Those unfamiliar with ABC's "Grey's Anatomy" might be under the impression that it's a squishy hospital soap opera where wacky incidents are interspersed with necking in the locker room.
They might not be entirely wrong. But that's not the whole story, according to creator/executive producer Shonda Rhimes. The show, which reaches its 100th episode today, was designed with a sharp scalpel edge to it.
"I loved the idea of a world in which competition wasn't just accepted, but fully expected of people," she says of the inception for "Grey's." "For me, it was about finding a world in which being cutthroat was rewarded."
In just four years, "Grey's," like Rhimes, has become a dominating force in TV. With ratings averaging in the 8s during the past five seasons among adults 18-49, the drama -- which focuses on a close-knit set of interns and doctors at Seattle Grace Hospital -- has become a zeitgeist phenomenon at a time when dwindling audiences and fragmented viewership have all but declared that impossible.
"Our show was really on the cusp of a lot of new global things, like how it's marketed, how it's distributed and how it reaches a global audience immediately," co-star Sandra Oh says.
Not that getting it off the ground was so easy.
Executive producers Betsy Beers and Mark Gordon had met Rhimes as an up-and-coming writer and helped her develop a pilot for a series about war correspondents. But in the early 2000s, that idea was an especially tough sell, so they started over.
"I was a serious medical junkie," Rhimes says. "I love to watch the surgeries on the Learning Channel."
The turning point, Beers says, was when Rhimes came up with the idea to use interns as a viewer entree to the jargon-heavy medical world. "If you took the point of view of people who also didn't know what was going on, that was the way to let the audience in on the process in an understandable fashion."
In the end, "Grey's" became not "a hospital drama, but a human drama," says Mike Benson, executive vp marketing for ABC.
But it was different from just any other new show -- medical or otherwise -- on TV. One reason was the emphasis on diversity in casting: Nearly every character was cast without a previously established ethnic description, in order to hire a wide range of potential players.
"There are plenty of times when I'm watching television and I think, 'Not one of these people looks like me,' and that's ridiculous in this day and age -- and honestly a little shameful," says Rhimes, one of Hollywood's few black showrunners. "It was important to have the cast reflect what I think the world looks like."
The rest of the world responded. The show got a strong lead-in from "Desperate Housewives" and immediately took off. Catch phrases like "McDreamy," and later "va-jay-jay," began peppering the national conversation, a ripple effect that proved TV shows could still have a wide reach.
ABC jumped on the marketing bandwagon, creating "Grey's"-branded product that included games for Wii, a book "written" by fictional character Dr. Sydney Heron ("Grey's Anatomy Guide to Healing With Love"), and three soundtracks. There were even greeting cards for Valentine's Day.
"Those elements have contributed significantly to the revenue of the franchise," Benson says.
That wasn't ABC's only response: Success with "Grey's" meant Rhimes earned the right to create a spinoff, and "Private Practice" premiered in 2007. She also is working on a pilot, "Inside the Box," which the Alphabet is considering.
"People who can deliver from whole cloth shows that have legs and life and success are few and far between," ABC Entertainment president Stephen McPherson says. "It's not surprising to me that she could do that.
" 'Grey's' has been one of the cornerstones of (the network's) turnaround," he adds.
The show hasn't been without its challenges. Original co-star Isaiah Washington was dropped after making an antigay slur and co-star Katherine Heigl has at times been vocal about her desire to leave the show to focus on her film career.
To questions about those issues, Oh simply says, "Go watch (the 1950 film) 'Rashomon.' It's been blown out of proportion, but it's about economics -- selling magazines, selling gossip."
While "Grey's" is the highest-rated scripted series this season among adults 18-49, its ratings dropped to 5.9/14 in the same demographic this season, a fall from a series' high of 8.9/21 during its second season. That has led some to suggest Rhimes has spread herself too thinly over all three projects.
"I think we went through those growing pains last year when she was frankly doing too much on both shows ('Grey's' and 'Private') and trying to put all the weight on her shoulders," McPherson says. "I think she's figured out a way to be a good manager, preserve her vision, be there hands-on when she needs to be, but allow herself to empower the right people."
Rhimes' vision continues to draw millions of viewers each week, which causes producers to take a long-term view of the show.
"The possibilities are endless," Beers says of the next seasons. "There's no end to the amazing surgeries and medical issues that occur in a hospital."
Perhaps most heartening for the long-term future of any show is when its creator can step back and let it fly, which is what Rhimes says she can do while focusing on "Private" and "Box."
" 'Grey's' is a very well-oiled machine at this point," Rhimes says. "There's an ease for us now. It's all about how to make the engine work."
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