"Grey's Anatomy" lost one of its surgeons on Thursday's sixth-season premiere, when Dr. George O'Malley died during the opening moments of the show.
The plot came as no surprise to fans who kept up with entertainment magazines over the summer. That's when viewers learned actor T.R. Knight, who portrays George O'Malley, wouldn't be returning to the show.
Two character's fates were uncertain when the last season of "Grey's" wrapped up. One of those characters was O'Malley, who jumped in front of a bus to rescue a woman he didn't know. The other character hanging to life: Dr. Izzie Stevens (Katherine Heigl), who had struggled with a brain tumor throughout the season.
When season five ended, O'Malley was covered in injuries and Stevens had lost consciousness after a risky operation. Their characters, dressed in fancy attire, met in an elevator -- presumed to be heaven.
Turns out Izzie only left the real world briefly. She regained consciousness shortly into Thursday's show, which tracked 40 days at Seattle Grace.
Dr. Callie Torres identified the mystery patient as George by a freckle on his hand. When the Seattle Grace doctors learned the news, everyone handled their grief differently. Dr. Miranda Bailey had an especially difficult time masking her emotions, and was especially distant in her ties with cancer-ridden Izzie.
George's mother asked Callie to decide whether George should donate his organs, since George and Callie were briefly married. Ultimately, however, Callie concluded Izzie should make the decision. Izzie decided to donate the organs.
Meanwhile, Izzie faced struggles in her new marriage to Dr. Alex Karev. Even after Izzie learned her cancer had stopped growing, Karev was reluctant to be intimate with her since she'd only recently almost died in his arms. Thursday's show ended with the pair kissing.
The show's other newlyweds, McDreamy and Meredith, continued to enjoy marital bliss -- after getting hitched via Post-It note last season. They savored displays of physical attraction, until Meredith learned she was only using intimacy as a way to cover her grief over George's death.
Meredith isn't the only Grey who's happy. Her younger sister Lexie continued a relationship with McSteamy and decided to move in with him -- even though his former fling (and current lesbian) Callie lives in the apartment across the way.
Lexie shouldn't have much to worry about, though. Callie -- who after a fight with Chief moved to neighboring hospital Mercy West -- is still seeing Seattle Grace pediatric surgeon Arizona Robbins.
Then, there's the relationship between trauma surgeon Owen Hunt and Cristina Yang. The pair decided to move forward with their romantic relationship, despite the fact that Hunt's PTSD caused him to strangle Cristina in her sleep last season.
They attended therapy together and ultimately shared a bed, even though the show ended with Cristina wide awake.
(It's probably smart to note Cristina might not be the most compassionate girlfriend, since she called a patient who suffered a horrible boating accident "ceviche." Yeah, that's a seafood dish.)
But let's not forget there's a hospital to run here. And that's not going so well.
Early in the episode, McDreamy was approached by a member of the hospital board and was asked to take over the position as chief of surgery. Why? Board members aren't happy with the hospital's performance and they're trying to unseat Chief. McDreamy told Chief what was happening, and did his best to stall the process.
At the end of the show, Chief announced Seattle Grace and Mercy West are merging. Nobody's job is safe.
Sounds like it's time to stop hooking up and start doing your jobs, doctors.
Weigh in: Did you watch Thursday's show? Are you sad O'Malley is gone? And most importantly, which Seattle Grace staffer would you most like to see lose his/her job?