Niko Terho plays Lucas on Grey’s Anatomy. The season 20 finale airs tonight at 9PM EST on ABC and will be available to stream on Hulu. The series, which is TV’s longest-running primetime medical drama, has been renewed for season 21. 

Wildfires threaten the Seattle region, leading to a flood of patients and emergency procedures. The doctors juggle overcapacity in the ER, complex surgeries and personal stress. Meanwhile, Meredith makes a rash decision that can’t be undone.

I spoke with the actor over Zoom to discuss his approach to creating his character, Lucas’ many different relationships, the season finale, filming the surgery scenes, and more. Keep reading for everything he shared!

When you think about your character in particular, how do you hope he fits into the Grey’s Anatomy legacy? 
Niko Terho: Yeah, I mean, that is tough. I’m not sure I have a lot of control over that, but my hope, I guess, is that he provides a relatable person, who has his challenges, and I think a lot of people are gonna be able to relate to him having to live up to an expectation, a legacy. Then also, having the challenges of dealing with ADHD and having to make that a part of his normal, everyday life, and still just carry on and get what he needs to get done, and accomplish hopefully great things in the future. 

Everyone was so excited to hear that he was Derek’s nephew. However, I imagine that must not only add a weight on him, but maybe a little bit of a weight on you, even though it was probably fun to dive into. Did you feel any of that or think, ‘I gotta figure out a way to incorporate this?’
First of all, I didn’t know that I was coming into the show to play his nephew. I had no idea. When I got the script, his name was Lucas Adams, and it was Lucas Adams right up until the first table read, where we had the first script. Then, I read the script and I was like, “Wait, what? Okay, is that what we’re dealing with now? All right, that adds a little tinge to this.” So, definitely felt the pressure to add it to him and create him with this, but I kind of maybe purposefully didn’t let it affect me. I didn’t feel it personally, but definitely felt it for the character, and it definitely colors a lot of his choices and decisions. 

That must have been a cool surprise, though. That’s kind of nice that you were already familiar with the character and got to build him before they were like, “All right, we’re gonna add a little sprinkle on top for you.” That way you got to deal with it after the fact and not before going in. 
True, I mean, it was actually great because I got to create him in a way that I wanted to create him without having to think, ‘Oh, he has to kind of be like this because of Derek, or like this because of Amelia.’ But no, he’s very much his own person, and he is feeling like an outsider in the family too, so he doesn’t quite fit the mold. So I think that’s what’s great about him, is he’s this totally different person, but has that weight of expectation and legacy on his back. 

Yeah, and I love Caterina, I love Amelia, so anytime you and her get to share scenes, I’m so happy. Can you tell me about working with her to do those scenes, and if you have any favorite moments from filming with her? 
Yeah, I mean, every one. It’s so great working with Caterina, and we both talk about it all the time, we’re like, “Man, this is a great story,” the aunt and nephew relationship has not been told very much, I feel like, on television, anywhere, in movies, I don’t think. It’s really amazing to be able to explore it, and it’s fun. It feels new and exciting, so anytime I have a scene with Caterina, I’m like, “All right, this is gonna be awesome.” They’re always so heartfelt and they hit you differently, because in a way, they didn’t really grow up with each other, they were both outsiders, but they still have this weird, intangible connection, you know? And they kind of fall into this role of family almost by accident, and it’s just really beautiful because other than — he has a little bit of this with Simone, but for some reason, he feels like he can speak to Amelia in a way he can’t speak to anybody else and I think vice versa. So, I think there’s a really great story and connection that can be explored there, and I’m excited to do it. 

I feel like they need each other, in a way. It’s not just Lucas relying on Amelia, they really need each other, and at this time, especially. 
Yeah, and that catches them both by surprise because at first, they’re both like, “Oh, this is a burden.” Like, “Oh man, I have my aunt working here,” and “Oh man, I have to deal with my nephew, who’s staying at my place and causing all this chaos.” But truthfully, they are leaning on each other and kind of need each other through all the hard moments. So it’s really beautiful.

Are there any shows that you are personally a fan of that you’d like to see Grey’s Anatomy do a crossover with? Like, in your wildest dreams, what would you pitch — past or present shows?
Okay, Game of Thrones. That would be an amazing one. You know, all these battles, they need some people to go in there and work on these people. Some dragon burns, I would love to be working on that. 

Is there a character from the show who has left or died that you would have liked to see Lucas interact with in some way? 
Yes, I would love to have seen his interaction with Derek. We can only imagine what it would be like right now, but yeah, I think that would be something that would be beautiful to explore because he did really look up to this guy. He was like this hero to him, and seeing how they interact with each other and seeing their relationship would be interesting.

I feel like they’re another duo that like Amelia and Lucas, would have been good in terms of needing each other. Derek could have used him in his life and Lucas could have asked some questions. They would have been a good dynamic to have.
Totally, and different. It would have been like a totally different one, too. 

Do you have a favorite dynamic for Lucas when it comes to the interns to explore besides Simone?
It’s gotta be Mika. I mean, I love their banter with each other and I love how they just poke at each other, but you can still see the love there. They really have this like brother-sister bond that is really great and it pretty much emulates my bond with Midori in real life. We’re like best friends outside of the show, so anytime we get to be in the show as best friends, it feels like it just runs smoothly into each other. 

I love that. Now, Lucas and Simone, what can you tell me? What is it like playing with that relationship? Do you have a favorite aspect of it? 
I mean, it’s a roller coaster. It’s messy and it’s, I think, very relatable to people. It’s that thing where it’s like, you have this crazy connection with somebody, but life just keeps getting in the way. It’s like other aspects just keep messing it up and yeah, it’s frustrating, but also exciting. It means that when you guys do get together, it’s always passionate because there’s always a thing trying to pull you apart, so you guys are fighting to come together. So yeah, I think it’s just a dynamic relationship and we’ll see how it goes. 

You know, it’s funny you say roller coaster because there’s so many shows that make you feel like that, but with Grey’s Anatomy, shipping is like a curse. Couples rarely get happy endings, besides Jackson and April. It’s like, my ships go through the wringer and sometimes they don’t even end up together.
It’s like, yeah, you have a toxic relationship with your ships. 

Right? That’s the best way to describe Grey’s Anatomy ships. You put your heart and soul into them and then one of them dies or leaves.
They just keep disappointing you in every turn, but then they give you something amazing and they just reel you in, and then throw you away and reel you [back] in, yeah.

We have the season finale coming up. Talk to me about where we leave Lucas in episode 9 and what are you most excited for fans to be left off with after the finale? 
Yeah, I mean, it’s a crazy decision. Like, we start off with that decision of, okay, wow, I have to repeat the year. That’s big. That’s like taking a year off your life, your career, you know? Then, all this work and stress that you’ve put in that whole year just seems like it’s for nothing and you’re like, “I barely made it through that one year, how am I gonna make it through again?” So all this turmoil comes into play and then, also being thrown a life raft, but it’s a cursed life raft in a way because it’s not what you expected or had envisioned for yourself, and it means that your life is gonna pan out differently. And so, you’re like, ‘Whoa, this is great. I can see it as a great opportunity objectively for anyone,’ but for him specifically, there’s all this baggage attached to Grey Sloan and becoming a neuro doctor. So I was like, wow, he’s dealing with a lot in this episode. His mind is racing in this episode and I love that the fans are gonna be left with this will he or won’t he decision at the end of it. Yeah, I think that’s exciting.

Yeah, it’s a nice twist to have thrown in there. Not nice for Lucas, he just wants a break. But I’m sure it’s nice for you, as an actor, to get to play with a storyline like that rather than him just being happy and left on the side.
He’s going through it, but oh definitely. I would take torture and pain as an actor any day. 

I know. Fans choose the same thing week after week. I don’t know what’s wrong with us. 
I know! You just can’t not look at it. You can’t not watch. 

It’s like the perfect train wreck. You need it. 
Exactly. You need it. You’re like, ‘I can see that this is terrible, but I just can’t take my eyes off of it.’

Have you gotten to take anything with you from set or is there something specific that you’d like to take when the show does eventually wrap?  
Weirdly, they’ve given us a bunch of stuff because they want us to be able to portray being surgeons effectively. And so, we’ve been given a whole bunch of kits, instruments, and stuff to work with. We have a fake latex skin to work on. It’s pretty crazy. So I have a part of my closet that just looks like it’s out of a horror movie, but yeah, that’s been pretty great to be able to take from set.  

The surgery scenes are one thing to watch as a fan, but I’m sure it’s a whole different thing as an actor being involved in them and to do them. Are there any surprising facts or secrets that you feel like fans would be surprised to know about filming those scenes? 
It’s actually very tiring to do those scenes. We’re standing up a lot of the time and trying to focus on these little things. Sometimes you’re working with meat, like proper organs and stuff, so you start dealing with the smells and then you start dealing with like — yeah, I guess it’s just hard. It doesn’t go as quickly as you see on the TV. Sometimes it takes a whole day to shoot one of them and you’re hot, you’re in like these suits all day. Yeah, it’s pretty tough. 

Do you remember doing your first one? Was it what you expected or was it like a complete like, ‘Oh, wow’ moment?
I’m trying to remember what my first one was. I just remember I had a lot of things to think about. I had to think while also saying my lines and I had to be like, ‘Okay, this, I have to cut this here, and then cut this here, and then pull this here, and then make sure this is hooked while I’m doing this and what order does that go in again? Okay, yeah, got it and I have to do it quicker because it has to match this line. Okay, all right.’

Because it’s not even just doing the lines, you’re doing the physical actions too.
Yeah, we’re actually going through and it has to look good. It has to look believable and we have to do it in the right order while we’re saying the lines and portraying the emotion. I guess that one took me by surprise because we go in and we just have a rehearsal before we shoot, so I don’t know what the steps are I’m gonna do the day before. I don’t know what actions my hands are gonna have to do and sometimes they throw it in a new one in the middle of the shooting. They’re like, “Actually, we want this to look like this and you would actually do this,” because we have a bunch of doctors on set and nurses, who come and they’re like, “This is how this is actually done and for some reason it’s not translating on camera, so we gotta do this.” We’re constantly being thrown with different things and our minds are racing, so that was the hardest thing about it and the most surprising part I didn’t expect.