When “Grey’s Anatomy” fan Seyward Darby says she keeps up with new episodes of the long-running medical drama, “people look at me sideways,” she said.

As a fellow fan, I often hear a similar sense of disbelief: “I can’t believe you still watch that show.”

But we’re not alone. “Grey’s Anatomy” is still one of the most-watched dramas on network television, and Thursday marks the beginning of its 20th season (seriously…seriously… seriously!).

After 420 episodes and almost two decades on the air, the legacy of “Grey’s Anatomy” and its effect on pop culture has been long discussed. It diversified casts. It attracted people to the medical field. It celebrated women for being ambitious and complicated — and for having good sex. It drew attention to social and political issues, such as gay rights and gun violence (sometimes imperfectly) that other shows often avoided completely. It launched the careers of creator Shonda Rhimes and original cast members Ellen Pompeo, Chandra Wilson, Katherine Heigl and Sandra Oh (and many other actors, writers and producers affiliated with the show).

It also became the longest-running prime-time medical drama on television, outlasting more characters than I can name, both of its spinoffs (“Private Practice” and now “Station 19,” which was just canceled), multiple showrunners (Meg Marinis is succeeding Krista Vernoff) and its titular lead character (Pompeo departed the show as a series regular last season).

Though all these accomplishments are noteworthy, what’s less obvious and less talked about is how, for almost 20 years, “Grey’s Anatomy” has reached fans across the world, touching their lives, shaping their choices and making them feel seen.

In honor of the 20th season, I spoke to several fans about what the show has meant to them, why they’re still watching and what they’re looking forward to this season. The origin story of each fan makes it clear that it’s impossible to separate what they love about “Grey’s Anatomy” from how they fell in love with it in the first place.

Some, like mother-daughter duo Melanie French and Judy Lamb, have truly been watching since the show’s inception in the spring of 2005. French, who was in college at the time, remembers watching episodes at her sorority house on Sunday nights. Across the state, her mom, Lamb, was tuning in at home. Now they live states apart, and they’re both still watching, albeit on different timelines. With two kids and delayed streaming options, French is often behind her mom. “I tell her to get the Kleenexes ready,” Lamb said.

Darby was also in college when the show premiered, and she remembers it being on in the background of her college newspaper’s office. But she didn’t become a regular viewer until she moved to Europe after graduation and was visiting a friend in Paris during the worst weather imaginable. She couldn’t walk around the city, so she ended up hanging out in his apartment, and he had the first few seasons of “Grey’s Anatomy” on DVD. She binged all of them and became deeply connected to the show when Denny Duquette (Jeffrey Dean Morgan) died at the end of Season 2, shattering Izzie Stevens.

Darby could personally relate to Izzie’s story, especially the iconic scene of her lying on the bathroom floor in her pink, strapless prom dress, because her boyfriend had died suddenly the year before. “I remember when it happened that, if I just lay on the floor, the floor will hold me because I just felt like I was falling all the time,” Darby said. She still thinks often of Izzie’s scene.

Fani Mari, who lives in Greece, also discovered the show via DVD around that same time. She’d either rent them or borrow them from another girl she knew. That girl quickly became a friend.

“Our love for ‘Grey’s Anatomy’ connected us,” Mari said.

In November 2020, she was watching the show’s depiction of the COVID-19 pandemic and how it portrayed its effect on health care workers. The episodes made her curious about what life was like for people around the world during that time. The show inspired her so much that she ended up interviewing people and writing the book “Hindsight 2020: Tribulations and Silver Linings During a Global Pandemic.”

Gen-Zer and college junior Miriam Gardner is one of the show’s younger fans. She discovered it via Netflix, binging the show over winter break during her first year of high school. It was a coming-of-age moment: “Grey’s Anatomy” was the first TV show she watched that had adult characters. She loved the medical aspect of the show and related to George O’Malley (T.R. Knight) always being the underdog. Also, she was, of course, drawn to the love triangle between Meredith, Derek Shepherd (Patrick Dempsey) and Addison Montgomery (Kate Walsh).

After catching up on Netflix, she started watching either live or the next day on Hulu. “I just always remember making sure I wouldn’t look at any Instagram spoilers or anything because I feel like everyone would always be talking about what happened on the episode on social media,” Gardner said.

For all these fans, “Grey’s Anatomy” has become a touchstone in their lives, and the characters feel like family. It’s why they’re still watching.

“When they killed off Patrick Dempsey, I was furious, and I was like, ‘I’m never watching that show again!’ And I really meant it,” French said. “And then a couple months go by, and it comes back on, and I just want to see what happens with Meredith.”

Now there’s far less Meredith. Pompeo appeared in only eight of the 20 episodes in Season 19, and she’s slated to appear in four of the 10 episodes this season. However, even the main character’s departure isn’t deterring these fans. “I definitely was skeptical at first and surprised by that [departure] because I thought they would kind of end the show whenever she left,” Gardner said. “But I definitely will still watch it to see what it’s like.”

These fans’ devotion is a testament to the world “Grey’s Anatomy” has created, a world that feels so real it can outlast its eras, becoming more than the intern classes, residents and (many) chiefs of surgery who propel it forward, more than its melodramatic plot arcs and enviable friendships and messy romantic entanglements.

Over 20 seasons, “Grey’s Anatomy” has become so much more than a television show.

“It’s its own extended universe, and it’s just moved so far from what it was initially and become part of our cultural discourse in a way that I just kind of imagine it going on for forever because it’s not like I’m hungering for some conclusion or eager to see where does this all wrap up,” Darby said.

She’s looking forward to the new season, to waking up on Friday mornings and streaming the show while she drinks her coffee and gives herself over to the world of Grey-Sloan Memorial Hospital and the big feelings and thoughts it inspires.

The flexibility viewers have in how they watch the show has also kept so many fans in its fold. Fans can watch weekly on ABC or the next day on Hulu. They can wait for the new season to drop on Netflix (and now Hulu) in the late summer and binge-watch the entire thing. They can even step away for a while and return, which is what Gardner is currently doing. She has been rewatching the show from its beginning and plans to continue with new episodes when she’s finished.

For those gearing up for the new season this week, they’re hoping to see the relationship between Meredith and Nick Marsh (Scott Speedman) develop, looking forward to the return of Arizona Robbins (Jessica Capshaw) and wondering what’s going to happen to the new intern class after Simone Griffith’s (Alexis Floyd) wedding that didn’t happen, Jules Millin’s (Adelaide Kane) declaration of love and the medical drama that could ensnare them all. They’re also still celebrating Miranda Bailey’s Catherine Fox Award for her contributions to and advocacy of reproductive health care and waiting to see what social issues the show engages with this season.

Ultimately, what becomes clear from these conversations with fans, who are at all stages of life and living all over the world, is that “Grey’s Anatomy” — as imperfect as it can be when social issues are handled too didactically, or the plot is dragging or a beloved character leaves — has been a gift in their lives.

I understand the feeling. I’ve grown up with the show. Its influence is evident when I “dance it out,” or call my Cristina or watch an old episode because I miss my mom (we watched our last Thursday night episode together in November of 2018 before she died).

At the end of Season 19, I began to question why I “still watched that show.” I questioned if I had the stamina to keep going, to invest in another class of interns. But I’m planning to tune in live Thursday night. I want to see what happens, and it feels fitting to mark the 20th season premiere of the show the way I first began watching it, commercials and all.