unmedicated C-sections, exposed carotid arteries, and toxic blood (plus that infamous musical episode). 

But there’s also something deeply intimate and human about the ordeal too. Bonnie Crasnoff (Monica Keena) and Tom Maynard (Bruce A. Young) are two strangers thrust together into an impossible situation. Yet they bring such a gentle, caring energy as they try to get through it, keeping each other calm and cracking dark jokes while they wait to see what will happen to them. “Normally, [my wife] Amanda would be a tad upset to find me pressed up against another woman,” Tom quips. “But in this case, I think I’ll get a pass.”

In fact, there’s such a jovial vibe to how this mass-casualty event is introduced that it initially fools you into thinking both patients will survive—that this is going to be a story about the heroic doctors of Grey’s Anatomy pulling off the impossible. This early into its run, Grey’s had already seen a handful of patients die. But it had yet to pull the trick of making you totally fall in love with a character only to tragically kill them off. 

Written by Krista Vernoff and directed by Jeff Melman, “Into You Like A Train” set that template, establishing Grey’s Anatomy as an Emotional Catharsis Show—the kind of old-fashioned tearjerker you come to in order to let it all out via network TV. The doctors eventually decide that since Bonnie has the least chance of survival, she’s the one they’ll move to save Tom. And that means that everyone—including her—has to quietly process the fact that she’ll soon be dead, even though adrenaline has her alert and making small talk at the moment. 

It’s a devastating short story in its own right, all the more so because the episode leans into a sense of quiet nobility rather than histrionics. Bonnie leaves final words for her fiancé with Derek, who is so shattered by her death that he needs to hide in an elevator and cry. Tom tries to talk the doctors into sacrificing him instead, only for Bonnie to remind him, “It’s not fair either way.”

That the episode also manages to make all that feel like a genuinely devastating metaphor for Meredith’s breakup is a testament to just how much Vernoff and Rhimes understand the art of melodrama. It somehow doesn’t feel laughably indulgent to watch Meredith stand over Bonnie’s body screaming, “What about her? We can’t just abandon her!” when she’s clearly talking about herself. You need total conviction to land an emotional manipulation that boldfaced—and that’s something Grey’s Anatomy would return to again and again.

In fact, when fans talk about the show, they tend to list off the most devastating moments—that harrowing hospital-shooting episode, a season of shattering peds losses, the tragic uses of guest stars like Mandy Moore and Scott Foley. Hell, during the pandemic, the show did a whole season just about having all the departed leads come back to hang out with Meredith on a ghost beach. (Bonnie herself would also get to return as a phantom-esque vision in the season-three episode “Some Kind Of Miracle.”)

For all its disaster-movie riffs and endless love triangles, the secret sauce of Grey’s Anatomy is tearjerking catharsis. And “Into You Like A Train” is the episode that first gave the show that identity. Before it, Grey’s Anatomy was a fun, sexy new spin on the medical-procedural formula. After, it became a heart-wrenching character drama with a distinctive voice strong enough to last 20 years and counting. 

 
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