By Natalie Abrams
Updated November 12, 2014 at 10:15 PM EST
Credit: Adam Taylor/ABC

There’s quite a commotion at Grey Sloan Memorial. A woman is getting increasingly angry, making a scene in front of half the hospital. She has good reason to be demanding a new doctor: She’s just realized that the surgeon working with her mother also happens to be an addict she knows from Narcotics Anonymous meetings. “Anonymous,” of course, is a relative term here: EW has hit the set of Grey’s to see Amelia’s (Caterina Scorsone) past—including her hardcore drug use and the details of her late boyfriend’s overdose—unravel for all to see in the span of roughly 30 seconds.

“Amelia has left a great deal of her life behind in L.A.,” Scorsone tells us between takes. “She’s established herself at the hospital as the head of neurosurgery. She’s got this really sweet life that she’s set up. In this episode, her anonymity is severely compromised. A lot of stuff that she thought she had left behind is thrown into her present.”

For those who may not be in the know, the former Private Practice character struggled with addiction from a young age after witnessing the murder of her father alongside her older brother, Derek (Patrick Dempsey). After overdosing in her youth, Amelia got on the straight and narrow and became a doctor—but struggled in later years, eventually turning to pills and alcohol. The tipping point came when her new boyfriend Ryan, whom she met in AA, died of an overdose after the two took the last of their pills and swore to get clean the next day. After rehab, Amelia later discovered she was pregnant with the late Ryan’s baby—but the child was born without a brain. Suffice it to say, things haven’t been easy for the youngest Shepherd sibling.

“This episode allows us to go back and revisit all of that stuff and bring her past into the present, so that all the Grey’s fans who weren’t familiar with that hardcore journey she went on in Private Practice will start to see that backstory, and start to see all the layers of this quirky, wacky neurosurgeon. Who is also Little Dreamy,” Scorsone says.

Among the crowd that witnesses Amelia’s confrontation is Owen (Kevin McKidd), who’s forced to reevaluate whether Amelia is the best person for this job. “You can understand why people would be slightly concerned, knowing that their neurosurgeon had a history with hard narcotics,” Scorsone says. “He doesn’t know how hard she’s been working on her sobriety.”

That all may work in Derek’s favor, as he’s been playing second fiddle to his younger sister after deciding against moving to Washington D.C. this season. “There’s been a lot of tension since she came to the hospital, because she originally moved and left her whole life with the idea that she was going to take over his position in the hospital—so that he could feel good about leaving and going to Washington. And of course, at the last minute, he decides to stay,” Scorsone says. “We’re stuck with two highly talented, brilliant neurosurgeons in a very small space. They’ve been having some sibling rivalry since she got there. In this episode, there’s an interesting and key moment when her credibility is thrown into question. It lands on Derek to make a decision about how he’s going to represent her, defend her honor and credibility—or not defend it.”

Credit: Lewis Jacobs/NBC

It goes without saying that Amelia hasn’t made a great first impression with some of her new co-workers—especially Owen. “It is not an ideal circumstance that they’ve come together like this,” she says. “He’s the chief of the hospital, and he’s confronting her about potentially having killed her boyfriend through drug use. It’s going to be an interesting challenge to see her rise above the demolished reputation that occurs in this episode.”

But this experience may just be the catalyst that brings the long-rumored Owen-Amelia romance one step closer to fruition. “They have both witnessed a lot of tragedy and experienced a lot of tragedy,” Scorsone says. “They both have mental health problems due to trauma, and both had journeys with babies. But I think Shonda has a great eye for romantic couplings. She’ll know when the right one is happening. I just trust that she’ll know.”

All that being said, could Amelia’s confrontation send her spiraling once again? “She has built herself a lot of support and structure emotionally,” she says. “She has done so much work on building her foundation and core, having meetings available to her. She’s really been on her program and her recovery. That said, I think that addiction is a mercurial, tricky, tricky disease. Anybody who has suffered from it and really understands what it is knows that you can’t get cocky. No matter how sober you think you are, you’re one drink away from seeing that demon. Amelia has a very healthy respect for that.”

Grey’s Anatomy airs Thursdays at 8 p.m. ET on ABC.

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Grey's Anatomy

Meredith. Alex. Bailey. The doctors are definitely in on Shonda Rhimes' hospital melodrama.

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