Spoiler alert: The following contains details from the Season 20 premiere of "Grey's Anatomy."

A malfunctioning self-driving car repeatedly ramming into an ambulance. Five interns nearly on the chopping block after the unnecessary death of a patient. An attending surgeon on death's door over a rare dental complication.

Yes, ABC's "Grey's Anatomy" (Thursdays, 8 EDT/PDT) began its unprecedented 20th season – and with it, its usual head-scratching, high-drama high jinks. Due to the aftermath of last year's actors' and writers' strikes, the 20th season consists of only 10 episodes, half of the typical 20-episode run for the longest-running primetime medical drama. It's a welcome change for this fan, who's seen all 420 episodes at least once, if not several times.

"It does allow you to tell a couple of different stories that maybe you wouldn't be able to tell in a 20-or-plus season," says executive producer Meg Marinis. "Things are a lot more immediate."

Most enduring in primetime:'Grey's Anatomy' begins its 20th season: See the longest running medical shows of all time

What happened on the 'Grey's Anatomy' Season 20 premiere?

The season kicks off right where the Season 19 finale ended. Teddy (Kim Raver) is in the midst of a major health crisis. She ultimately lives after an emergent valve replacement due to bacterial endocarditis. Meredith (Ellen Pompeo) walks back her controversial take that decades of Alzheimer's research are wrong, although she asks Amelia (Caterina Scorsone) to keep investigating on the side. The interns' love lives and careers are in limbo ― just like when Izzie (Katherine Heigl) cut the LVAD wire in Season 2 ― but no one loses their job. Instead, Nick (Scott Speedman) resigns as residency director and a familiar face, Miranda Bailey (Chandra Wilson), takes his place.

Longtime fans will notice that the season premiere feels an awful like its pilot episode from 2005, with Bailey uttering a very familiar five words: "I have five rules ..." Those were the first lines she told then-interns Meredith, George (T.R. Knight), Izzie and Cristina (Sandra Oh). Goosebumps shot up and down my arms: "Grey's" felt back, for the first time in awhile.

"Bailey is not going to make it easy for those interns," Marinis teases. She's worked on the show since Season 3, and promises more Easter eggs throughout the season. The theme of the season? Back to basics, after some heavy moments in the characters' lives: a near-death experience, a non-wedding and a near-alcoholism relapse, for starters. "So much happened in the finale that it's going to take awhile to unpack it all," Marinis says.

Aww:'Grey's Anatomy' cast reunites on Emmys stage: See who showed up (and who didn't)

'Grey's Anatomy' Season 20: What will happen next? Who's coming back?

While fewer episodes is admittedly "a bummer," Marinis says the writing staff wielded their scalpels ― er, pencils ― to their advantage.

"We've never gotten this opportunity to do it that way," she adds. "Season 1 was short, but that was because it was a new series. Since then, we've always had these really long seasons. We took the opportunity to tell a couple stories differently, which may not have worked over more than 10 episodes."

Fans can expect to see Meredith return (she's scheduled to appear in three more episodes). "We're so grateful that (Pompeo) is still so invested in the show," Marinis says. Ditto Nick. "They just had this wonderful chemistry and this wonderful back and forth. And I feel like the character also challenges her in a way." While the interns are certainly lovable, "Grey's" needs a dose of its eponymous "Grey" from time to time to tie the show together.

What else can we look forward to? Appearances from characters Arizona Robbins (Jessica Capshaw) – who left in Season 14 ― with a serendipitous storyline you'll have to wait and watch for yourself, and Nico Kim (Alex Landi), who catches up with ex Levi (Jake Borelli).

We stand by this:Meredith Grey (and Ellen Pompeo) has left ABC's 'Grey's Anatomy,' and it's about time

How 'Grey's Anatomy' (might) end

Any "Grey's" fan knows people are shocked the show is still on. And some of them think it's high time the show shut down its ORs for good (myself included). Marinis certainly imagines what a perfect last shot might look like, but producers were thinking that 10 years ago, too, and the show lasted another decade anyway.

"That vision has to change, because our characters change and our stories change. I've imagined a few different ways of how it would end, but obviously I would check in with (creator Shonda Rhimes), and we would make sure that her vision and my vision align."

For now, just know that "Grey's" will keep on giving classic "Grey's." Even if it seems as ridiculous as a self-driving car repeatedly smacking that ambulance.