Some of the best shows in television history came from unremarkable beginnings.

Test audiences notoriously loathed the 1989 pilot forSeinfeld.

SHONDA RHIMES (Creator):I always associated hospitals with good things.

PATRICK DEMPSEY, ELLEN POMPEO

Patrick Dempsey and Ellen Pompeo on ‘Grey’s Anatomy’.Craig Sjodin/ABC

That’s where I got fixed.

We all think of doctors as amazing and magical, but they’re just people at work.

We were really encouraged by Shonda’s writing.

Grey’s Anatomy

(L-R) James Pickens Jr., Chandra Wilson, Justin Chambers, Katherine Heigl, T.R. Knight, Sandra Oh, Isaiah Washington, Ellen Pompeo, and Patrick Dempsey on ‘Grey’s Anatomy’.FRANK OCKENFELS/ABC

We thought the television industry was due for a medical drama.

PETER HORTON (Executive Producer):It was always about relationships.

It was primarily a story about Derek and Meredith and longing.

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Justin Chambers on ‘Grey’s Anatomy’.ABC

You saw these two people and how they longed for each other.

PETER HORTON:Derek and Meredith were the cornerstones of that show.

The opening scene of the piece is the two of them having just slept together in a one-night stand.

Now, it was like, “We can’t be together because you’re my boss.”

STACY MCKEE (Writer):The original script was really long, an unmakeable draft, ultimately.

At one time Preston Burke and Richard Webber may have been related.

There were a few relationships that might have shifted over time.

But the core story was always there.

ABC didn’t look far for its star intern.

ELLEN POMPEO:The connection didn’t go for it.

Me… as the head of the Secret Service!

SHONDA RHIMES:I kept saying, “We need a girl likethe girl fromMoonlight Mile!”

Finally, somebody said, “I think that girl is Ellen Pompeo.

We have a deal with her at ABC.”

ELLEN POMPEO:I said, “I hate medical shows!

They make me think I’m gonna die all the time.”

And they said, “c’mon just go meet Shonda.”

I just liked her.

We were the same age.

I married a Black man!

And I trusted her.

She had a vision for the show.

PETER HORTON:She’s got that “every girl” beauty.

She’s not model-y, she’s not overly gorgeous, she’s just beautiful.

That’s exactly what Meredith needed to have.

I just felt so blessed to be making a living this way.

Katherine Heiglhad a little more experience than Pompeo, but not by much.

PETER HORTON:Trying to find someone that beautiful who reallycanact is really hard.

Katie came in and just nailed it.

There were a couple of other girls we were considering, but Katie just obliterated it.

STACY MCKEE:She was wearing glasses in the pilot.

I think her hair was probably up in a bun for the pilot, as well.

I came in and read for Shonda,Betsy Beers, and Peter Horton.

And it was great.

And then they came back and said, “We want you to read for Bailey.”

I said, “What else is available?”

And they said, “Cristina is available.”

For me, at that time, I was interested in playing a role that was the antagonist.

In the pilot, she was the antagonist and also not in a position of authority.

Bailey had authority; she was their teacher.

PETER HORTON:We said, “Sure.”

She went away for a little bit, studied the sides, came back, and read for Cristina.

We were like, “Oh, my God.

That’s Bailey and Cristina, no doubt about it.”

HARRY WERKSMAN (Writer):We called Bailey a Nazi [in the pilot].

Anything onGrey’swas always done to take the piss out of it.

There was no evil connotation with calling her a Nazi.

It’s just [meant to call her a] taskmaster.

It’s much catchier to call someone “the Nazi” than “the taskmaster.”

JENNA BANS (writer):Shonda was always really aware of being inclusive.

But I also remember that she didn’t want to sacrifice a joke, in a good way.

And sometimes for comedy, you might’t be so worried about offending.

You’re going to offend someone.

And sometimes people are a little offensive and say the things they shouldn’t.

She kind of let us have free rein with that punch in of thing.

CHANDRA WILSON (Dr. Miranda Bailey):People leave me alone because they think I’m mean.

I’m not mean…

But that meant they were really well-trained actors.

PETER HORTON:T. R. Knight just did a great read for George.

That grated into his quirkiness.

just made him stand out.

T. R. KNIGHT (Dr. George O’Malley):Who was I coming in?

[Casting director] Linda Lowy really stuck her neck out, and I was so appreciative of that.

There was even some discussion about whether George should be the show’s only gay man.

HARRY WERKSMAN:There was certainly a desire to include a gay character on the show.

We eventually got it [first] with Callie, but she was bisexual.

George seemed to make sense.

Alex was the macho guy, and it clearly was not McDreamy or Burke.

We were like, “Well, it could be George.”

We had no idea that T.R.

I think a pin was put in it.

I think that was about as far as it got.

And I literally thought, Are you kidding me?

Ellen [who was in her thirties at the time] was obviously too old to be my child.

ISAIAH WASHINGTON (Dr. Preston Burke):I didn’t audition for Burke, I auditioned for McDreamy.

I had a beard and Afro and was going for a Ben Carson character at the time.

That didn’t go that way.

The context is that she’s not into white men.

I supported her with that.

PETER HORTON:The web link wanted us to castRob Loweas Derek Shepherd.

He’s not exactly who we had in mind for McDreamy, but we met with Rob.

He had a choice of either doing our show orDr.

Vegas.Then we were like, “What aboutPatrick Dempsey?”

The online grid initially was resistant to it, but we really felt right about it.

TONY PHELAN:Rob Lowe!

That pilot could have gone in a very different direction.

ROB LOWE (actor):My picker was awesome!

The real, honest reason was [former CBS Corporation chairman] Les Moonves’s pitch to me.

His personal pitch was amazing, and there was no pitch from ABC.

ABC just never said anything.

I just had a better meeting with CBS.

The scripts were incomparable.

The script forGrey’s Anatomywas great.

I went with the vibe over the script.

The rest, as they say, is McDreamy.

People had such a strong idea of who I was, based on who I had played years ago.

I was so over it.

ELLEN POMPEO:I definitely was involved in the process of hiring Patrick.

Ultimately I don’t have a say; the internet is going to do what they want to do.

But they saw the chemistry between us.

There were five or six guys in the final process, and I read with all five of them.

And then I think they only brought three or four to the web link.

PATRICK DEMPSEY:With Ellen, there was the magic.

I just played with her.

We were just present to each other and listening to each other.

It was always very magical, but very professional.

SHONDA RHIMES:We called him Dr. McScreamMeF—Me during the pilot.

[McDreamy was] the PG-rated version.

But they never made it past episode one.

(Ramamurthy was later cast as geneticist Mohinder Suresh in the NBC sci-fi dramaHeroes.)

Two other bit players from the pilot, however, got to stay in Seattle for a long time.

JOSH BYWATER (Intern No.

It was an under-five role, which is an actor who has under five lines.

I said something about Izzie being a super-model.

I can vaguely recollect some notion of wondering if this might grow into something bigger.

I don’t think at the time anybody knew really what was going to happen.

SENDHIL RAMAMURTHY (Intern No.

2):I had gone in and read for T. R. Knight’s part.

I’ll take it.

It was either my first or second job on U.S. prime-time TV since I left drama school.

MOE IRVIN (Nurse Tyler):I remember seeing Gabrielle Union in the waiting room for my callback.

I thought I did a good job.

I didn’t hear anything for about three weeks.

Then I got a call that said, “We’re casting you as Tyler.”

Apparently, there was kind of like a juggling thing between me and Steven Bailey.

That’s what Tyler was.

George promised he was going to be okay and then he died.

Filming on the pilot began quietly at an abandoned veterans hospital in Northridge, California.

PETER HORTON:We needed a practical hospital that had the topography that could double for Seattle.

Since I was from Seattle, I was being really picky.

Perfect to shoot in.

STACY MCKEE:There were a lot of empty buildings.

Our writers' offices were literally hospital rooms.

The windows were nailed shut because, apparently, it had been a psych ward or something.

It was pretty special.

ERIC BUCHMAN (Writer):ABC basically treated the show as if it were a low priority.

They had two shows with lead characters named Dr. Shepherd.Lostalso had a Dr. Shephard!

It seemed to me like no one cared.

JOSH BYWATER:It was the first big set I’d ever been on.

We were shooting a scene in the cafeteria and he’s supposed to be eating because he’s nervous.

He just kept eating.

The more takes we did, he said, “I need a bucket.

What am I doing to myself?”

And I grew up watching Patrick Dempsey inCan’t Buy Me Love!

He came in and said, “Hey, I’m Patrick.”

I’m all, “I f—ing know who you are.”

He was so gracious.

I remember the first read-through.

There was a catered lunch or something.

It was really nice.

PATRICK DEMPSEY:I’ve been around long enough that my hopes weren’t up too high.

MOE IRVIN:I remember Jon Voight came on the set.

He was the godfather to Skyler Shaye, who was the first patient in the pilot.

I remember going, “What the f—, man?

This s— is real.

These people ain’t playing around.”

I had done one other pilot, commercials, stuff like that.

But not to this level.

We altered them all, but we wanted them to look real.

The thing that was really challenging as a costume designer forGrey’sis that everything had to be subdued.

The story was first, and the clothes couldn’t distract from the story at all.

If someone’s coming into the hospital, it’s emotional.

I worked really hard to never have the clothes upstage anything.

Even in surgery, you see the bottom of the scrub cap and their eyes.

I didn’t want anything to distract from their eyes, even in those real tight close-ups.

I wanted the character and the story to come out.

I don’t want someone to go, like, “What coat is that?”

Or, “Ooh, that’s a cool bag.”

Also, when the show started, my intention was to have the clothes really subtle.

They’re medical people just taking care of stuff, without makeup.

I don’t think Shonda or [her producing partner] Betsy Beers particularly liked that.

They were young, pretty people anyway, what are you going to do?

My whole thing was to do no harm.

It’s a TV show.

With everything finally in place, filming began in 2004.

PETER HORTON:My original opening for the pilot was Ellen lying naked on the couch.

The opening scene of the pilot was Derek and Meredith having just slept together in a one-night stand.

You didn’t even really know what it was as the credits were rolling.

[Her body] would come into focus as her eyes opened.

I kind of regret it.

We seriously could have kept it.

Most of the men wanted to take the scene out.

You’re taking your heroine to a place where she’s too promiscuous!

Because they said no woman does that, and the kind of woman who does is really trashy.

There were all these old men in the room, and I had no idea how to respond.

She told the raunchiest story, and none of the men could get away fast enough.

And no one ever brought it up again.

Former ABC Studios ExecutiveWe did the right thing and listened to them.

That wasn’t the only disagreement over the pilot.

HARRY WERKSMAN:At one point Steve McPherson hated the titleGrey’s Anatomy.So for a week we were calledComplications.

It was written by Atul Gawande.

There were things that would overlap.

That was the working title.

Shonda just outright hated that.

And somethingor someonefelt like it was missing from those intern gatherings in the lunchroom.

Grey’s Anatomytested better thanLostorDesperate Housewives,but the concern was thatGrey’swas very generic, very derivative.

And the concern was, how do you make a medical drama break out?

Steve also felt, looking at the research, that there was something missing in the characters.

They needed to add another younger male character.

He wasn’t going to schedule the show until he was happy with what the second episode looked like.

TONY PHELAN:We had shot the whole pilot withoutJustin Chambers.

One of the notes after the pilot test was: “You need a bad boy.

You need a male member of the intern class who’s not just an asshole, but male.”

PETER HORTON:So we shot his scenes with him later.

JUSTIN CHAMBERS (Dr. Alex Karev):There were definitely nerves.

Thank God it worked out.

Still, the addition of a new series regular wasn’t enough.

McPherson continued to have concerns, which did nothing for his reputation.

I wasn’t even at the connection that it was on during its run!

I also, to this day, have not ever met Gary David Goldberg.

PETER HORTON:ABC was very worried.

We had this one time where they decided our show wasn’t colorful enough.

I mean, it was really absurd.

Steve McPherson was a very controlling executive, more so than any I’ve ever worked with.

We had this locker room scene in the pilot where they’re all meeting.

It was shot with a steady handheld camera.

I mean, it was like an overreaction to every little thing.

But that’s the nature of the game.

So he shut down production after the producers turned in the first episode.

Because she forced that program on the air.

And then it was a great big hit, and he got all the credit."

We tested four episodes that first season and they all tested very well.

So we knew we had something.

PETER HORTON:ABC was convinced we’d blown it.

FORMER ABC EXECUTIVE:The rough cut was terrible for the second episode.

They didn’t shoot this particular scene very well, and you couldn’t see two of the people.

HARRY WERKSMAN:Steve was unhappy with a particular scene that had already gone through the approval process.

We made it funny, these two jot down-A personalities competing with one another.

They find the head of the guy’s penis in her stomach.

It was really dark but very Shonda-esque.

It was a really brilliant episode.

And then Karev and Cristina were tasked with giving bad news to people.

It was very funny, but it was dark.

Steve saw that and was outraged.

This is not what will go on ABC."

So he shut the show down.

That’s all that happened.

Writers are going to get fired.

They clearly see something totally different than what we see."

And then they fired my director of photography.

They blamed it on him, for no reason.

Everyone else took a two-week break.

JAMES D. PARRIOTT:It was a larger issue.

It wasn’t just, “Oh, gee, that’s too dark, fire him.”

We felt that he was dismissive and gruff and so that was all part of it, too.

The way I’ve heard some executives present it is like they savedGrey’sand turnedGrey’saround.

We didn’t change any of the scripts that we shot before that episode.

PETER HORTON:Then we started up again and nothing really changed.

STEPHEN MCPHERSON:Shonda and I have joked since then.

I guess I was a little foul-mouthed while being straight with her about this amazing show.

But we had some serious work to do.

STACY MCKEE:No one thought it was going to be a phenomenon at that point.

It was new to everybody, including Shonda.

We all were just hoping and dreaming.

How to Save a Lifewill be published on Sept. 21 and isavailable for preorder now.