How to Save a Life (Grey's Anatomy)

"How to Save a Life" is the twenty-first episode of the eleventh season of the American television medical drama Grey's Anatomy, and is the 241st episode overall. It aired on April 23, 2015 on ABC in the United States.^[1] The episode was written by showrunner Shonda Rhimes and directed by Rob Hardy, making it the first episode Rhimes has written since the season eight finale "Flight". The episode marked the death of lead character, Derek Shepherd, played by Patrick Dempsey who had starred on the series for the past eleven seasons.

The episode focuses on Derek as he witnesses a car crash and tries to help the victims, but he is later involved in an accident, sending him to the hospital. The episode also has the fewest series regulars in an episode, with only six regulars appearing in the episode: Ellen Pompeo, Patrick Dempsey, Chandra Wilson, Kevin McKidd, Sarah Drew and Caterina Scorsone.

The episode's original broadcast was watched by 9.55 million viewers and registered the show as the week's highest rated drama and third-highest rated scripted series in the 18–49 demographic. It received mixed reviews from the critics who mainly lauded Pompeo's portrayal of Meredith Grey and deemed her "terrific" and called her performance "among the best work she's ever done on the show".

Plot

The episode begins with Meredith flashing back, to her mom losing her in the park, inter cut with memories of saying goodbye to Derek, before his recent trip to D.C. and earlier on in their relationship.

In morning he leaves for Washington, Meredith missed a call from Derek because she was rushing off with the kids, but later in the morning, he chats via speakerphone with Amelia, April, and Bailey while driving to the airport, until the call cut out. Moments later, a reckless driver zooms past Derek, loses control and crashes causing another driver to do the same. Derek stopped to tend to the injured. He fixes a dislocated leg, drags a couple away from their car seconds before it exploded, and uses dry cleaning bags to hold a young woman’s intestines in place, all while reassuring everyone that he doesn't let people die.

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 plows into him at a speed. Derek is taken to an overcrowded hospital, but is awake and conscious, even talking himself through his multitude of injuries—albeit just mentally, as he’s lost the ability to speak.

As Derek futilely tries to will the ER team into ordering a head CT, they instead rush him to an operating room, and Derek realizes he was probably going to die because they were making a mistake. The neurosurgeon took an hour and a half to arrive because he was at dinner, dismisses the only doctor who knew what she was talking about, and eventually discovers that it was too late to save Derek.

Shortly after arriving at the hospital with Bailey and Zola in tow, Meredith is informed by the surgeons that there was nothing they could have done to save Derek’s life. Meredith pointed out that they should have ordered a head CT—and later corrected a doctor who called her “Mrs. Shepherd.” 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.

One of the hospital's doctor tearfully apologizes to an understanding Meredith. Meredith returns to the hospital room to say a final goodbye to her husband, accompanied with a montage of moments of their relationship, set to a piano version of Snow Patrol’s “Chasing Cars”, performed by Sleeping At Last (in international airings, this song is replaced by "You Were Supposed to Be Different" by Aron Wright.)^[2]

Production

The episode marked the death of lead character Derek Shepherd played by Patrick Dempsey.

The episode was written by showrunner Shonda Rhimes and directed by Rob Hardy.^[3] It was the first episode Rhimes has written since the season eight finale "Flight". The episode featured the songs "Today Has Been OK " originally by Emilíana Torrini but the episode used a new version by Sleeping at Last, "Sedona" by Houndmouth, "Gulls" by David Gray, "Into the Fire" by Erin McCarley, "Chasing Cars" originally by Snow Patrol but the episode used a new version by Sleeping at Last. Filming lasted three weeks.^[4]

Speculation about Dempsey maybe exiting the medical drama began in November, when Dempsey mentioned in an interview regarding his departure from the show that he "might be leaving "very soon" ".^[5] Despite signing on for two more years after the tenth season,^[6] Patrick Dempsey decided that the eleventh season would be his last. The announcement was made on April 23, 2015, just a few hours before the episode aired.^[7]

In an interview with Entertainment Weekly, Dempsey explained how the bold move could have been made when he had just re-upped his contract as he said: "It just sort of evolved. It’s just kind of happened. It really was something that was kind of surprising that unfolded, and it just naturally came to be. Which was pretty good. I like the way it has all played out." He continued commenting on when he found out that he would be written out of the show, as he said "Things happened very quickly, where we were like, “Oh this is where it’s going to go.” It just sort of unfolded in a very organic way. I don’t remember the date. It was not in the fall. Maybe February or March. It happened very quickly."^[7]

Regarding his co-star Ellen Pompeo and how it was like working with her, he said "it’s beautiful. We’re like a married couple. It’s 10 years, and it was magic from the beginning. Chemistry right away.”^[8]

Dempsey gave thanks to his fans on Twitter as he wrote "I want to thank all the fans, what an incredible 11 yrs, I love you all."^[9] Creator Shonda Rhimes released the following statement about Dempsey’s departure: “Derek Shepherd is and will always be an incredibly important character—for Meredith, for me and for the fans. I absolutely never imagined saying goodbye to our ‘McDreamy.’ As Ellis Grey would say: the carousel never stops turning.”^[10]

Ellen Pompeo took to Twitter to react to the death of Derek and wrote “I am honored and excited to tell the story of how Meredith goes on in the face of what feels like the impossible,” It was the first time she spoke out publicly about losing Patrick Dempsey’s Derek. “I hope you will all join me on her journey.” she added.^[11]

Reception

Broadcast

"How to Save a Life" was originally broadcast on April 23, 2015 in the United States on the American Broadcasting Company (ABC). The episode was watched by a total of 9.55 million.^[12] up 23 percent from its last years telecast airing around the same time.^[13] In the key 18-49 demographic, the episode scored a 2.8 in Nielsen ratings,^[12] up 22 percent from last year, scoring the best ratings since the eleventh season premiere.^[13] It was the second best TV show in the 8.00 pm slot, beating Bones, The Vampire Diaries and a rerun on The Blacklist, but was beaten by The Big Bang Theory.^[12]

The 9.55 million people tuned into the episode marked a 24 percent increase from the previous episode (7.60), in addition to the installment's 2.8 Nielsen rating in the target 18–49 demographic marked a 33 percent increase from the previous episode (2.1).^[12][13] The Nielsen score additionally registered the show as the week's highest rated drama and third-highest rated scripted series in the 18–49 demographic, only behind CBS's The Big Bang Theory (3.6) and ABC's Modern Family (3.0).^[14]

Reviews

The episode received mixed reviews by critics who majorly lauded Pompeo's performance but many were critical of the writing. Zap2it wrote, "Rhimes could have focused solely on Derek for the hour and pushed Meredith's reaction to the next episode. But that would both have lessened the immediacy here and cheapened Meredith's response had it come amid everyone else's grief at hearing the news. Rhimes, however, made the smart move, and that decision combined with Pompeo's performance made all the difference in the episode."^[15]

However the writing of the episode was criticized by TvEquals, "My disappointment is in the melodramatic, over the top, ridiculous manner in which the writers decided to kill Derek Shepherd. Derek Shepherd survived being shot and a freaking plane crash and this is how you send him off."

Pompeo's performance was a major point of praise among critics.

Pompeo's performance was hugely praised, Rick Porter reviewing the episode for Zap2it wrote, "Without Meredith, and without one of Pompeo's strongest performances in her long time on the show, "How to Save a Life" would have run the risk of coming across as a baldly manipulative death episode, the likes of which the show has done several times before. He added. "How to Save a Life" may not be the ideal Emmy-submission episode for Ellen Pompeo, considering Meredith is off screen for more than half of it. But it's among the best work she's ever done on the show.".

TvEquals praised both Pompeo and Dempsey for their performance writing, "Ellen Pompeo was terrific. She was great at capturing the sadness of a grieving widow, the worry of a newly single mother and the anger of an experienced surgeon who knows her husband was not cared for properly."^[16] Also praising Dempsey the site wrote, "Patrick Dempsey did very well with the material given to him. In particular, he did a great job at capturing the frustration and hopelessness that one should rightfully feel."^[16] Guardianlv wrote, "One of the most moving moments of the whole episode was seeing Pompeo’s range of emotions. Meredith goes through many stages that families go through when she has to give the bad news. She had the anger, the resignation when she realized there was nothing she could do, and the compassion she had for the young doctor who had failed to save her husband."^[17]

USA Today also lauded Pompeo's performance saying, " In some ways, the episode was even more of a showcase for Pompeo. She didn't play a prominent part until late in the hour, but she had some of the more memorable and well-played scenes, from her angry response to the doctor who tries to tell her what her choices are, to her resignation when she realizes she has to comfort and motivate the young doctor whose mistakes cost Derek his life."^[18] Spoilertv criticized the writing calling the episode, "an arrogant, unoriginal, self-indulgent episode which contrasted so sharply with the loving and well crafted departure of Mark Sloan, or by Lexie Grey’s tragic ‘meant to be’." Also criticizing the absence of the series major cast from the episode the review said, "The presence of so many inconsequential and uninteresting characters was continually in danger of swamping the dreaminess of Derek. I ended the episode feeling suspicious at the obvious lack of interaction between Derek with and the other series regulars."^[19] however praised Pompeo's character, "Despite being on her own in a strange place, without the rest of the cast, the writing of Meredith was completely on point. She was clinical, as we would expect her to be.",

Derek' death came as a shock to the audience and was a major topic of discussion among critics. Ashley Bissette of TV Fanatic wrote, "Even though I can see Derek's death offering some interesting possibilities for the show, I'm beyond heartbroken. That ugly crying I mentioned before? You can bet I was a blubbering mess. We've seen tragic deaths and lost beloved characters, but never quite like this. I don't think I'll ever get over it."^[20] Ariana Bacle of Entertainment Weekly emphasizing on Derek's death wrote, "The magic of Grey’s is that its characters made committing to the show almost irresistible. Sure, it has its weak moments, and there are still characters I wish didn’t exist, but every so often, Meredith or Derek or Webber will have a moment that reminds me why I keep watching, why I never stopped—so watching one of those characters die hurts. It really, really hurts."^[21] On Derek's death New York Post wrote, "“Grey’s Anatomy” did the unthinkable, killing off one of the few remaining original cast members, Derek Shepherd, But with Derek out of the picture, what will become of the rest of the Grey Sloan Memorial Hospital family? Is there still a future for “Grey’s Anatomy”?."^[22]

References