Grey Sloan Memorial has gotten a lot of its staff back, but that doesn’t necessarily mean that things have gotten easier. The Grey’s Anatomy Season 21 premiere saw Meredith (Ellen Pompeo) once again go head-to-head with Catherine Fox (Debbie Allen). We know that Meredith was able to strike some deal with Catherine that got Amelia (Caterina Scorsone), Teddy (Kim Raver), and Hunt (Kevin McKidd) their jobs back, but the Alzheimer’s Disease research is still very much in question. And we suspect that Catherine’s recent collapse made her softer than she would have been otherwise.

Bailey (Chandra Wilson) also still has a fight ahead of her to get her job as resident director back. She’s hoping that she’ll have Ben (Jason George) in her corner at the hospital as he returns to medicine, but it’s going to be tough convincing Catherine to let her have the residents instead of Sydney Heron (Kali Rocha), who has already taken over the program. 

Meanwhile, Jo (Camilla Luddington) and Link (Chris Carmack) will be preparing for their third child. Schmidt (Jake Borelli) is once again looking to settle on a specialty, and the interns are trying to keep their heads above water. That might be even more difficult now that Lucas (Niko Terho) and Simone (Alexis Floyd) are now officially giving their relationship a go. 

Parade talked to Grey’s showrunner Meg Marinis about the premiere and what fans can expect next in Season 21. 

Related: Everything to Know About Grey’s Anatomy Season 21

What made you decide to bring Catherine’s cancer back? 
It’s a blood clot on her liver due to the burden of her cancer. That’s Budd-Chiari Syndrome. That’s the medical definition. It’s aways there. She lives with a chronic illness. That’s part of Catherine’s story and we want to pay respect to the reality of people who live with cancer. It’s kind of a rollercoaster. Sometimes everything is great for a year or two, and then other years you have a complication. I also think that with Catherine as the villain, whenever you see her in a vulnerable position, it is amazing story for us. Debbie has this amazing talent to just play the villain and at the same time has an emotional power that she really delivers. 

We see in the premiere that Jackson is really invested in Meredith finding this cure to Alzheimer’s, but Meredith has now made this deal with Catherine that seems to have taken her out of it. How much will we see Jackson in relation to getting Meredith back on this case?
Even if he’s not on screen, we love to play him in our story. We love having Jesse whenever we can, but Jesse has a very busy schedule, so we don’t have him as much as we want sometimes. He brought Meredith this idea back in Season 19, the idea of her working on Alzheimer’s Disease for the Fox Foundation. He feels that not only is this a personal betrayal, but it’s a personal betrayal. He thought they were going to do this together. There’s tension between the two. 

How soon are we going to find out exactly what Meredith promised Catherine to get everyone’s jobs back? 
It continues right after Episode 1. We won’t go away from it. 

Related: Grey’s Anatomy Boss Teases ‘Intense’ Season 21 as Catherine Embraces Her Villain Role

How are Teddy, Owen, and Amelia approaching their jobs now that they almost got fired. Are they back with gusto or is there some hesitance considering what happened?
All three of them have a different reaction to it. There is a little bit of fear of misstepping again. 

Did the Spartacus moment in the Season 20 finale actually unite the interns? Would you say they are on the same page now?
Yes, I think they are getting on the same page. Those five have a knack for getting in trouble and thinking impulsively without considering their other colleagues. 

Lucas and Simone have a very dramatic kiss at the end of the premiere, but they’ve had those before. What gives them a shot at finally making it work this time around?
I’ll tease that we’re going to see the two of them try to crack this relationship. We’re going to let them try and you’ll see complications from that. This is a coming together that is a real coming together. It’s not a heat of the moment kiss. He is giving up a huge opportunity for her. 

How does that moment of Richard and Winston going over the surgery change Richard’s outlook about his career?
It’s been a 21-year journey for [Richard] contemplating when he’s going to put the scalpel down. Winston says that medicine has become so specialized, especially in its teaching. There are not a lot of surgeons and doctors like Richard Weber left still practicing. He’s going to realize that he is a secret weapon when it comes to teaching, not just the interns but also the fellow attendings.

Grey’s Anatomy Season 21 continues Thursdays at 10 p.m. ET on ABC. 

Next, Grey’s Anatomy Star Camilla Luddington Opens Up About ‘Distressing’ Health Diagnosis.

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