Grey's Anatomy S11E21: "How to Save a Life" Thanks to an ill-timed news leak, many of us knew that "How to Save a Life" wasn't going to end well for Dr. Derek Shepherd. But just how bad did it get? The short answer: Pretty bad. Get your tissues ready. We began with Meredith flashing back, as she did earlier this season, to her mom losing her in the park, intercut with memories of saying goodbye to Derek, before his recent trip to D.C. and earlier on in their relationship. On the morning he left for Washington, as luck—or fate—would have it, Meredith missed a call from Derek because she was rushing off with the kids, but later in the morning, he chatted via speakerphone with Amelia, April, and Bailey while driving to the airport, until the call cut out. Moments later, a reckless driver zoomed past Derek, lost control, and crashed, causing another driver to do the same. Derek stopped to tend to the injured, a group that included Sidney from Parenthood and Lisa Shay from Suburgatory. And of course nobody had cell service. Over the next few... minutes? Hours? It's hard to tell for sure, but Derek basically had a worse day than he'd probably ever experienced back at Grey Sloan. He fixed someone's dislocated leg, dragged a couple away from their car seconds before it exploded, and used dry cleaning bags to hold a young woman's intestines in place, all while (somewhat unconvincingly) reassuring everyone that he doesn't let people die. "It's a beautiful day to save lives," Derek mumbled before thankfully hearing sirens in the distance. All the patients were safely loaded into ambulances and a fireman shook Derek's hand, sending him on his merry way. (Side note: Wouldn't he have been taken in for questioning after having witnessed an accident? The rules are different in Shondaland, I suppose.) Whew! And everyone lived happily ever after. Oh wait... the episode is only halfway over? Oh no. As Derek reached over to the passenger seat of his car to grab his buzzing cell phone, a tractor-trailer came flying around the curve and plowed into him at a speed I don't even want to contemplate. Derek was taken to an overcrowded hospital, but was awake and conscious, even talking himself through his multitude of injuries—albeit just mentally, as he'd lost the ability to speak. Then Shonda Rhimes dialed the heartbreak factor up a notch, having Derek mentally coach the doctors while diagnosing his own injuries, recognizing the mistakes they were making, and being unable to do anything about it. As Derek futilely tried to will the ER team into ordering a head CT, they instead rushed him to an operating room, and Derek realized he was probably going to die—because "these people weren't trained properly." (If only he'd gone to Grey Sloan! Cruelest of ironies.) Sure enough, the neurosurgeon took an hour and a half to arrive because he was at dinner, dismissed the only doctor who knew what she was talking about, and eventually discovered that it was too late to save Derek. Time for Grey's to tease us with false sense of security! After we saw police show up at Meredith's house, the next scene revealed her talking to a bandaged Derek in a hospital room. But alas, it was only a fantasy. Meredith was really still back at the house, where the cops were telling her there'd been an accident. Shortly after arriving at the hospital with Bailey and Zola in tow, Meredith was informed by the lackluster surgeons that there was nothing they could've done to save Derek's life. False! Meredith pointed out that they should have ordered a head CT—and later witheringly corrected a doctor who called her "Mrs. Shepherd." Dark and Twisty Meredith was back in full force! She condescendingly reviewed all of her options with said doctor before demanding that he give her the papers so she could sign off on pulling the plug. That's when the hospital's one good doctor tearfully apologized and was met with a "you can't win 'em all" talk from Meredith—who was acting remarkably level-headed and calm by that point, no? Meredith told the doctor to get back on that surgical horse the next day, and then promptly threw up next to a tree. When Meredith returned to the hospital room to say a final goodbye to her husband, we were treated to another knife-twisting montage of the sweetest MerDer moments from Grey's Anatomy's 11 seasons—all the glances, hugs, kisses, sex, and witty banter that defined their roller coaster of a relationship, set to a piano version of Snow Patrol's "Chasing Cars." "Ready?" the attendant said. "No, but go ahead," Meredith responded. Cue the sound of Derek's monitor flat-lining. What did you think of "How to Save a Life"? Are you shocked that Derek is dead? Did you have the luxury of watching the episode without being spoiled? Where will Meredith go from here? And can Grey's go on without MerDer?



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