There are a lot of predictable shows out there, but Grey’s Anatomy isn’t one of them. Over its long run it has lost probably just as many main characters as Game of Thrones. It has had the craziest season finales that no fan could have seen coming. But that doesn’t mean there aren’t a few things that happen every episode. Here are 12 common occurrences on the medical drama.

1. The doctors who have pretty much seen everything get shocked by a weird new case.

2. Meredith finds a new reason to be in a bad mood.

3. Two doctors have a lot of sexual tension.

4. An intern makes a huge screw up and then debates whether they should actually be a doctor.

5. A medical case teaches a doctor a life lesson.

6. A patient nearly dies.

7. Someone operates on an “inoperable” case.

8. Webber swoops in to give advice to a doctor in need.

9. One of the doctors is trying to handle working with their coworker…who they just broke up with.

10. Two interns at war start insulting each other.

11. Doctors do something wildly unprofessional with little to no consequences.

12. Surgeons give each other life advice during surgery.