In August 2022, ABC announced that Ellen Pompeo, currently the highest-paid actress on American network television, was leaving Grey’s Anatomy, the show on which she has portrayed the eponymous general surgeon Meredith Grey since 2005; her final episode aired in the US on 23 February 2023. I’ll put my cards on the table right away: I was devastated. It will be a long goodbye. Pompeo is doing episodic voiceovers for the rest of the season, and will ‘come back to visit’. But can Grey’s exist without Meredith? It has been her show from the beginning. The committed (me) have spent 19 seasons watching her progress from the first day of her surgical internship at Seattle Grace Hospital to becoming the Chief of General Surgery of the renamed Grey Sloan Memorial. Her storylines haunt its corridors: Pompeo told Deadline that, like the ghost of a loved one, she will ‘never truly be gone as long as that show’s on the air’.

Of course, many will say that say that the series should have ended a long time ago. Opinions differ as to when exactly it jumped the shark. Was it when Meredith lost her best friend, Cristina Yang (Sandra Oh) to a Swiss hospital with 3D-printed hearts in season 10, or when she lost her husband, Derek Shepherd (Patrick Dempsey), to a semi-truck in season 11? Was it the switch from film to digital? Was it at the start of season 14, when Shonda Rhimes left for a lucrative Netflix deal and handed the reins over to Krista Vernoff? Or was it even earlier than that, with season 7’s – frankly abject – musical episode? It’s definitely a much worse show than it used to be, but that’s beside the point. To fully understand Grey’s, you have to free yourself from the expectation of good dialogue, believable character development, well-plotted episodes, or inspired soundtrack choices. Long gone are the days of Oh in leathers dismounting from a motorbike as Rilo Kiley’s ‘Portions for Foxes’ plays in the background. What remains is something else: endurance.

The politics of the show are recognisably and unexceptionally liberal: it takes progressive positions on race, sexuality and gender, and highly conservative positions on American wars in the Middle East. Although it has, especially in later seasons, incorporated current events into its plots – most notably COVID-19, the protests in the wake of George Floyd’s murder in 2020 and the 2022 overtunring of Roe v Wade – Grey’s is not really invested in world historical time, and its attempts to process and represent its changing context over the years have been mixed at best. Instead, the commitment it requires of its viewers is what roots it in time: it demands an enormous, ongoing investment. (Cynically, you could say that in writing this I’m trying to get something out from what I’ve put in, which is – given my recent rewatch – almost 800 hours of my one wild and precious life). And, of course, Meredith anchors the show’s duration. It feels significant to watch someone evolve from the cliché usually played out by a female protagonist – an ingenue with everything to gain – into a woman who reaches middle age and lives on past the final consummation of the romance plot (I never cared for Derek, uptight little misogynist that he was, but we needed him for the story).

In On Living with Television (2021), the television studies scholar Amy Holdsworth describes the concept of a ‘television autobiography’: memories and associations that are produced by the medium’s reliance on intimacy, familiarity, repetition and duration. At this point, I should impart a crucial aspect of my own. Although I’m now grimly committed to its weekly schedule, I hadn’t watched a single episode of Grey’s until January 2021, three months into the second period of lockdown that, where I live in Glasgow, lasted from October 2020 until the following April. It feels obvious, now, to assert that time changed during lockdown, as days lost their familiar distinctions. It stretched out, doubled in on itself, became less reliable but also less punitive. It felt exhilarating to watch a show full (too full) of events, and especially one in which illness itself is made so visible. I can’t construct an exact chronology of what happened in my own life during that period, though I remember being obsessed with watching the sunset every night, perhaps to prove to myself that the day was ending. What I can remember, however, is what was happening at Seattle Grace Hospital. I lived Meredith Grey’s time instead of my own. Despite the return, in my life at least, of chronology, this connection persists: when things happen to her, it feels like they are happening to me. And now, her exit has become a personal crisis.

Pompeo is Meredith Grey: since the pilot episode aired, she has taken on no other roles, only appearing as Meredith in the Grey’s spin-off Station 19. This is not unusual for soap actors – William Roache currently holds a Guinness World Record for playing Coronation Street’s Ken Barlow since 1960 – but Grey’s is technically a ‘medical drama’, a more prestigious category with a more serious reputation: it has minted several Hollywood careers, including those of Oh and a pre-rom-com Katherine Heigl, and launched Shonda Rhimes’s juggernaut production company, Shondaland. In 18 years we’ve seen a five-year-old Meredith witness her mother’s suicide attempt, be abandoned by her father, and then, as an adult, nurse her mother through early-onset Alzheimer’s. We’ve seen her almost drown, almost get blown up by a bomb inside a patient’s chest, get stranded in the woods for four days after a plane crash in which her half-sister dies, endure an emergency C-section during a power outage that leads to a splenectomy, get brutally attacked by a patient, and contract a case of COVID-19 so severe that she spends half a season in a coma. She’s lost multiple friends, including in a mass shooting in which her husband almost died, miscarried whilst performing emergency surgery during the same mass shooting, and then actually lost her husband and the father of her children in a car crash. Finally, in the most recent episode, her house, which was also her childhood home, got struck by lightning. Ouch.

TV time is rarely linear. Although Grey’s characters live what the theorist Elizabeth Freeman would define as ‘chrononormativity’ – maximally productive in both labour and in life, they accumulate milestones like work, marriage, childbearing, home ownership and money – such significant events occur with increasingly wild regularity before being quickly undone. By the twelfth season, marriages get proposed and take place within a matter of weeks before dissolving acrimoniously almost as swiftly. Unplanned pregnancies happen with surprising regularity for a series focussed on medical professionals, and people almost die and almost break up and almost move across the country every other episode. Achieve as many milestones as you want, the show tells us; nothing really matters. Meredith in particular is a character stuck in an eternal loop, a highly melodramatic stasis: she has been experiencing the un-experienceable and surviving the un-survivable, 22 episodes a year, for almost two decades. She’s got nothing left to give, but she goes on giving, her emotional responses getting a little less believable, a little more clichéd, each time she goes round the trauma carousel.

As the affective impact of the show reduces in direct correlation with the outlandish size of its storylines, its own temporal loops are getting smaller. Plots are repeating themselves, relying increasingly on montages that draw recursively on the show’s own archive and sometimes introduce actual ghosts, a tendency exacerbated during the Covid season, in which several episodes featured the spirit of a comatose Meredith following her colleagues around like the Ghost of Surgery Past. Temporally, you could say, it remains faithful to trauma. In Enduring Time (2017), the academic and psychotherapist Lisa Baraitser considers the suspension of time – ‘modes of waiting, staying, delaying, enduring, persisting, repeating, maintaining, preserving and remaining’ – that can be produced by certain kinds of experiences. One such experience is grief, the atemporality of which, Baraitser notes, ‘has something to do with persistent attachments we maintain with others, including those who are dead’. Suspended time, then, can tell us something ‘about care, and our capacities to go on caring when time has pooled’. Meredith, as the seasons go by, is more attached to the dead than the living, and as viewers we are too: each new experience is a palimpsest imposed on top of an old one, with the appropriate nostalgic clip inserted. By season 10, after the plane crash, she goes to work every day inside a hospital named after her dead half-sister and her husband’s dead best friend. She spends her time trying to arrest death inside an emotional mausoleum. Who could fail, in these conditions, to see ghosts around every corner? (Baraitser, in the introduction to Enduring Time, describes it as ‘an unfinishable book about time’s suspension’. Grey’s, in one sense, is an unfinishable show about the same.)

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Attachment, to the dead and to the living, is a central concept of psychoanalysis, especially in attachment theory itself, first formulated in the 1950s by the British practitioner John Bowlby to theorise the bonds between an infant and its caregiver. Grey’s has an ambivalent relationship with psychotherapeutic practice within the medical landscape of treatment and diagnosis it dramatises – talking cures, after all, are slow work, ill-suited for primetime. Despite this, it has explicitly foregrounded attachment theory in its dialogue and character development from the start. Characters insert references to their attachment issues, daddy issues, mummy issues and abandonment issues in even the most banal conversations. At one point, the cardiothoracic surgeon Teddy Altman (Kim Raver), a former ‘G.I. Jane’, declares herself – after falling in love with a trauma therapist – to be ‘Attachment Barbie’. The first five seasons of the show are centred around Meredith’s will-they-won’t-they relationship with Derek, with their many make-ups and break-ups blamed not on his wrongdoing – he was secretly married when they met – but in Meredith’s psyche. She is, as the show constantly tells us, ‘dark and twisty’ thanks to her emotionally absent mother, Ellis (Kate Burton), also a renowned general surgeon, and physically absent father, Thatcher (Jeff Perry).

Meredith’s childhood is identified repeatedly as the reason she puts herself in the way of danger – why she placed her hand on the bomb in that patient’s chest; why she didn’t fight harder to save herself from drowning – in dialogue that often sounds excerpted from an introductory essay on the death drive. When her paternal half-sister Lexie (Chyler Leigh), who grew up in a decidedly un-broken home, joins the hospital staff in season four, their relationship provides a secondary ground for Meredith to work through her issues, something she explicitly spells out. ‘We don’t have the same dad, Lexie, you and I,’ she tells her. ‘We do not have the same dad. My dad disappeared when I was five years old and I never saw him again, does that sound like the daddy that you grew up with?’ On her issues with Derek, she continues, ‘I kicked a man out of my bed in the middle of the night, the world’s most perfect man, who loves me, and I can’t let him… it doesn’t take a shrink to figure out why. Because our dad chose you’. (Lexie gets progressively more likeable the more bad things that happen to her: by the time her mother dies of hiccups, we’re all in). After the fifth season ends and Meredith and Derek get married, the focus shifts to her ‘dark and twisty’ nature obstructing not romantic or sexual fulfilment but instead her creation of a ‘normal’ family: she sabotages a longed-for adoption and, aided by the discovery of her mother’s old journals, begins to recover childhood memories which suggest at least some of her emotional blockages are maternal ones. It’s almost seemed as though Grey’s anticipated the surge in the popularity of attachment theory in recent years, which is frequently simplified, decontextualised, and turned into TikToks about ‘dating styles’ which demonstrate an eagerness for self-pathologisation that understands attachment to be terminal. (During lockdown, I did an online attachment style quiz that, once it delivered the bad news – fearful-avoidant – sent me an email decorated with sad faces and butterfly emojis, with the subject line ‘How are you holding up, Helen?’)

Structurally, Grey’s is fundamentally hysterical. (Or: Bowlby in the streets, Freud in the sheets). ‘Hysterics’, Freud and Breuer tell us in 1895’s Studies in Hysteria, ‘suffer mainly from reminiscences’. Past experiences, repressed, are converted into physical symptoms in the present. Time is distorted, recursive: the past can reanimate itself at any moment, make us crazy. In the promotional material that prepared the ground for Meredith’s exit, the show announced five new interns, a nod to the five central members of Meredith’s class at the show’s beginning. The network chose to quote Taylor Swift: ‘On a Thursday, in a stairway, I watched it begin again’ is the tagline of a short video where the new cast stands at the bottom of the iconic hospital stairs. (Grey’s airs on Thursday nights). ‘Begin Again’ is a song from Swift’s fourth studio album, 2012’s Red, and therefore also from Red: Taylor’s Version (2021), the most recent offering from Swift’s ongoing project of re-recording her first six albums. In this way, it feels like a doubly appropriate choice: Swift, the most significant contemporary laureate of heterosexuality, has built a career on the back of the contemporary hysteric, the ‘crazy’ ex-girlfriend and, in her rerecording project, is stuck in her own time loop, attempting to intervene in linearity.

‘Mad’ or unreasonable behaviour is gendered in Grey’s as it is in life, especially in the categorisation of Meredith and Cristina by their husbands – misogynist neurosurgeon Derek and ex-army, anti-abortion, uber-misogynist trauma surgeon Owen Hunt (Kevin McKidd) – as the ‘twisted sisters’. Cristina, we learn, watched her father die on the roadside after a car accident, and several of her major storylines centre around specifically reproductive turmoil. (In season two, recovering from an ectopic pregnancy which ruptures one of her ovaries, her mother hovering around her and her partner chastising her for not telling him she was pregnant, when she finally starts to cry she is unable to stop, eventually screaming: ‘SOMEBODY SEDATE ME!’).

Hysteria troubles linearity in its treatment as well as in its symptoms: it isn’t something that can be simply cured. In Studies on Hysteria, Freud ventriloquises the hysteric’s complaint: ‘Why, you tell me yourself that my illness is probably connected with my circumstances and the events in my life. You cannot alter these in any way. How do you propose to help me, then?’ It’s a good question. Psychoanalysis might help the hysteric find the sources of her illness, but its power to alleviate them is limited. It can’t rewrite the history she is reliving. Michelle Rada, in her recent introduction to a special issue of differences: A Journal of Feminist Cultural Studies on ‘Psychoanalysis and Solidarity’ reads this as ‘a scene of disappointed solidarity’, a challenge to ‘the talking cure’s constrained scope’: ‘Psychoanalysis cannot abolish or bring to justice the patriarchal social order it profoundly links to hysterical misery’. Freud knows that the material conditions of the patient’s life are making her ill, but all he can offer in response is the understanding that misery might helpfully be transformed into a more bearable ‘common unhappiness’. In Rada’s words, this ‘reframes the hysteric’s individual pain in collective terms. All share in unhappiness because what we have in common, psychoanalysis proclaims, is an unconscious’. (Or, to put in in Meredith’s words: ‘nobody can be happy all the time. That’s not mental health, that’s crap’.)

Giving full weight to the unconscious allows us to form bonds with each other not despite but because of our shared agonies. Meredith’s ‘dark and twisty’ nature is frequently identified, at least outside the realms of her toxic romantic relationships, as a strength, and specifically a strength that makes her better at practising medicine. She tampers with medical trials to give drugs to those who need them, helps an intern evade ICE, commits insurance fraud to treat an undocumented child and, when doing community service for this fraud, sets up a free street clinic for her fellow workers, leaning on her colleagues to provide treatment. In an early episode, she attends the execution by lethal injection of a patient she treated for a spinal injury, a serial killer who brutally murdered five women. She didn’t, she explains, want him to die alone.

In Studies on Hysteria, Freud compares ‘cathartic psychotherapy with surgical intervention’:‘I have described my treatments as psychotherapeutic operations; and I have brought out their analogy with the opening up of a cavity filled with pus’. Yet this analogy is not, he clarifies, to be understood as representing the ‘removal of what is pathological’ but rather a diagnostic aid. These ‘operations’ result in ‘the establishment of conditions’ that make recovery more likely. Surgery, especially in the multi-billion-dollar environment of a fictional American teaching hospital, is not satisfied with such half measures. The patient care we see on Grey’s concerns profoundly, ludicrously visible symptoms. Just off the top of my head, we’ve seen two people impaled together on a metal pole; a woman with a stiletto embedded in her heart; a man with a tree growing inside his lungs; a man with seven nails embedded in his brain; a man with ten Judy doll heads in his bowel; a teenager encased in concrete; a man mauled by his new girlfriend’s pet lion. (I could go on.) Despite allusions to the inequality of care in the US, it dramatises a fantasy of diagnosis and remedy: the health of the patient is the narrative priority, and answers are almost always found. Grey’s might have a hysterical narrative structure, but it is continually resisting the lessons which psychoanalysis has to teach about (un)productivity and duration: it is invested in the idea of a treatment that cures. Central to scholarly projects that seek to complicate ideas of normative time is the understanding of care as ‘maintenance work’: unproductive, repetitive, and ongoing. Surgery is the opposite of such work and Grey’s is uninterested in showing it – nurses are barely present, and cleaning staff, even in the Covid season, are non-existent.

It is also the opposite, in its solution-based narrative approach, to what the academic Alison Kafer has termed ‘crip time’, which ‘bends the clock to meet disabled bodies and minds’, rather than the other way round. Although an unlikely number of the hospital’s doctors experience extreme sickness or injury themselves, there is a division enforced between surgical staff, who are allowed, as the main characters, to experience chronic illness – OCD, addiction, cancer – and the rotating supporting cast of patients, whose ill health is strictly scheduled by the timestamp of the episode. The doctors’ afflictions are often ironic, reflective of their unique professional skills: brain surgeons with brain tumours, OB/GYNs with fertility issues, trauma surgeons with PTSD. When it comes to the patients, a metaphorical substitution occurs: their ailments are there to hold up mirrors to the circumstances in the lives of their surgeons, whose perspective is the one shared by the viewer. Deciding to terminate a pregnancy? You’ll end up treating a pregnant woman choosing to die of cancer instead of aborting. Embarrassed about a one-night stand? He’ll show up at the hospital with priapism. Ignoring niggling doubts about your relationship? Your patient’s cold will turn out to be fatal. And if it’s Valentine’s Day, nobody’s heart is safe. Whether played for comedy or tragedy, patients are sacrificed on the altar of narrative mimicry. Doubly displaced, they become identified not only with their symptoms but with the things their symptoms symbolise. I’m reminded of Joanna Hedva, writing in Sick Woman Theory (2020), of endometriosis:

When I explained the disease to a person who didn’t know about it, she exclaimed: ‘So your whole body is a uterus!’ That’s one way of looking at it, yes. (Imagine what the Ancient Greek doctors – the fathers of the theory of the ‘wandering womb’, in which the uterus was said to roam the body in search of fertilization, supposedly the cause of madness or ‘hysteria’ – would say about that.) But I try to keep close something someone else once said to me when I told them how confusing this disease has been as a person who does not identify as a woman: ‘Well, you shouldn’t identify as a uterus either.’

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Sickness, of course, has always been rich with the potential for metaphor. In 1978’s Illness as Metaphor, now a mainstay on most undergraduate literary theory syllabi, Susan Sontag charts the evolution of the ‘popular mythology’ of first tuberculosis, and then cancer. These diseases – ‘identified with death itself’ – have unique relationships to psychic life, and to desire in particular. Whilst tuberculosis was commonly conceived of as ‘a variant of the disease of love’, and the impetus for the declaration in Thomas Mann’s tubercular romance The Magic Mountain that ‘all disease is only love transformed’, cancer, on the other hand, is understood to be symbolically caused by the repression of either sexual or violent feelings. (Memorably, Sontag cites Norman Mailer’s explanation that, had he not stabbed his wife and ‘acted out a “murderous nest of feeling”’ he would have died of cancer himself.)

In Grey’s, it is Alzheimer’s disease that is ‘love transformed’. A neurodegenerative condition associated most commonly with the uneven loss of memory and an inability to disentangle the present from the past, a disease of the body that presents as a disease of the mind, it is emblematic of the show’s own hysterical relation to the past. Narratively, it frames the entire series, linking central female characters together and passed down along maternal lines: Meredith’s mother Ellis dies of it, and so does her surrogate father Richard Webber’s wife Adele, the woman for whom Meredith tampers with a clinical trial, threatening her precarious marriage to Derek and the adoption of their first child, Zola, in the process. In season 15, it’s feared that Richard Webber himself has it, but that turns out to be cobalt poisoning instead (of course, because Webber, expertly played by James Pickens Jr, is the ultimate good patriarch). In season 17, Miranda Bailey (Chandra Wilson) deals with her mother’s worsening memory during the height of the pandemic. The threat of Meredith herself developing Alzheimer’s hangs over the show. It is not until season nine that she tests positive for the disease’s genetic markers, but it’s been a symbolic possibility from the beginning of the series. In season 19, her motivation for moving to Boston is twofold: Zola, now in junior high, is chronically anxious that her mother is going to die of Alzheimer’s, and right on cue an old friend from Seattle, Jackson Avery, now the head of a prestigious foundation, offers her a state-of-the-art Alzheimer’s lab. Even the show’s deterioration in quality seems to mimic memory loss in the repetition of plots and the recycling of origin stories. Of the five new interns seeking to fill the void at Grey Sloan Memorial, Simone (Alexis Floyd) is being positioned as the new Meredith: not only is she romantically involved with Derek Shepherd’s nephew, but she is entangled in her own  complex maternal web caring for her grandmother, a dementia sufferer, who keeps mistaking Simone for her own dead daughter.

Sontag writes that tuberculosis, ‘like all really successful metaphors’, had two ‘contradictory applications’: it could describe the death of someone, like a child, ‘thought to be too “good” to be sexual’, and it was also a way of describing sexual feelings and the consequences of their repression. In Grey’s, Alzheimer’s has a similarly split function, centred around the show’s good patriarch, Richard, as the same disease kills both his wife and his former mistress. Ellis, an award-winning surgeon, arrogant and sexually duplicitous, flew too close to the sun. She gets destroyed by the very thing she thrived on – her mind. (Wilhelm Reich, Sontag reminds us, linked the cancer of the jaw that killed Freud to his ‘beautiful speech’. The philosopher Gillian Rose offers in her memoir Love’s Work an ‘anthology’ of interpretations of her ovarian cancer: Camille Paglia called it ‘Nature’s revenge on the ambitious, childless woman’, while ‘faith healer’ John Petty diagnoses ‘transgenerational haunting’.) Adele Webber (Loretta Devine), on the other hand, is the victim of displacement until the end. She never, it is implied, understood Richard’s intellectual life which, in his affair with Ellis, also doubles as his sexual life, and yet her death, when it comes, cannot escape the ironic resonances with the earlier demise of the woman who threatened to replace her. Another way of looking at it, perhaps, is that Ellis and Adele both succumbed to their shared unhappiness. The psychic effort required to maintain identity categories – wife, mother, surgeon, success story – becomes overwhelming, and the body can no longer sustain their separation.

In Love’s Work, Rose writes of surgeons as professionals who have never faced their own ‘finality’:

Surgeons are not qualified for the one thing with which they deal: life. For they do not understand, as part of their profession, ‘death’, in the non-medical sense, nor therefore ‘life’ in the meaningful sense, inclusive of death. When they fail to ‘cure’, according to their own lights, they deal out death.

Grey’s, in its uneven and melodramatic way, offers a corrective: it brings death back into surgery. But it is also, in televisual time, representative of the ways in which the dead remain with us, and so, too, the ways in which we keep faith with the children we once were. Meredith reconstructs her family unit multiple times throughout the course of the show. First, with friends and housemates, then, a nuclear household which always has space for another person (platonically, at least) in the marital bed, and, finally, in a household shared with her half-sister, Maggie – Ellis and Richard’s secret lovechild, played by Kelly McCreary – her sister-in-law Amelia Shepherd (Caterina Scorsone), and a group of their assorted children. This depicts survival, not despite our early abandonments and our later crises, but alongside it. Survival that is rooted in our social bonds. Meredith’s extraordinary unhappiness – she is spectacularly unlucky – is rendered, by the unrelenting repetitiveness of the show and by its duration, ordinary. In staying put at the site of so many traumas, Meredith endures past the limits of the endurable: she commits to a place and the people in it, and so I have never bregrudged her the claims she’s made on my time. But now she’s gone. In the episode that marked her final appearance, one of the most famous speeches from the show’s earliest years came back again, altered. Instead of telling Derek, in their pre-marital days, that he should ‘Pick me, choose me, love me’, Meredith refuses to ask her most recent love interest, Nick (Scott Speedman), to follow her to Boston: ‘I want you in my life if you want to be in my life. But if I have to choose, I’m going to pick me, I pick my kids, and I pick what’s best for us, and I’m not going to beg you to love me.’ I suppose we have to recognise this as progress. The hysteric has exited the labyrinth, and maybe, in disentangling herself from the loops of memories that ensnare her, she can escape a symbolic Alzheimer’s diagnosis, too. But, oh, dark and twisty Meredith Grey. I will miss her.