Grey’s Anatomy: Behind-The-Scenes Secrets

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14. Writers Best Kept Secrets

We’ve heard in the past actors talk about having a relationship with the writers and always knowing what’s coming up for their character in a particular series, but when it came to Grey’s Anatomy, Shonda knew she wanted to land a huge surprise at the end of the series. Apparently when she wrote the pilot she always knew Derek would end up being married — it was just a matter of when the secret would come out. Of course, she decided to use it as a cliffhanger at the end of season 1, and she kept a tight lid on what was in the works. Ellen Pompeo didn’t know that Derek was married until the Season 1 finale was already being filmed, and Patrick found out a little earlier, about halfway through the first season.

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13. Character of Miranda Bailey

The character of Dr. Miranda Bailey is loosely based off Shonda Rhimes’ mother. When asked about the similarities Rhimes said, “A little bit. She’s very no-nonsense. Dr. Bailey says stuff like ‘These people are nasty-all they think about is sex while we’re trying to save lives here.’ My mother is definitely that kind of realist.” This character was also the only one written with a description in mind. “I pictured her as a tiny blonde with curls. I thought it would be unexpected to have this sweet-looking person open her mouth and say tough things. But then Chandra Wilson [an African-American actress] auditioned, and she opened her mouth and said those same things. I thought, “That’s exactly who Miranda is.”

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12. Medical Jargon

The phrase “vajayjay” has become an infamous tagline for the character of Miranda Bailey. The term was originally coined by an assistant who worked on set. When Shonda Rhimes caught wind of it she wrote it into the script. Also, all of the medical jargon that is used on the show is put in by real doctors. The writers will do all of the creative writing to develop a storyline and the dialogue between characters, but because it’s a medical drama there’s lots of mumbo-jumbo medical talk going on! The writers want to keep the show as authentic as possible, so they work with real doctors to make sure they are including the proper medical terminology. When writing the script they will write “medical” in bold where they want “medical talk” to happen then hand off the script to real doctors, who will then give samples of appropriate words that could be slotted into each sentence.

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11. Hiding Pregnancies

In season 6, Meredith ends up undergoing surgery to give part of her liver to her estranged father, Thatcher (Jeff Perry). The reason this storyline was created was because Ellen Pompeo got pregnant in the middle of filming, so writers made Meredith undergo surgery so that she could be bound to a hospital bed and her growing belly would be hidden under the sheets.

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10. Cast Members Have to do Their Homework

In order to keep the show as authentic as possible, the cast members are given tons of material to study before shooting a scene that requires them to act out a particular surgery. There’s also a medical technician who works alongside the actors to give them insight on how things are done in a real hospital. The cast has access to an archive of medical videos and articles and many of them have spent time in a hospital shadowing real surgeons. Isaiah Washington, who played the character of Preston Burke in the first couple seasons of the show, took his role very seriously. In an interview with Shonda Rhimes, she said, “Isiah Washington learns all of his surgeries before he performs them on TV. Scarily enough, I think if he stopped at an accident on the street, he’d know exactly what to do. He has pulled shifts at the hospitals where he follows the surgeons around for 48 hours.”

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9. Props on Set

Real cow organs are used on set and the blood is a mixture of red Jell-O, blood and chicken fat. Other props that have been used are lamb brains and a cow’s heart. They also use real surgical nurses on set so when they are filming, they are handed all the correct instruments that would be used in that particular surgery and most of the time when it’s a close up shot of hands performing a surgery, those are the hands of actual surgeons. In an interview with Sarah Drew, who plays the character of Dr. April Kepner, she said, “We work with Bovine organs, which is cow’s organs. The smell is repulsive and makes us all gag. And we use an actual soldering tool to solder the organs. It smells like burning flesh. There’s also a lot of silicone and blood matter – red jello mixed with blood and chicken fat. It’s pretty gross.”

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8. Real Medical Stories

The medical storylines used on the show are all real scenarios that have been found in medical journals, or from articles in the paper. The writers also receive stories sent in from viewers about things they find interesting. Sometimes the writers and Shonda Rhimes will just sit in a room and hammer out ideas saying, “Is this possible? Could this happen? Run to our medical researcher and ask her ‘can this happen?’ And she comes back and says ‘You can impale two people on a pole and they can still be talking, or yes, an entire hospital can have syphilis.”

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7. The OR Board

The names on the OR board are the names of Grey’s crew members.

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6. Color Blind Technique

One of the greatest things about Grey’s Anatomy is the diversity among the cast and the writers. More than half of the writers on the show are women and there’s a great mix of ethnicity on the show. Shonda Rhimes used a color blind technique when casting the characters to ensure no one was hired based on appearance alone. Executive producer, Betsy Beers said, “Shonda was really insistent about the idea that we cast the character with no preconceived notion as to what they should look like or be like, just that they would be the best actor for the part.”  In an interview with Oprah, Shonda said the only character who came with a description was Miranda Bailey, but the rest were unknown which made it harder to write the pilot. “We read every color actor for every single part. My goal was simply to cast the best actors. I was lucky because the network said, “Go for it.” If they had hesitated, I don’t know if I would have wanted to do the show. But it was difficult to write the pilot because it’s easier to imagine people in terms of color.”

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5. Firing Erica Hahn

The character of Dr. Erica Hahn, played by Brooke Smith, didn’t last very long on the show. She was a cutthroat surgeon who came in to replace Dr. Preston Burke after he left the show and she stood as a love interest for Sara Ramirez’s character, Dr. Callie Torres. She was let go from the show because the writers told her they could no longer “write for her character.” There were rumors that she was let go because the network “had issues” and was feeling uncomfortable with the explicitness of the relationship between Callie and Erica at the time. In an interview Brooke Smith said, “Frankly, it was you that warned me this might happen on the red carpet back in July. You said [sometimes networks get cold feet] with gay relationships. And I was so naive. I’m like ‘It’s 2008.’ But I’m starting to realize that not everyone feels the way I do.”

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4. The Post-It

In the scene where Meredith and Derek write down their vows and create a kind of make-shift marriage license on a post-it note, Dempsey was actually writing down the things that were being said in that moment.

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3. Casting Patrick Dempsey

When Patrick first came in for his audition he thought Shonda Rhimes didn’t like him! In an interview with Manhattan magazine, Dempsey said, “At first I thought (show creator) Shonda Rhimes hated me, but she was calculating in her head where to put me and what I’d be right for. They liked me, but they wanted me to do a chemistry read with lead actress Ellen Pompeo. I had an immediate connection with her because she has a Boston accent, and I’m from Maine, so that disarmed me.” When asked about casting the famous McDreamy, Shonda said, “When we were shooting the pilot, Patrick was seriously the most adorable man we’d ever seen on camera. We’d watch the monitor and think, ‘Look at his dreamy eyes!’ So we started calling him Patrick McDreamy, and it stuck.”

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2. Creating the Interns

Shonda has been asked why she made the show start off being all about interns and not well-established surgical doctors. Her response to that question was: “There’s something really horrible about not knowing what you’re doing for a living.” She’s been very adamant in the past about creating shows with characters who reflect the people we see in the real world. Typically women on-screen play the same old ‘nice-nice’ role of the wife or best friend, but she wanted to create something different. Shonda wanted to create three-dimensional characters like Christina who is strong, driven and competitive, or even women who might be considered a b-tch. She wasn’t afraid to take those risks and that’s what makes the characters on the show so great!

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1. Episode Titles

For the majority of the seasons, the episode titles are names of popular songs. For example, in season 1 the episode, “The First Cut is the Deepest,” is a Sheryl Crow song. In season 6 the episode titled, “Shake Your Groove Thing,” is a song by Peaches and Herb and in season 8, Lady Gaga’s “Poker Face” is the title of another episode. The titles reflect the theme of the episode. In season 1 there is an episode called “If Tomorrow Never Comes” by Garth Brooks — this is supposed to reflect the theme of procrastination. The themes of each episode are developed before writing the script. so writers develop a theme and then brainstorm medical scenarios that would work well with the theme and create a storyline to carry it out.

Katherine G

Katherine is the Managing Editor for Health and Parenting, but she has a soft spot for entertainment. She loves binging shows on Netflix, reality TV is a guilty pleasure, and country music is her go-to playlist. When she's not writing, she's spending time outdoors, especially with her puppy Zoey!