‘Grey’s Anatomy’ Fall Finale Reveals 2 Shocking Diagnoses -Recap

SPOILER ALERT: The story includes details about Season 22 Episode 6, “When I Crash,” of ABC‘s Grey’s Anatomy.

The promos for tonight’s Grey’s Anatomy fall finale had prepared fans for perilous situations involving two Grey Sloan doctors: Teddy (Kim Raver), who was seen under a crashed bus as it dropped on her, and Jo (Camilla Luddington), with Winston (Anthony Hill) telling Link (Chris Carmack) that “her heart is failing.”

In light of that, Jo’s heartbreaking peripartum cardiomyopathy diagnosis did not come as a complete surprise but Grey’s managed to deliver a bombshell, one we didn’t see coming — in the final minutes, Richard (James Pickens, Jr.) revealed that he had cancer.

His admission capped an out-of-character confrontational storyline between Miranda (Chandra Wilson) and Richard throughout the episode as the two butted heads over multiple things, including resuscitating a victim from the bus crash who lived because Richard defied Miranda’s order to stop and call time of death. Turns out Richard had been distracted lately while waiting for his biopsy results.

For some reason, Jo and Link are attracting all bad luck on Grey’s this season. After Link almost died after the explosion in the season premiere, it was now Jo and their babies’ turn to have a brush with death in the fall finale.

After possibly overexerting herself in the previous episode performing a difficult delivery at 30 weeks pregnant and experiencing leakage on her way home, Jo, with Link by her side, went back into Grey Sloan. What first appeared to be a routine checkup, with the babies looking good, quickly turned ominous when Jo’s shortness of breath was identified as a symptom of peripartum cardiomyopathy. That in itself didn’t sound scary at first, as Winston revealed that the condition could be controlled with pills or a heart pump to give the babies more time to develop in utero.

However, the pills didn’t work and what was supposed to be a routine procedure to insert a pump quickly went south in the OR, with Jo and her babies crashing. For some reason, there were no OBGYN doctors available, leaving Winston with the job of performing his first C-section since medical school. No pressure. We will have to wait until Jan 7 to see how he did.

While Grey’s Anatomy is known for its dramatic cliffhangers, the series already had one doctor fatality this season when Monica (Natalie Morales) died in the season premiere. Both Luddington and Pickens Jr. are series regulars, who, as Deadline has reported, are slated to appear in 14 of Grey’s Anatomy‘s 18 episodes this season with no indication that any of them would be leaving prematurely. (Both play fan-favorite characters, too.)

In an interview following the Season 22 premiere, showrunner Meg Marinis confirmed that Jo and Link’s babies will be delivered this season, which would indicate a live birth. And after the Season 21 finale that left Link’s life in danger, she indicated that “nobody wants those two unborn girls to be fatherless,” which should also apply to them being left without a mother.

Meanwhile, Pickens Jr. is a Grey’s OG and on the show’s Season 22 key art, alongside fellow OGs Ellen Pompeo and Wilson; he is not going anywhere for the foreseeable future. There have been multiple characters living with cancer on the show, including Richard’s wife Catherine (Debbie Allen) who has been battling the disease for years.

While Jo and Richard faced life-threatening conditions, Teddy, who looked seconds from being crushed in the promos, was totally fine. She got out from under the bus without a scratch after stabilizing the woman trapped underneath. (She survived too, BTW.)

What did not survive was Owen’s second fling with childhood friend Nora (Floriana Lima). After a night together, they were walked in on by Teddy — as well as her and Owen’s kids — with Nora still in bed, naked. By the end of the day, Nora told Owen that she was too entangled with Teddy after the groundbreaking surgery the latter performed on her to jeopardize that relationship by getting involved with him.

Meanwhile, Teddy and Owen admitted to each other that neither loves to see the other with a new partner (Cass and Nora, respectively) but when Owen once again brought up the specter of their marriage, suggesting that they may be rushing into a divorce, Teddy shut down a possibility for reconciliation by saying, “I don’t think we are rushing it, it’s complicated but we’ll figure it out.”

In interns/residents developments we had the first of Grey’s famous elevator make-out sessions this season as Kwan (Harry Shum Jr.) and new plastic surgeon Kavita’s (Anita Kalathara) tension over the past couple of episodes culminate in a kiss.

Simone (Alexis Floyd) and Wes (Trevor Jackson) are not there yet — but getting close as she was moved by his compassion helping an autistic patient and the two shared a moment in a supply closet, with Simone summoning some serious will power to leave.

Her pact-mate, Jules (the two had vowed to focus on work and not get distracted by romance) is not doing very well keeping the blinders on either. She invited Winston to group drinks and he said yes. (Grey’s continues to push the HR-violating relationship between the duo, with Kwan and Kavita now joining them in the questionable power dynamic pairing group.)

In other developments, new intern Dani (Jade Pettyjohn) was back after her memorable first day in the season premiere, and another new intern, Harrison, played by recurring co-star (Anton Starkman), is starting to get attention with more lines in important scenes. (He was asked to pronounce the crash victim dead in the fall finale.)

As Grey’s Anatomy wrapped its fall run, many fans were not ready for it.

“How are we at the fall finale already?,” one wrote under one of the promos for the episode. “The show JUST came back wtf do you mean fall finale,” another asked.

Long gone are the days of 22-episode seasons where shows, including Grey’s Anatomy, used to run originals through mid-December, including Thanksgiving and Christmas episodes. Grey’s Anatomy is doing a full-season 18 episodes. Fellow ABC drama High Potential, which also is doing 18 episodes, aired its fall finale even earlier, on Oct. 28.

The good news is that, instead of returning in late February or early March per broadcast tradition, all ABC fall scripted series will be back in early January, with Grey’s next episode airing Jan. 7.