Warning the following contains spoilers from Grey's Anatomy season 9, episode 18.

Grey’s Anatomy season 19, episode 18 saw Jo bonding and flirting with Sam, a patient who has expressed interest in dating her, but if they were to get together, it would continue some of the saddest storylines. The Grey’s Anatomy season 19 two-hour finale promo video featured Link and Jo arguing, likely over the potential romantic relationship between her and Sam. Grey’s Anatomy has been hinting at Link as Jo’s new love interest, and maybe even endgame, for a while now, and Sam could throw a wrench into that plan while also having Jo continue a sad storyline.

The Grey’s Anatomy season 19 finale will have Maggie and Meredith returning for the Catherine Fox Award ceremony, but it also seems to be a big episode for Jo. Season 19 has seen Jo settle into being an OB/GYN resident, wearing Grey’s Anatomy’s black scrubs to protest for women’s reproductive rights and helping Bailey with her new reproductive health clinic. While she learned that her daughter has progressive hearing loss, it’s been a relatively good season for Jo, who has been through quite a bit over the years. However, the Grey’s Anatomy season 19 finale and a relationship with Sam could change things for the worse.

Grey’s Anatomy’s Patient-Doctor Relationships Never End Well

Izzie cuts Denny's L-VAD wire in Grey's Anatomy

While Sam and Jo proved to have chemistry in Grey’s Anatomy season 19, episode 18, the show’s history has also proven that patient-doctor romantic relationships never end well. There have been four major doctor-patient romantic relationships in Grey’s Anatomy, with three ending in death and the other in heartbreak. The first big patient-doctor romantic relationship in Grey’s Anatomy was Denny and Izzie’s, which ended in tragedy at the end of season 2 when Denny died of a stroke on the night of the hospital prom.

Teddy and Stephanie also went on to fall in love with patients in Henry and Kyle, respectively, only for them to die as well. When Alex fell for Jane Doe after the season 3 ferry crash, it ended up being a tragic relationship that involved a hysterical pregnancy and ended with Ava/Rebecca being put under psychiatric care. While Sam’s condition seems relatively stable compared to the previous patients mentioned, Grey’s Anatomy also had a character die of hiccups. Whether Sam was to die or not, Grey’s Anatomy history suggests that there’s no way he and Jo could have a successful, happy relationship.

Jo Has Been Through Enough Heartache In Grey’s Anatomy

An image of Jo reading a letter and Alex smiling in a suit in Grey's Anatomy

Jo’s character was first introduced in Grey’s Anatomy season 9, and throughout her backstory and the past 10 seasons, her character's been put through the wringer. She was left at a fire station as a baby, grew up in the foster care system, and lived out of her car as a teenager. Her first marriage was abusive, leading her to flee and change her name. Her second marriage ended in Grey’s Anatomy season 16 when Alex betrayed Jo for Izzie and their secret children in his exit from the show. On top of this, she’s also suffered from depression that led her to seek in-patient psychiatric care.

In Grey’s Anatomy season 19, Jo seems to finally be in a better place, and if she were to start a relationship with Sam, only for it to end tragically, it would just be added trauma for her character. Whether Link is meant to be her endgame or not has yet to be seen, but it’s about time for Jo to have a relationship that doesn’t end in heartbreak and tragedy. Patient-doctor romantic relationships have been a big part of Grey’s Anatomy in the past, and Sam and Jo have the unfortunate chance of continuing this sad storyline.