A Guide to Grey's Anatomy's Most Epic Romances—and Their Often Tragic Endings

In honor of former Grey's Anatomy star Sara Ramirez's birthday on Aug. 31, a look back at love in Shondaland over the last 15 years.

By Billy Nilles Aug 31, 2020 7:15 PMTags
Related: "Grey's Anatomy": By The Numbers

Welcome to Shondaland, where the romances always burn white-hot and usually end in tragedy.

Over the last 16 seasons, Grey's Anatomy has delivered more than its fair share of epic romances involving a rotating roster of unbelievably attractive doctors and, at times, their equally impressive patients. It is a glossy nighttime soap, after all. That's what they do. 

And no one does it better than Grey's

From Meredith Grey's (Ellen Pompeo) life-altering—for us, as much for her—romance with Derek "McDreamy" Shepherd (Patrick Dempsey) to Izzie's (Katherine Heigl) ill-fated love affair with Denny Duquette (Jeffrey Dean Morgan) and all that have followed, Shonda Rhimes and her team have never failed in their quest to make us swoon week after week, usually as we're full-on sobbing.

With the show's return date for season 17 still up in the air thanks to COVID-19, we thought it was as good a time as any to take a trip down memory lane and reminisce about all the epic-ness the show has delivered up to now. You know, to help us get over our separation anxiety. It's good to remember the good times.

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Grey's Anatomy and Station 19 Couples Status Check

Now, you'll notice that not every couple ever is in here. That's because not all of them really rank as "epic" in our eyes—or because some, like Mer and DeLuca (Giacomo Gianniotti), are only just getting started. So, spare us your angry tweets. Please.

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Meredith and Derek

The one that started it all. The love story between Meredith Grey (Ellen Pompeo) and Derek "McDreamy" Shepherd (Patrick Dempsey) grabbed us from the very first episode, when we learned along with Mer that her one-night stand just so happened to be with a doctor at Seattle Grace Hospital—where she was starting her surgical intern program. Over 11 seasons, we watched as they overcame returning wives (his), attempted suicides (hers), and a whole litany of life-threatening disasters to finally get married...with a Post-It. Sadly, thanks to Dempsey's decision to walk away from the series, their story—though not their love—was cut short when Shonda Rhimes wrote Derek out the only way she felt she could: Killing him in a car wreck.

Izzie and Denny

Pour one out for the first tragic doctor-patient relationship Grey's ever introduced us to. When Izzie (Katherine Heigl) met cardiothoracic patient Denny Duquette (recurring guest star Jeffrey Dean Morgan) in season two, it was all over for the intern. She was head over heels for the lovable grump—and so were we. When they became engaged, we knew it couldn't last. And it didn't. His condition deteriorated and she put her career on the line by deliberately cutting his LVAD wire to move him up the donor registry. He got his new heart, but stroked out hours later and died in the season finale. His memory lived on, though, when Izzie inherited $8.7 million from him and she opened the Denny Duquette Memorial Clinic, a free clinic at the hospital. As for us, we've never been able to listen to Snow Patrol's "Chasing Cars" quite in the same way, even all these years later.

Cristina and Burke

Cristina Yang's (Sandra Oh) first appearance on this list is mostly notable for how it ended. Her romance with Preston Burke (Isaiah Washington) was sort of the anti-MerDer in that Burke was a bit of a jerk and the way he let Cristina covertly do his surgeries for him after he'd been shot was so unethical we can't even. And then he got mad at her for confessing? No, bruh. And then he left her at the altar and disappeared from her life forever? (A move necessitated by Washington's infamous firing over his unsavory behavior towards gay cast member T.R. Knight.) Good riddance. When he returned in season 10 to offer Cristina his hospital in Switzerland (to help send Oh off), it was literally the very least he could have done. Can you tell we don't like Burke?

Callie and Arizona

Yes, Callie Torres (Sara Ramirez) had relationships prior to Arizona Robbins' (Jessica Capshaw) arrival in season five, but none of them mattered nearly as much as the epic romance that was Calzona. (Sorry, not sorry, George.) The couple got married, raised Sofia, Callie's daughter with Mark Sloan (Eric Dane), together, and weathered Arizona's leg amputation and infidelity before eventually getting divorced in season 11. It seemed like one of TV's greatest lesbian love stories would remain a tragedy when Ramirez left the show in season 12, with Callie moving across the country with new girlfriend Penny, but when Capshaw was written out at the end of season 14, fans got a glimmer of hope as a newly-single Callie was ready to welcome Arizona to NYC with open arms. (If only Ramirez had returned for the episode...)

Alex and Ava/Rebecca Pope

In season three, Alex Karev (Justin Chambers) got his first taste of truly tragic love when a ferryboat accident brought a pregnant Jane Doe (recurring guest star Elizabeth Reaser) with amnesia into the hospital. As they grew closer, Alex helped her forge a new identity, picking the name Ava. When her memory returned after she gave birth, she admitted her name was Rebecca Pope and she'd left a bad marriage. After going back to her husband, she returned to Alex's life in season four, telling him she was pregnant. Unfortunately, when the pregnancy was revealed to be a hallucination, the result of a personality disorder, and Rebecca attempted suicide, Alex realized she needed more help than he could provide and was forced to admit her for psychiatric care and say goodbye.

Richard and Ellis

Sure, Chief Webber (James Pickens Jr.) and Mer's mom, the brilliant surgeon Ellis Grey (played by recurring guest star Kate Burton), were married to other people when they began their love affair back in the day. But it was torrid enough to tear Mer's home life apart and deliver us a surprise love child in the form of Maggie Pierce (Kelly McCreary), whom we first met in season 10 and has since become a cornerstone of the series. It was an illicit love that would never last, not least because Ellis was ravaged by Alzheimer's until her death in season three. But it had so much impact on just about everything.

Mark and Lexie

Sure, Meredith's other half-sister Lexie (Chyler Leigh) and Mark "McSteamy" Sloan were in a handful of other relationships throughout their times spent roaming the halls of Seattle Grace. But no relationship was more important to either of them than the one they struck up in season five, tormenting them with its on-off nature until they professed their love for one another and promptly died in the season eight-ending plane crash. RIP.

Izzie and Alex

Izzie and Alex always found a way to be there for the other when they were recovering from their latest heartbreak at the hands of someone else. And their growing bond could've really been something if Heigl hadn't decided to leave the show in season six after the characters tied the knot, leaving us with another cruel "vanishing lover" scenario, à la Burke's disappearance. Little did we know it would come back to offer Alex a way off the series when Chambers abruptly left Grey's in early 2020, shocking fans with the revelation that Izzie had been raising Alex's kids on a farm somewhere, providing the only possible reason for him to abandon his wife that might not make him look like a total monster.

Cristina and Owen

Cristina's second appearance on this list was a little more successful than the first in that the couple actually made it down the aisle, despite that time Owen (Kevin McKidd), stricken with PTSD-induced nightmares, nearly choked her to death in his sleep. But when she got pregnant and chose to have an abortion, he couldn't really handle it and it eventually tore them apart. They divorced and we realized that perhaps Cristina's greatest love affair would always be with her career. And you know what? That's A-OK.

Bailey and Ben

Miranda Bailey's (Chandra Wilson) first marriage ultimately ended in disaster, but it allowed her, in season six, to meet a cute new anesthesiologist by the name of Ben Warren (Jason George). Their marriage has been through it all: his impulsive need to change jobs on a whim (first to become a surgeon and now a firefighter) and her heart attack. And though there is real pressure on the union thanks to Ben's new high-risk job—something that's playing out both on Grey's and its spinoff series, Station 19—something tells us there isn't anything these two can't (and won't) overcome.

Teddy and Henry

When we met Teddy Altman (Kim Raver) in season six, her story was all about her mysterious past with Owen and how it might affect his relationship with Cristina. But by next season, she found herself in one of Grey's patented doctor-patient tragedies after falling for Henry Burton (recurring guest star Scott Foley). They impulsively got married so he could use her health insurance to cover the ongoing cost of treatment, eventually falling in love. Naturally, he would succumb to his heart condition during surgery in season eight, leaving Teddy devastated and out of a job. (Owen fired her so she could move on, knowing she'd never do it on her own.)

Alex and Jo

After all his romantic stops and starts, Alex just may have finally found the one in new bride Jo (Camilla Luddington). But getting to husband and wife, something that only happened in the season 14 finale, took them overcoming her dark, abusive past marriage and his nearly going to jail for beating the snot out of a co-worker. (Poor DeLuca didn't deserve that beating, no matter how things looked when Alex walked into the room!) Once they were finally married and she'd taken his last name, this thing looked like endgame to us. Sadly, Chambers' shocking exit from the show halfway through season 16 would forcibly prove us wrong.

Jackson and April

Ah, Japril. The romance that started in calamity—never forget when April (Sarah Drew) left her fiance standing at the altar to run off with Jackson (Jesse Williams)—and ended in tragedy. After eloping and discovering she was pregnant, the new couple discovered that their unborn child had a fatal condition, requiring April to give birth to their stillborn son, Samuel. They divorced in season 11, though a one-night stand brought a daughter, Harriet, in season 12. By the time Drew left the series in season 14, she was reunited with jilted beau Matthew (Justin Bruening), spontaneously marrying him with Jackson's blessing.

Richard and Catherine

As wife Adele (Lorette Devine) was deteriorating due to her Alzheimer's diagnosis, Richard found himself on the receiving end of advances from Jackson's powerful mom, Catherine Avery (recurring guest star and executive producer Debbie Allen). He refused on the grounds that he was a married man, not wanting to be a cheater twice over. But as Adele eventually succumbed to her illness in season nine, he warmed to Catherine and they entered into a relationship and were happily married from season 11 to 16. Of course, this is Grey's we're talking about and they've since separated following Catherine's angry power plays in the wake of Meredith's insurance scam at the end of season 15. Not even a brush with death was able soften Richard's feelings of betrayal over Catherine's actions.

Owen and Amelia

Was Owen's relationship with Derek's recovering addict sister Amelia (Caterina Scorsone) epic? Sure, but mostly because it was so riddled with dramatic obstacles and little happiness. They never saw eye-to-eye on children, a sticking point for Owen since his days with Cristina. They had to overcome her relapses and brain tumor. They'd gotten married and divorced. And then, when raising a foster child and his drug-addict teen mother, Teddy returned—pregnant with Owen's child. They've finally gone their separate ways, with Owen and Teddy trying to make it work—emphasis on trying—while Amelia's starting a family of her own with hunky new doc Link (Chris Carmack). 

Meredith and Herself

She is the sun, after all. 

Grey's Anatomy returns to ABC sometime in the 2020-21 season.

(Originally published on Nov. 1, 2018 at 3 a.m. PST.)