Grey's Anatomy's alt-reality episode truly is a love letter to the fans.

In this new reality, Ellis Grey was never diagnosed with Alzheimer's, which leads to a very different upbringing for Meredith, the least of which: Her last name is now Webber. That is just one of the nice surprises in the alt-reality. Let's check out the rest:

Music nostalgia: The episode opens on Rilo Kiley's "Portions for Foxes," which was the first song played in the Grey's pilot. Throughout the episode, we also heard songs featured in the first season, including Róisín Murphy's "Ruby Blue" and Inara George's "Fools in Love."

Meredith Webber: Meredith still lives in her mother's house, but so does her mother, Ellis, and her husband Richard! Ellis is now the Chief at Seattle Grace, and is being awarded her third Harper Avery award. Meredith is desperate to please her mother, and while she says she doesn't want special treatment, she isn't afraid to use her status to get in on Yang's surgery. Meredith later realizes her mom makes everyone feel ordinary so she can feel extraordinary. A nice nod to the two-part episode where Ellis died.

Poor Derek: Not only is Addison still married to Derek, but she's pregnant, too. However, their marriage leads to a miserable existence for both of them. They live in the trailer since Derek never built the McMansion, and he doesn't even seem to want the baby that's on the way. "It's a beautiful day to save lives," Addison throws in Derek's face at one point, the line he used to say before each surgery. Derek is also not the hot shot doc anymore, and when a fight between Addison and Derek seems to indicate she'll leave Seattle Grace, Ellis threatens that she'll fire Derek over Addison quitting. (One good thing: It's nice to see Callie and Addison reunited. I always loved their banter.)

Callie's conflicting feelings: Though Callie has kids with Owen, it's clear that it's not a happy marriage. When Arizona excitedly hugs Callie, the look on Callie's face spells a sudden attraction to her co-worker. Plus: Owen still has PTSD, and it seems that unfortunately Callie was the one whom he once choked in reaction to a PTSD flashback. That's OK, he's getting help from his war buddy Teddy, whom Callie thinks is a man. Of course, it's not much help since he later punches through a glass window. Cristina helps him clean up his hand, and it's clear there's an attraction there as well.

The real Nazi: It's not Bailey, that's for sure. She's back to being the timid doctor once called Mandy, one of the few characters that we've already seen before. She's extremely nervous around Ellis and can't stand up for herself, which eventually leads to Ellis firing her. (The elevator scene with Alex at the end did show a stronger Mandy, who may be turning into Bailey.)

A scary Yang: Cristina is a heartless, hard-core cardio doc who has absolutely no bedside manner. She's not even Meredith's person anymore, April is. It turns out, Yang has no friends because she was ostracized for sleeping with an attending, Dr. Burke.

Fallen comrades: Izzie actually got kicked out of Seattle Grace — and possibly shot up the place? — after Meredith ratted her out for sleeping with a patient (Denny) and stealing a heart for him. George, on the other hand, failed his intern exams, like he did in the regular universe. However, he just never showed his face again.

Meredith's new beau: Meredith is actually engaged to dorky Alex, and they're quite the perfect couple... sort of. He's actually hooking up with April on the side, which Yang discovers and reveals to Meredith in front of everyone. Upon learning this, Dr. Percy ironically says, "Just shoot me now."

Lexie the cokehead: Though she still has photographic memory, Lexie is not the smart doc we know and love. Instead, she's a strung-out addict who overdoses and is brought to Seattle Grace. Both her parents have died — her mother of stomach issues, and her father killed himself — but she knows about her half sister at the hospital (aka Meredith). While Jackson suggests her ODing is a sign to turn things around, Lexie secretly steals his keycard so she can raid the drug cabinet. She's later brought back into Seattle Grace by... Mark!

Mark's baby: After Mark brings Lexie in to Seattle Grace, he seeks out the mother of his unborn child... Addison. That's right, Addison's baby is not Derek's.

Cristina and Meredith, the couple that was always meant to be: Though Yang undermines Mer in surgery, the two team up to save Lexie's life. They end up going tequila shots at the bar, bringing things full circle to Season 1. (Nearly their whole bar conversation is exact dialogue previously used in the pilot.)

MerDer: After Cristina leaves the bar, Derek begins chatting with Meredith, asking what people around the hospital call him. It's McDreary. But he's not McDreary tonight. He's just a guy in a bar, and Mer's just a girl in a bar. (Another nod to the pilot, as well as Lexie's first appearance on Grey's.)

What did you think of Grey's Anatomy's alt-reality episode? What surprised you most? Hit the comments with your thoughts.

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Grey's Anatomy's alt-reality episode truly is a love letter to the fans.

In this new reality, Ellis Grey was never diagnosed with Alzheimer's, which leads to a very different upbringing for Meredith, the least of which: Her last name is now Webber. That is just one of the nice surprises in the alt-reality. Let's check out the rest: read more

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