If Grey’s Anatomy is good at one thing, it’s killing off doctors while Chasing Cars plays in the background. Derek Shepherd got similar treatment, dying emotionally and shockingly late into the show’s run.
Lexie, Mark, George, Derek… only The Walking Dead cast know fear like the actors working on Grey’s Anatomy do.
You could be in a devastating plane crash, ferry accident, or involved in a bomb threat at any moment, especially if showrunner Shonda Rhimes is feeling restless ahead of a finale, eager to cement Grey’s as one of the best TV shows.
That, and behind-the-scenes drama, came into play when the series ejected Dr. Shepherd. Here’s the episode when Derek died and the medical mistakes that led to it.
When does Derek die in Grey’s Anatomy?
Derek Shepherd died in Grey’s Anatomy Season 11 Episode 21 ‘How to Save a Life’.
The episode’s title references Shepherd’s catchphrase, “It’s a beautiful day to save lives,” as well as the song of the same name by The Fray, which the show previously used.
How Derek died
Derek sustained a severe head injury when he was hit by a truck. Mistakes made by doctors meant he couldn’t be saved.
Derek was on his way to D.C. when he saw a car crash on a remote road. He saved four people from the wreckage before an ambulance arrived to transport survivors to Dillard Medical Center.
Playing with the audience’s nerves, the show made us think all was okay. After returning to his car he was distracted by a phone call, and then a semi-truck hit the side of his car.
Derek was taken to Dillard to be examined. Conscious but non-verbal, he knew that he needed a head CT scan.
Highlighting the high-pressure environment of emergency rooms and the chain-of-command issues that can arise, we hear the neurosurgeon narrate the care he receives in his mind as the remote doctors argue over whether to do the scan.
Penelope Blake — who guest stars in Season 12 in the most awkward dinner scene of all time — was in favor of the CT but was shut down by her superior, Paul Castello, who wanted to prioritize Derek’s bleeding.
Hearing Derek’s pleas and him repeating “You’re too late,” as he lies there, unable to use his world-class expertise to help himself, made it particularly gut-wrenching.
Derek was rushed to the Operating Room. But, by the time a neurosurgeon arrived an hour later, it was too late and he was left brain dead.
Meredith was contacted, and she sat with him as he died, knowing her husband would not want to be kept on life-support in that state.
Why Derek was killed on Grey’s Anatomy
Patrick Dempsey was also ready to move on after starring as Derek for nearly 10 years. It’s also a well-known rumor Shonda Rhimes and Dempsey’s working relationship had deteriorated by Season 11.
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In a People interview in 2016, Dempsey said, “It had been long enough. It was time for me to move on with other things and other interests. I probably should have moved on a couple of years earlier. I stayed a bit longer than I should have.”
Dempsey thinking he should have left earlier might be referring to how Derek’s presence had been reduced in the story when the character took a job in D.C. The actor also said he wanted to spend more time with his family.
Rhimes has spoken about the decision to kill Derek rather than write him off another way, explaining that Derek would never leave his family.
In-universe this makes sense (even if losing him officially made Meredith the most unlucky woman on Earth), as they were the show’s main couple and had multiple children.
However, reports at the time noted things weren’t sunshine and rainbows behind the scenes — nothing new for Grey’s.
What happened between Patrick Dempsey and Shonda Rhimes
Most claims point to the dynamic between Dempsey and Rhimes being the main culprit for animosity on the Grey’s Anatomy set.
In the book How to Save a Life: The Inside Story of Grey’s Anatomy, former executive producers James D. Parriott and Jeannine Renshaw alleged Dempsey complained about how intense the production schedule was (network TV with 20+ episodes per season can be hardcore).
They also implied his weaning interest in the role got on Rhimes’ and series lead Ellen Pompeo’s nerves. Considering the latter’s long-term commitment and work ethic, she’s even back for Grey’s Anatomy Season 21, this isn’t surprising.
Parriott explained [via LA Times], “There were [Human Resources] issues… sort of terrorizing the set. He had this hold on the set where he knew he could stop production and scare people.”
If Dempsey had complaints, production would allegedly pause to air them out. Parriott said meetings were held with the network and studio to discuss how he “didn’t like the inconvenience of coming in every day and working.”
Renshaw’s interviews also claimed Pompeo “would get angry that he wasn’t working as much.”
It’s salacious, and there’s a commercial incentive to play up drama to sell book copies, but Renshaw admitted, she would remind Dempsey, “Look around you. These people have been here since 6.30 AM” and “he would get it.”
Rhimes was ultimately the decision maker and reportedly organized Derek’s exit, with what we can only assume was Dempsey’s blessing.
Season 21 is coming soon, thankfully. But, you can watch Grey’s Anatomy on Disney Plus or check out the Grey’s Anatomy Season 20 release schedule to see what you’ve missed. For more juicy, binge-worthy TV shows, check out our list of best romantic TV series.