"How to Save a Life" is the twenty-first episode of the
eleventh season of the American television
medical drama ''
Grey's Anatomy
''Grey's Anatomy'' is an American medical drama television series that premiered on March 27, 2005, on ABC as a mid-season replacement. The series focuses on the lives of surgical interns, residents, and attendings as they develop into s ...
'', and is the 241st episode overall. It aired on April 23, 2015 on
ABC in the United States. The episode was written by
showrunner Shonda Rhimes
Shonda Lynn Rhimes (born January 13, 1970) is an American television screenwriter, producer, and author. She is best known as the showrunner—creator, head writer, and executive producer—of the television medical drama '' Grey's Anatomy'', ...
and directed by
Rob Hardy, making it the first episode Rhimes has written since the season 8 finale "
Flight
Flight or flying is the process by which an object moves through a space without contacting any planetary surface, either within an atmosphere (i.e. air flight or aviation) or through the vacuum of outer space (i.e. spaceflight). This can be a ...
". The installment marked the death of the series’ male lead character,
Derek Shepherd
Derek Christopher Shepherd, M.D., F.A.C.S., also referred to as "McDreamy", is a fictional surgeon from the ABC medical drama ''Grey's Anatomy'', portrayed by actor Patrick Dempsey. He made his first appearance in the pilot episode, " A Hard D ...
(
Patrick Dempsey
Patrick Galen Dempsey (born January 13, 1966) is an American actor and race car driver. He is best known for his role as neurosurgeon Derek "McDreamy" Shepherd in ''Grey's Anatomy''. He had early success as an actor, starring in a number of fi ...
), who had starred on the series since its inception.
In this episode, Shepherd is involved in an accident while attempting to help the victims of a car accident. He is later pronounced brain dead, in part due to the surgeons not providing him with a timely CT scan. Only 6 regular cast members
Ellen Pompeo
Ellen Kathleen Pompeo (; born November 10, 1969) is an American actress. She is best known for her role on ''Grey's Anatomy'' as the titular Dr. Meredith Grey. One of the world's highest-paid actors since 2017, she has made multiple appearances ...
, Patrick Dempsey,
Chandra Wilson
Chandra Danette Wilson (born August 27, 1969) is an American actress and director. She is best known for her role as Dr. Miranda Bailey in the ABC television drama ''Grey's Anatomy'' since 2005, for which she has been nominated for the Emmy ...
,
Kevin McKidd
Kevin McKidd (born 9 August 1973) is a Scottish actor and television director. Before playing the role of Dr. Owen Hunt in '' Grey's Anatomy'', for which he is widely known, McKidd appeared as Tommy Mackenzie in Danny Boyle's '' Trainspotting' ...
,
Sarah Drew
Sarah Drew is an American actress and director. She played Hannah Rogers in The WB family drama series ''Everwood'' (2004–2006) and Dr. April Kepner in the ABC medical drama series ''Grey's Anatomy'' (2009–2018, 2021–2022).
Early life
D ...
and
Caterina Scorsone appear in the episode. "How to Save a Life" also marks the first appearance of Dr. Penelope Blake (
Samantha Sloyan).
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 critics upon release, who were divided on the show's handling of Shepherd's death. However, they were largely laudatory of Pompeo, with critic Rick Porter deeming it the best performance of her career.
Plot
The episode opens with a flashback of a five-year-old Meredith Grey (
Ellen Pompeo
Ellen Kathleen Pompeo (; born November 10, 1969) is an American actress. She is best known for her role on ''Grey's Anatomy'' as the titular Dr. Meredith Grey. One of the world's highest-paid actors since 2017, she has made multiple appearances ...
) lost in a park. In the present, Dr. Derek Shepherd (
Patrick Dempsey
Patrick Galen Dempsey (born January 13, 1966) is an American actor and race car driver. He is best known for his role as neurosurgeon Derek "McDreamy" Shepherd in ''Grey's Anatomy''. He had early success as an actor, starring in a number of fi ...
), is on his way to Washington to resign from the President's brain mapping project. He witnesses a road accident and pulls over to help the victims. He rescues a young girl named Winnie (Savannah Paige Rae) and helps her mother, who has a dislocated leg. With assistance from Winnie, he rescues another couple involved in the accident.
Paramedics arrive at the scene and transport the victims to a nearby medical facility at Dillard. Just as Derek is about to drive away, he is hit by a semi-truck, and is rushed to the ER at the closest hospital. He is unable to speak as the doctors examine him, with him subconsciously telling the doctors to order a head CT. However, Shepherd is rushed into surgery. One of the surgical residents, Dr. Penelope Blake (
Samantha Sloyan), who wants to perform a CT is dismissed by her attending and by the time the doctors discover his blown pupil, Shepherd realizes that he will die. He is eventually declared brain-dead after the neurosurgeon arrives too late.
Grey is brought to the hospital by the police authorities and is informed by the surgeons that Shepherd is
brain dead
Brain death is the permanent, irreversible, and complete loss of brain function which may include cessation of involuntary activity necessary to sustain life. It differs from persistent vegetative state, in which the person is alive and some aut ...
; she immediately points out that they should have ordered a head CT, much to Blake's dismay. She reviews all of her options with the doctor in-charge of Shepherd's case, before signing the papers to authorize the removal of his life support. Blake tearfully apologizes to a forbearing Grey, who then returns to Shepherd's room to say a final goodbye. This is accompanied by a montage of the heyday from their relationship.
Production
"How to Save a Life" was written by
showrunner Shonda Rhimes
Shonda Lynn Rhimes (born January 13, 1970) is an American television screenwriter, producer, and author. She is best known as the showrunner—creator, head writer, and executive producer—of the television medical drama '' Grey's Anatomy'', ...
and directed by
Rob Hardy. It was the first episode that Rhimes had written since the show's season eight finale "
Flight
Flight or flying is the process by which an object moves through a space without contacting any planetary surface, either within an atmosphere (i.e. air flight or aviation) or through the vacuum of outer space (i.e. spaceflight). This can be a ...
". Filming took place both at the studio in Los Angeles and outdoor locations over a span of three weeks. Samantha Sloyan, Larry Cedar, Mike McColl,
Allie Grant, and Savannah Paige Rae made guest appearances in the episode; Sloyan reprised her role in the show's 250th episode "
Guess Who's Coming to Dinner
''Guess Who's Coming to Dinner'' is a 1967 American romantic comedy-drama film produced and directed by Stanley Kramer, and written by William Rose. It stars Spencer Tracy (in his final role), Sidney Poitier, and Katharine Hepburn, and feature ...
" and was subsequently promoted to a recurring character for the twelfth season.
The soundtrack for "How to Save a Life" featured covers, recorded by
Sleeping at Last, of such previously used tracks as "
Today Has Been OK", originally by
Emilíana Torrini
Emilíana Torrini (born 16 May 1977) is an Icelandic singer and songwriter. She is best known for her 2009 single "Jungle Drum (song), Jungle Drum", her 1999 album ''Love in the Time of Science'', and her performance of "Gollum's Song" for the 2 ...
and "
Chasing Cars
"Chasing Cars" is a song by Northern Irish-Scottish alternative rock band Snow Patrol. It was released as the second single from their fourth studio album, ''Eyes Open'' (2006). It was released on 6 June 2006, in the United States and 24 July ...
", originally by
Snow Patrol, and the originals "Sedona" by
Houndmouth, "Gulls" by
David Gray, and "Into the Fire" by
Erin McCarley
Erin Elizabeth McCarley (born January 8, 1979) is an alternative music singer-songwriter. McCarley attended college at Baylor University, and is now based in Nashville, Tennessee.Chase, Sandy (2008)LIVE AND DANGEROUS: Erin McCarley floats with ...
.
Speculation about Dempsey's exit from ''Grey's Anatomy'' began in November, 2014, when Dempsey casually mentioned during an interview that he might be leaving the series very soon. Despite signing on for two more years at the end of the
tenth season of the show, he disclosed that he would make his final appearance in the eleventh season. The official statement was released on April 23, 2015, just a few hours before the airing of "How to Save a Life".
Dempsey went on to share further details on his character being written out of the show, saying that it happened very quickly and in an organic way. The developments leading up to the impending exit, he said, had begun in February, 2015.
![Patrick Dempsey 2011 (cropped)](https://upload.wikimedia.org/wikipedia/commons/9/98/Patrick_Dempsey_2011_%28cropped%29.jpg)
Amidst speculation of a rift between Dempsey and Pompeo, and the showrunner Rhimes, Dempsey maintained his stance of leaving in a "very good" place with his co-star of ten years.
In an interview with ''
Entertainment Weekly
''Entertainment Weekly'' (sometimes abbreviated as ''EW'') is an American digital-only entertainment magazine based in New York City, published by Dotdash Meredith, that covers film, television, music, Broadway theatre, books, and popular cu ...
'', Dempsey explained that if his exit had been a result of a conflict with the production team, it would have had happened at the end of the tenth season, when his previous contract had expired. He added that though the death of the character might be viewed as a surprising decision, he "
ikedthe way it has all played out." On his relationships with Pompeo, he said: "it’s beautiful. We’re like a married couple
t has been10 years, and it was magic from the beginning” Rhimes asserted on the importance of Dempsey's character in the statement she released at his departure:
Pompeo posted on Twitter to react to the death of Shepherd, writing that she was honored and excited to tell Meredith's story "in the face of what feels like the impossible". She encouraged fans to continue watching the series, saying, "I hope you will all join me on her journey.” It was the first time that Pompeo spoke publicly about Dempsey's much publicised exit.
Reception
Broadcast
"How to Save a Life" was originally broadcast on April 23, 2015 in the United States on the
American Broadcasting Company
The American Broadcasting Company (ABC) is an American commercial broadcast television network. It is the flagship property of the ABC Entertainment Group division of The Walt Disney Company. The network is headquartered in Burbank, Cali ...
(ABC). The episode was watched by a total of 9.55 million,
up 23 percent from its last years telecast airing around the same time.
In the key 18-49 demographic, the episode scored a 2.8 in Nielsen ratings,
up 22 percent from last year, scoring the best ratings since the eleventh-season premiere.
It was the second best TV show in the 8.00 pm slot, beating ''
Bones
A bone is a rigid organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red and white blood cells, store minerals, provide structure and support for the body, a ...
'', ''
The Vampire Diaries
''The Vampire Diaries'' is an American supernatural teen drama television series developed by Kevin Williamson and Julie Plec, based on the book series of the same name written by L. J. Smith. The series premiered on The CW on September 10, ...
'' and a rerun on ''
The Blacklist
''The Blacklist'' is an American crime thriller television series that premiered on NBC on September 23, 2013. The show follows Raymond "Red" Reddington (James Spader), a former U.S. Navy officer turned high-profile criminal who voluntarily s ...
'', but was beaten by ''
The Big Bang Theory
''The Big Bang Theory'' is an American television sitcom created by Chuck Lorre and Bill Prady, both of whom served as executive producers on the series, along with Steven Molaro, all of whom also served as head writers. It premiered on C ...
''.
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).
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
''Modern Family'' is an American family sitcom television series created by Christopher Lloyd and Steven Levitan for the American Broadcasting Company. It ran for 11 seasons, from September 23, 2009, to April 8, 2020. It follows the lives of th ...
'' (3.0).
Critical reception
The episode received mixed reviews by critics who had polarizing views on the writing and handling of Shepherd's death.
Ashley Bissette Sumerel of ''TV Fanatic'' gave the episode the highest praise in a 5 out of 5 star review highlighting the "interesting possibilities" that the death would offer for the show. However, she stated, "I'm beyond heartbroken.
..We've seen tragic deaths and lost beloved characters, but never quite like this. I don't think I'll ever get over it." She also acknowledged the show's emotional connect with its audience and its courage to attempt the "inconceivable". Ariana Bacle of ''
Entertainment Weekly
''Entertainment Weekly'' (sometimes abbreviated as ''EW'') is an American digital-only entertainment magazine based in New York City, published by Dotdash Meredith, that covers film, television, music, Broadway theatre, books, and popular cu ...
'' took the opportunity to reminisce the early years of the show saying that it is the compelling characters that have made committing to ''Grey's'' "irresistible". She added that despite some "weak moments" that the series suffers from, characters like "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." In a mixed review for the episode, a ''Spoiler TV'' writer criticized the plot calling it a "self-indulgent episode", contrasted it with "well crafted departure of
Mark Sloan, or by
Lexie Grey
Alexandra Caroline Grey, M.D. is a fictional character from ABC's medical drama television series ''Grey's Anatomy'', portrayed by actress Chyler Leigh. Created by series producer Shonda Rhimes, the character is first mentioned in season 2 by ...
". 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." However, appreciative of Pompeo's character, the reviewer remarked, "the writing of Meredith was completely on point. She was clinical, as we would expect her to be."
![Ellen Pompeo LF](https://upload.wikimedia.org/wikipedia/commons/8/88/Ellen_Pompeo_LF.JPG)
Pompeo garnered widespread acclaim from television critics for her performance in the episode; Rick Porter of
Zap2it was largely laudatory of Pompeo's performance which he thought "made all the difference in the episode". He wrote highly of her role in the arc saying, "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". He noted that although it might not be the "ideal Emmy-submission episode" for Pompeo, because of the amount of time that she spent on screen, it was among the best work she's ever done on the show."
Robert Bianco of ''
USA Today
''USA Today'' (stylized in all uppercase) is an American daily middle-market newspaper and news broadcasting company. Founded by Al Neuharth on September 15, 1982, the newspaper operates from Gannett's corporate headquarters in Tysons, Virgi ...
'' thought of the episode as "a showcase for Pompeo", agreeing that although she didn't play a prominent part until the later half of the episode, but some 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." Alexandria Ingham ''Guardian Liberty Voice'' was also impressed with Pompeo’s "range of emotions", which she described similarly, as going through many stages, including anger, resignation compassion.
Shepherd's death came as a shock to the audience and was a major topic of discussion among critics, who gave polarising views on the character's exit. Janalen Samson, a contributing Writer for
BuddyTV
BuddyTV is an entertainment-based website, which generates content about television programs and sporting events. The website publishes information about celebrity and related entertainment news through a series of articles, entertainment profile ...
noted the episodes generation of shock in the times of the omnipresent media saying, "Genuine surprise is a rare occurrence in television viewing these days", and added, "Imagine my amazement, then, when I sat down to watch
.."How to Save a Life"". Calling the death a "lightning bolt" David Hinckley of ''
New York Daily News'' wrote, "In one of the most stunning moments from a high-mortality television season, "''Grey's Anatomy''"
..killed off Patrick Dempsey's Dr. Derek Shepherd".
Also talking about the shock value Shepherd's death in her ''
New York Post
The ''New York Post'' (''NY Post'') is a conservative daily tabloid newspaper published in New York City. The ''Post'' also operates NYPost.com, the celebrity gossip site PageSix.com, and the entertainment site Decider.com.
It was established ...
'' review Lindsay Putnam wrote, "“''Grey’s Anatomy''” did the unthinkable, killing off one of the few remaining original cast members", additionally putting up the question of the future of the series asking, "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''?"
The sentiment was echoed by ''
Slate'' writer Aisha Harris who weighed heavily upon importance of the death and its impact saying that despite the show’s
ensemble cast, "Meredith has always remained the central figure of ''Grey’s'', so this death marks a very important turning point in the show". Optimistic of the prospects for the show, she added, "if anyone can come out of this tragedy as a tougher, better character than ever, it’s Meredith Grey."
References
External links
*
{{Grey's Anatomy episodes, 11
2015 American television episodes
Grey's Anatomy (season 11) episodes