Yup. Everything really has changed.

On Thursday night, Grey’s Anatomy kicked off Season 19 with an episode titled “Everything Has Changed,” doing so in the wake of the bombshell announcement that Ellen Pompeo will only be appearing this year on a scant number of installment.

Also, five new series regular have been cast to comprise a new set of interns.

With Pompeo looking to the future, this premiere felt like a blast from the past, hearkening back to when Meredith and company were just starting out.

“Congratulations. You all made it,” Meredith set by way of an introduction to the interns.

“You’re here… We didn’t hire you for your grades, we hired you for your fight. We are all getting our second chance here today.”

Because this is Grey’s Anatomy, of course, it didn’t take long for these fresh faces to encounter their first major trauma in the hospital after a bus blew off a cliff and flipped over during the tornado, leaving up to 14 people brain-dead.

After learning that nine patients were organ donors, one of the interns, Mika, announced it was an “organ-palooza.”

The crash brought transplant surgeons from around the nation… including Meredith’s former love Nick Marsh (Scott Speedman), who returned from Minnesota for the first time in six months.

He was later offered the job of residency director by Meredith, who is now the full-time chief of surgery.

Indeed, she has gone from intern to doctor to the hospital’s top dog.

And fans on social media had plenty to say in response…

“WHY IS MER BEING CHIEF SO HOT SO MILF IM SCREAMING #GreysAnatomy,” another fan excitedly tweeted, taking things in an interesting direction.

Will this new job somehow be what leads to Meredith’s eventual departure?

No.

Showrunner Krista Vernoff said this week that something will happen with Meredith’s kids that prompts a major change in the doctor’s life.

Elsewhere on the premiere…

… Miranda Bailey (Chandra Wilson) returned to check on the new intern class after she quit her job at the end of last season.

She later told Richard that he made a residency class “from the bottom of the barrel, the rejects” and added:

“That smacks of desperation. I will not cosign.”

… Owen Hunt (Kevin McKidd) and his wife Teddy Altman (Kim Raver) also returned to the hospital after the former had his medical license suspended for illegally giving pills to veterans as a form of assisted suicide.

Grey’s Anatomy airs on Thursday nights at 9/8c on ABC.

Grey’s Anatomy Season Premiere Rocks the Twitterverse: Where Will Things Go From … was originally published on The Hollywood Gossip .