The doctors on Grey’s Anatomy we’ve come to know and love for 22 seasons are excellent at taking care of other people’s bodies, but when it comes to managing their own hearts, that isn’t really the case. Nobody can judge their instinct to find a mate at work: Their jobs are insanely stressful, and they spend so much of their time in the hospital, they practically live there, making office romances inevitable. Naturally, not every pairing is gonna be as healthy as the relationship between Ben (Jason George) and Bailey (Chandra Wilson). But good relationships don’t necessarily make for addictive, can’t-look-away TV — you need a little mess! So, in celebration of the mess, here are 10 of the craziest couples on Grey’s Anatomy, ranked from “kinda sus” to total hot mess.
10. Derek Shepherd and Rose
The love story between Meredith Grey (Ellen Pompeo) and Derek Shepherd (Patrick Dempsey) remains one of the most significant in all of TV history. Which is why the love story between Derek and Rose (Lauren Stamile) just couldn’t hold a candle (he-he) to what he and Mer had. The painful truth was that Rose was really just a rebound option for Derek after he and Meredith initially broke up, and that manifested in their inability to connect on a deeper level and his coolness toward her after they had sex. Worse, Rose got a little vengeful after she and Derek fizzled out — pretending that she was pregnant was further proof this whole situation was not good for either of them.
9. Owen Hunt and Teddy Altman
After this couple’s years of “almosts,” missed connections, physical distance over the seasons, and even an attempt at an open marriage, you’d think their eventual commitment would be built to last. But Owen’s (Kevin McKidd) need for stability and slight control issues meant butting heads with Teddy’s (Kim Raver) strong-willed nature. Things finally reached their breaking point, and they called it quits at the end of season 21. In hindsight, Teddy cheating on Owen on their wedding day was probably a bad omen.
8. Owen Hunt and Cristina Yang
Owen really wanted to be a parent, and Cristina (Sandra Oh) didn’t — a conversation they definitely should’ve had before getting married. Yet when she was really clear that she didn’t want her future to include diapers, things got ugly. He cheated on her and high-key manipulated her into feeling guilty for prioritizing her career, sawing through her confidence like a bone in the ER. They finally got divorced but not without what felt like an eternity of anguish.
7. Owen Hunt and Amelia Shepherd
Owen thought he was going to be able to create the family unit he so desperately wanted with Amelia (Caterina Scorsone), but their on-again, off-again partnership ended up being another strikeout. They too disagreed on starting a family, and Amelia’s brain tumor caused her to make erratic, impulsive decisions that wore their dynamic down. His tendency to push made her withdraw, and their explosive fights made it evident their rushed marriage was a major oopsie.
6. Jackson Avery and Maggie Pierce
Who’d have thought dating your stepsibling would be a bad idea? Jackson (Jesse Williams) and Maggie (Kelly McCreary) were kinda doomed from the start due to the awkward nature of their situation, and with their constant fighting and Jackson’s tendency to disappear, Jaggie was sometimes tough to witness.
5. Preston Burke and Cristina Yang
Poor Cristina put all her needs and boundaries on the back burner to be with the controlling Burke (Isaiah Washington), setting the standard for the show’s most compelling bad romances. It totally wrecked us to see him humiliate her by calling off their wedding at the altar, giving them the dubious honor of having one of the most disastrous wedding ceremonies in Grey’s Anatomy history.
4. Izzie Stevens and George O’Malley
Going from besties to lovers can be a beautiful blessing … or in the case of Izzie
(Katherine Heigl) and George (T.R. Knight), a tragic mistake. They didn’t exactly start off on the right foot — with that drunken one-night stand that ruined George’s marriage to Callie (Sara Ramirez) — and their discovery that they couldn’t re-create the same magic as that first night revealed a lack of chemistry. That, coupled with their guilt, did their romance in, shanking their friendship to death in the process.
3. Jackson Avery and April Kepner
Kicking off with a spontaneous sex sesh triggered by the stress of their medical board exams, Japril evolved into a model for a high-quality hot mess. After April (Sarah Drew) moved on and got engaged to Matthew Taylor (Justin Bruening), Jackson had the bold audacity to stand up at their wedding and shout out his love for her. Their happily ever after hit severe road bumps with the death of their first child and a later divorce, but they were able to find their way back to each other. Still, their path rivaled Dorothy’s in The Wizard of Oz in terms of intensity and the utterly insane things happening.
2. Izzie Stevens and Ghost Denny
Decades before “ghosting” became a thing in the popular lexicon, Izzie shocked audiences by … dating a phantom. She and heart patient Denny Duquette (Jeffrey Dean Morgan) found love in season two, but their bond was cut short by his heartbreaking death, which she was partly responsible for after cutting his LVAD wire to get him a transplant. But it was his return (in her mind) that got wild; in season five, poor Izzie starts seeing Denny around the hospital and begins having full-on conversations, arguments, and even sex with him, which all ended up being signs of a tumor. Not exactly healthy, but hey, dating a ghost is easier than dating a human, eh?
1. Alex Karev and Ava/Rebecca Pope
Catching feelings for a patient who’s suffering from amnesia is crazy work, and this storyline kept getting juicier and wilder as the seconds ticked on. Alex (Justin Chambers) not only stomped over doctor-patient ethics by getting googly-eyed for her but also went so far as to name the Jane Doe patient Ava (Elizabeth Reaser). Their bond got spectacularly twisted when she remembered her real name (Rebecca) and that she had a husband, which kick-started a mental health spiral that included a suicide attempt. Alex eventually helped her get the care she needed, but the whole event was a long, strange trip indeed.
