Sarah Drew Warns There's a Huge Cliffhanger in the Grey's Anatomy Season 18 Finale

The doctors on Grey's Anatomy cannot catch a break. Not only is their resident program and teaching hospital status at risk due to the physician shortage, but in Thursday's two-part Season 18 finale (which makes up the series' 399th and 400th episodes), the hospital is going to run out of blood. 

There is some good news though — the team will have help. Jackson (Jesse Williams) and April (Sarah Drew) return to help the hospital in crisis. While Jackson tries his best to mitigate the hospital's accreditation issue, April is thrown back into the pit to cover incoming traumas. Spoiler alert, that's really difficult to do in a hospital that has no blood supply. As Ben (Jason George) explains to April in a clip from the episode, she's going to have to close the hospital's trauma center and that is not going to go over well when the team is being evaluated by the medical board. 

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It sounds like an intense finale, right? TV Guide caught up with Sarah Drew to talk about the double-sized season-ender, what's going on with Japril, and how fans should prepare for the "explosive" cliffhanger on the way.

What brings Jackson and April back to the hospital before they find out about the blood shortage?
Sarah Drew: There is a lot of upheaval regarding the hospital and Jackson is brought in to navigate that and figure out where the hospital goes from here, and kind of try to solve the crisis that the hospital finds itself in. And I am there as well, you know. It's not entirely clear, I think maybe I work for the foundation, but I'm not entirely sure because it's not specifically spoken about while I'm there — but I'm there to be support... It's fun. There's a lot going on, a lot of big question marks at the end of the episode that will leave the audience going, "Oh my gosh, what's going to happen?"

The last time you returned to the show, it was just you and Jackson in that house. What was it like actually getting to be back in the hospital set and with the rest of the cast this time?
Drew: It was amazing. It was such a beautiful homecoming. It was so fun to walk the halls, the ER, and the breezeway, and the attendings lounge - just all the places that I spent nine years walking around. When I went to do the episode last year with Jesse, that wasn't even my crew. It was a separate unit that was shooting that episode. So I actually got to be with my crew and on the stages [this time] and got to act and interact with so many of my favorite cast members from the show and it was pretty surreal. I mean, I just found myself sitting there going, "I feel like I was literally here yesterday doing this with you. It feels so normal and regular."

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Has April changed as a doctor since we last saw her operating?
Drew: I am not entirely sure that she's been out of the operating room. I know that she went off to help underprivileged folks in the medical field, but I don't know exactly how that manifested itself. I don't know if she's been doing surgeries. I don't know if she's been in emergent situations. Going off of what was discussed in the episode last year, she's really living in her purpose, in what she feels like she's meant to do with her life... that it feels very specific to who she is and that she's using her gifts in ways that she feels are part of her purpose in life. I find her to be much more grounded now, and sure of herself.

She's more grounded, but she's facing a giant blood shortage in this episode. How is that going to stress April out in the finale?
Drew: What's great about April in this is that she doesn't freak out. We're used to April freaking out on the show. She's just like the frequent freakout queen, but she doesn't [here]. She handles it with grace and she moves into what's the next thing we need to do, let's go. So it was fun. It was fun to get to have her dive back into her role in the pit for this episode. I really enjoyed that part of it.

What can you say about Jackson and April's relationship status when we see them again?
Drew: I can say absolutely nothing about Jackson and April's relationship status. I can tell you that they are both there, at the hospital. I can tell you that they both share the screen. You'll see them interact. I can tell you that you'll get a little window into what's going on with them, but I can't tell you anything else.

Grey's Anatomy season finales can be very taxing for the audience. What can you tease about how this is going to end?
Drew: I really wouldn't call it happy. It's explosive. It leaves you with giant, epic, question marks. It's a huge cliffhanger and you're going to be like, "What is going to happen in Season 19??" That's what I can say. 

The Grey's Anatomy Season 18 finale begins Thursday at 8/7c on ABC.