Genuine surprise is a rare occurrence in television viewing these days. The omnipresence of media  (both social and traditional) has made it nearly impossible to stay spoiler-free. In fact, viewers have to make a concerted effort to stay in the proverbial dark, all-the-while hoping with baited breath and crossed fingers that people associated with any given show won’t leak an important twist.

Imagine my amazement, then, when I sat down to watch Grey’s Anatomy episode “How to Save a Life” having no idea what was going to happen to Derek Shepherd. Sure, the anticipation had been mounting since Derek didn’t show for his meeting in Washington, D.C.  I had my theories, of course. There seemed to be anvils aplenty that Derek was doomed. Yet, despite all of this, I started the episode not knowing what events led to the police showing up at the Dream House to talk to Meredith. Was Derek injured or (perish the thought) dead? And, if so, what on earth happened? In “How To Save A Life” my questions were finally answered.

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Ferry Boats

The moment I read that Shonda Rhimes penned this episode herself, I was filled with a sense of dread. GA‘s creator hasn’t written an episode since the season eight finale (“The One With The Plane Crash”). Still, despite the foreshadowing that seemed to permeate the last few episodes, part of me held on to hope that Shonda wouldn’t kill McDreamy. Right? RIGHT? Wrong. 

The episode opened with Meredith’s voiceover about the elusive nature of memory and how the carousel “never stops turning.” As has happened a few other times this season, Meredith’s memories both overlapped and became intertwined. Parallels were drawn between the season four season finale (“The One With The House of Candles”) and Derek’s departure for Washington, D.C. in the present day. Astute viewers may remember that the season five season premiere (“The One With The Ice Storm,” in which we met Owen Hunt) Meredith fantasized that Derek had died in a car wreck and the doctors were unable to save him. 

So, anyway, Derek took one last ride on this beloved ferry and then headed to the airport taking a shortcut through an area which apparently had no cell reception. He expressed profound irritation and exasperation as another car followed too closely and then passed him dangerously. 


The ABC promo revealed that Derek witnessed a horrific car crash and came to the aid of its victims and, indeed, this did come to pass very early in the episode. The occupants of one vehicle, Sarah and her daughter, Winnie, were trapped inside their SUV. Derek got them both out after assuring Winnie that she was not dead because she still had a pulse. Sarah had a dislocated hip, but Derek dragged her to safety and then popped it back into place, Callie Torres-style (translation: without warning).

The sports car that caused the accident also had two occupants: two high school students on their way to school. Alana was an honors student who spontaneously accepted a ride from handsome, but dumb and reckless Charlie. Both were found outside of their vehicle. Charlie had short-term memory issues and couldn’t remember what happened from one moment to the next. Alana’s intestines were falling out of her body.

Fortunately, Derek Shepherd, being an outstanding surgeon, was able to save all of these people. He even managed to get Charlie and Alana to safety before their car exploded. The ensuing smoke alerted the world to the accident and emergency responders were soon on the scene to whisk the wounded away. The McDreamy crisis was averted. But not so fast.

Derek got back into his car and started to drive away, paused to reach for his cell phone, which had slipped between the car seats, and promptly got broadsided by a semi. Nooooooo!!!

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John Doe

There were a couple of mean tricks tonight and this was the first one. Owen and Amelia received an incoming trauma victim to Grey Sloan, but it wasn’t Derek. Derek got taken to a smaller, more rural hospital that was “not a trauma center.” Why? WHY? Owen and Amelia (Trauma God and Neuro Goddess, respectively) would probably have saved Derek’s life, which was lost, in part, because the medical staff at the hospital to which he was taken did not have proper training.

In a clever touch, viewers experienced Derek’s treatment from his point of view. He knew exactly what was happening and how to treat himself, but could not speak. One of the doctors wanted to do a CT (which Derek needed) but another doctor prioritized getting him into surgery (which could have waited). By the time the doctors realized their mistake (Derek had a severe head injury), it was too late. The neurosurgeon, (who was at a dinner and took 90 minutes to get the hospital), couldn’t save Derek, who died of a head trauma that he could have fixed had he been the doctor!

Flashing Lights

Meredith Grey is not always my favorite character, but I surely felt for her tonight, as her world came crashing down around her. Mean trick number two was a scenario where Meredith was called to the hospital and Derek, while injured, would recover from his accident. This, of course, was a fantasy.

In actuality, Meredith (kids in tow) went to the hospital to find that Derek was already, for all practical purposes, dead. Technically, he was still breathing, but his brain was dead and there was basically no chance of recovery. So Meredith Grey, who had herself been the doctor in this equation more times that she could probably count, signed the papers to have her husband taken off the machines that were keeping him alive. While she would have been willing to donate his organs, there wasn’t much left of him to donate. Stroking his cheek, Meredith gave Derek permission to go. Cue the MerDer Montage as “Chasing Cars” played in the background. With that, one era ended and another began. 

There have been many departures over the years. The list is long. Some characters moved on to new opportunities (Burke, Addison, Izzie, Teddy, Cristina). Others died (George, Henry, Lexie, Mark, Adele). Of these departures, Cristina’s was, perhaps until now, the most significant because the Meredith/Cristina friendship was, arguably, the heart of the show. Yet, Cristina is still out there, somewhere, in the Grey’s Anatomy universe. I have hope that we will see her again one day. 

But now we have lost our McDreamy. And one could certainly make the case that the Meredith/Derek love story was also the heart of the show, with Derek the central male lead for eleven seasons. Unlike Cristina, however, Derek can never come back. He’s gone for good. And, thus, Grey’s Anatomy is forever and irrevocably changed. Where do we go from here?

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“Lost him.” – Amelia (in a moment of foreshadowing), as Derek drove into an area with no cell phone service 

“I don’t let people die.” – Derek Shepherd to the crash victims

Derek talking about kissing Meredith for the first time.

“You’re going to be fine.” – Doctor to Derek

“No. I’m not. You should have taken a head CT.” – Derek’s inner voice

“I’m going to die because these people aren’t properly trained.” – Derek’s inner voice

“I’m afraid there’s been an accident.” – Police officer to Meredith

Meredith’s First Monologue

“Learn from this. Better yourself. And you will be better next time.” Meredith to the Smart Female Doctor 

Meredith’s Second Monologue

“Derek…it’s okay. You go. We’ll be fine.” Meredith’s last words to Derek

Watch a look back video of Derek on Grey’s Anatomy: 

Grey’s Anatomy airs Thursdays on ABC.

(image courtesy of ABC)

Janalen Samson

Contributing Writer, BuddyTV