While other 11-year-olds in the ’90s may have been preoccupied with cruising the mall or playing video games after wrapping up homework, Meg Marinis was often hovering over the family’s clunky electronic word processor, punching out “ER” scripts like an inspired TV writer on deadline.

“Scripts” may be an overstatement, the showrunner of “Grey’s Anatomy” clarifies. “It might better be called fan fiction,” she says in a recent interview.

With two older sisters, Marinis often watched television shows that were slightly inappropriate for her age — like “Friends,” “Beverly Hills, 90210” and “The X-Files.”

But she really loved the workplace drama and the medical aspect of “ER,” often crafting her own flashback-heavy episodes and exploring the angsty romance potential between characters like Mark Greene (Anthony Edwards) and Susan Lewis (Sherry Stringfield) or Carol Hathaway (Julianna Margulies) and Doug Ross (George Clooney).

“I got so into the (medical) terminology. I thought it was so cool, I don’t know why,” she says. “And the way that everything was on the move and quick and alarms would be blaring. It was so exciting and, in the middle of it, there were love stories. It wasn’t just one thing.”

Maybe manifestation was at work. These days, she’s busy helming the medical drama stalwart over on ABC. “Grey’s Anatomy” recently returned for the second half of its 21st season.

Keeping the stories flowing on television’s longest-running medical drama can be an intricate challenge, not unlike the procedures that take place at Grey Sloan Memorial Hospital, the show’s setting. The series also boasts a large ensemble cast, and the presence of its namesake character, played by Ellen Pompeo, was scaled back.

But Marinis has been with the show nearly as long as the remaining original cast members. She was hired right out of college as a writers’ production assistant as the drama was heading into its third season. She worked her way up, becoming a writer’s assistant and medical researcher before being promoted to staff writer. She was tapped to oversee the show ahead of its 20th season, which launched in 2024.

This interview with Marinis has been edited for clarity and length.

Q: Starting with Season 19, Ellen Pompeo’s screen time was scaled back as she pursued other projects. It was announced she’d appear in at least seven episodes this season. Is that still the case, and will we see more of her?

A: We’ve aired three with her, so you at least have four more, and I’m just gonna let y’all continue to watch to see what else you get. With Ellen, we always want her to be here as much as she can and she wants. That’s an open conversation moving forward. … What we did this last season, we tried to look at her episodes as groups of episodes because it’s more fun to tell an arc with Meredith, rather than a bunch of different one-offs. Meredith’s relationship with Nick (Scott Speedman) is really important to me. I love her being able to find love after Derek (Patrick Dempsey). Scott Speedman is amazing. He’s so game to come here and play with us whenever he’s able to. It’s just staying true to her character as she’s evolved over 20 years and how she interacts with the new characters that we’ve brought, is really interesting to me.

Q: Can you imagine “Grey’s” without Meredith? Her name is in the title, her story set this world in motion.

A: I hope that we don’t ever have to see a “Grey’s” without Meredith every now and then. We have an amazing cast alongside Ellen Pompeo. I think our episodes without her are just as strong, but it’s just so nice to hear her voice with the voice-overs. But I also feel that even when she’s not in the episodes, it feels like she can be there. We constantly reference her. She’s obviously come out as a world-class surgeon out of this hospital. Bailey (Chandra Wilson) and Richard (James Pickens Jr.), when they’re dealing with a new class of interns, they invoke that spirit of Meredith that anytime they think that they’ve got a difficult intern, they remember who they brought up and what she became. We still have (Derek’s family) Amelia Shepherd (Caterina Scorsone) and Lucas Adams (Niko Terho). The essence of Meredith never disappears.

Q: What is the challenge of taking over a show that has been on for two decades?

A: I feel better about it this year now that I’ve done one season. The pressure is immense. You’re taking Shonda Rhimes’ baby and taking care of it for her when she’s built it to be an industry icon. And also just the immense pressure from the fans — making the stories feel fresh and exciting after 20 years; not repeating yourself. And just the pressure of being the leader of the show because there’s not really a day where you can hide in your office and be sad about the fires (in the Los Angeles area). You have to build up all your strength because you really set the tone and if you seem in control, your crew’s going to feel safe.

Q: Because of budget trims, you were tasked with having to slim the cast down and scale back screen time for some veteran cast members. How did you approach that?

A: It was several conversations with Shonda. She came here and spoke to the cast with me and helped explain what was going on. They completely understood that when she and I spoke to them together, they knew it wasn’t something that we wanted to do, that it was just the state of the industry. It was one of the worst moments of my job, knowing the climate of what’s happening, and I love every single character here, and nobody wants to make that phone call.

Q: “Grey’s” has endured as others in the genre have come and gone. When you see something like “The Pitt” become this drama that has people talking, what do you take from that at this stage in “Grey’s” run?

A: There’s a couple of things — you can’t help but think, “Oh, what kind of stories are they telling? Are they telling cooler stories than we are?” I really want to watch “The Pitt,” I’m waiting until hiatus because I do love medical shows, but I try not to watch them when I’m writing just to stay completely focused on “Grey’s.” I don’t want to compete or compare. They’re all different. The interest means that people still like medical shows. They’re still relevant.

Q: The life “Grey’s” has on TikTok is pretty amazing.

A: I think it’s a testament to Shonda Rhimes and what she created with those original characters — watching them grow through their career. Everybody can identify with starting your first job and not knowing what you’re doing and not making a lot of money and not having time for relationships and your best friend is your co-worker. It’s so fun to be able to see people relive those moments or live those moments for the first time. I think that there’s something comforting in a show that’s been on for so long, that you can always turn to “Grey’s Anatomy.”

Q: You’re currently putting the finishing touches on the season finale. Is there something you can tease now that will make sense once we watch it?

A: Teddy will do something she’s never done before.