WARNING: This article contains spoilers from Thursday’s episode of Grey’s Anatomy.

As promised, the late Derek Shepard (Patrick Dempsey) made another appearance on this week's episode of Grey's Anatomy in a series of Meredith Grey’s (Ellen Pompeo) vivid dreams.

Questions about Derek’s presence abound: Does he represent some heavenly light? Should Meredith walk towards him, or away? But that was hardly the biggest mystery of the episode. Next week’s teaser promises the return of another character from Meredith’s past coming to her in the same beach dream sequence.

McDreamy’s appearance aside, the biggest worry around Grey-Sloan Memorial is Meredith’s health, as she battles a particularly severe case of the coronavirus.

At the end of last week’s two-part premiere, Meredith collapsed in the parking lot, raising suspicion that she had gone from a doctor treating the coronavirus at every turn to a patient fighting it herself.

“How is she feeling? Any body aches, increased fatigue?” cardio head Teddy Altman (Kim Raver) asks at the beginning of the episode, with Andrew DeLuca (Giacomo Gianniotti), a newly appointed attending, by her side.

It’s soon revealed that Meredith is the patient Teddy is inquiring about. “Why don’t you ask me yourself?” she yells back. She begins insisting that she’s feeling better, that she should be discharged to quarantine in a hotel to clear up the bed for someone else.

Luckily for Meredith, her friends — doubling as her doctors — do not comply with her wishes, as she’s later discovered on the floor of her hospital room, having collapsed after trying to take a few steps.

The second collapse leads Mer back to the beach and back to Derek, who is waving his hands at his wife from afar. They call out each other’s names but Meredith is awoken by sister Maggie Pierce (Kelly McCreary) checking to make sure she’s okay.

“I was just trying to take a couple of steps, but I couldn't make it,” a disoriented Meredith tells Maggie, before referencing her McDreamy dreams. “I want to go to the beach.”

Meredith then gets an MRI as Maggie, former beau DeLuca and Altman anxiously await results. “We should’ve got scans hours ago,” Deluca insists.

“She felt fine hours ago,” Altman replies, highlighting the harsh reality of coronavirus patients quickly going from fine to worse.

Later, Maggie makes sure that Altman has a handle on Meredith’s case and indicates that her sister may be worse off than she initially seemed. “We both know what happens when a patient's lungs start to look like that, they could turn on us at any moment,” she says.

“I need you to swear that no matter what you have going on in your personal life, you have this,” Maggie then tells Teddy, referring to the recent crumbling of her engagement to Owen Hunt (Kevin McKidd). “Because I can’t be her doctor, I have to be her sister.”

“I have this,” Teddy promises.

Derek appears again after Meredith endures a troubling conversation with sister Maggie and sister-in-law Amelia Shepherd (Caterina Scorsone), in which they question Meredith about her “healthcare directive” and urge her to reconsider something. Meredith dodges the questions, instead choosing to talk to her kids.

Before she knows it, she's back on the beach in what is perhaps Derek’s most confusing appearance yet.

“Derek, why can’t I get anywhere?” Meredith, trying to walk towards him, asks.

“You’re worried about the kids,” he says, to which Meredith, reasonably replies, “I don’t understand.”

“The sand isn’t real, Meredith,” Derek concludes.

Before we get to see the former couple in action again, however, the plot turns back to Meredith’s healthcare directive, and this time she has to endure questioning from Dr. Miranda Bailey (Chandra Wilson). Bailey reveals that Meredith had chosen Alex Karev (Justin Chambers) as the person who would make decisions on her behalf if she was unable to herself. That presents a problem, as Alex left Grey-Sloan last season to start a new life to former love Izzie Stevens (Katherine Heigl).

“I know what Alex Karev means to you. I know he would have your best interests at heart but he is halfway across the country and we can't even travel yet,” Bailey says. “God forbid this thing is any worse, he might have to make decisions regarding your care and you know those decisions can be rough over the phone. You need to pick someone local.”

“Amelia can’t even decide what’s for dinner. Maggie, she doesn't know when it's time for someone to die she has a hard time letting them go," Meredith says of her "sisters." "So at least Alex can pull the plug if I need him to.”

She then gets advice from Dr. Cormac Hayes, the Irish doctor with whom Meredith has had a long-running flirtationship. “Choose someone that will choose you over and over again," he suggests. "Now get some rest."

“I’m afraid,” she admits in a rare moment of vulnerability. “If I fall asleep, I’m afraid I might not wake up.”

Meredith eventually chooses father-figure Richard Webber in place of Alex, and the others around the hospital grapple with their own issues: Tom Koracick tests positive for COVID, Amelia struggles with being at home with the kids rather than in the hospital, and a new class of interns arrive, leaving Richard to once again give his O.R. speech first seen in the show's pilot 17 seasons ago.

The important thing, however, is that Derek appears once more. This time Meredith is walking furiously towards him, but they don’t seem to be getting any closer.

“You can walk too, you know,” she says. “Wouldn’t make a difference,” he replies.

Still confused, she asks why not. “Because the sand isn’t real Meredith.”

Running now, Meredith falls face first on the sand, sending both into a fit of laughter.

“You said it wasn’t real! I hate you,” she teases and — cue the tears and the chills — he responds, “You love me. God knows I love you. I’ll be right here when you’re ready.”

Unfortunately, next week’s trailer seems to bring more questions than answers to the ongoing dream saga.

“Meredith’s not improving. They can’t wake her,” Richard says, as a voiceover promises that another person from her past will return in the next new episode, two weeks from now.

Who could it be? We have some guesses…

Grey's Anatomy airs Thursdays at 9 p.m. ET on ABC.

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