Grey's Anatomy: Why Patrick Dempsey's Derek Shepherd Was Killed Off In Season 11

Fans of "Grey's Anatomy" were shocked when, partway through season 11 of Shonda Rhimes' long-running medical drama, Dr. Derek "McDreamy" Shepherd — played by Patrick Dempsey — died on-screen, with his secret girlfriend-turned-wife Meredith Grey (Ellen Pompeo) by his side. First introduced as a one night stand who turns out to be Meredith's boss in the show's inaugural season (all the way back in 2005 when the series premiered as a humble mid-season replacement), Derek turns out to be one of the most important characters on the series as a brilliant, world-class neurosurgeon who woos his first-year intern (Meredith), only for the show to reveal that he had an estranged wife all along. (To be fair, Kate Walsh's entrance as Addison Shepherd, clad in a massive fur coat as she says Meredith must be the "woman sleeping with [her] husband," is awesome, even if it makes Derek look like a real smacked ass.)

Throughout the series, Meredith and Derek battle ups and downs and date other people and argue about their future until, finally, they get married (on a Post-It), adopt a child and have two more, becoming a happy family. So, what could go wrong? In Shondaland, something can always go wrong. But why exactly did Dempsey leave the show, and why did Rhimes choose to kill Derek instead of simply writing him off? (The short answer is that Shonda Rhimes is a vengeful god — but we'll circle back to that.)

In the 21st episode of season 11, "Grey's Anatomy" killed off one of its original characters in a particularly brutal way — so here's how it all goes down. In the aptly-named installment "How to Save a Life" (a reference to a song by The Fray that soundtracked a major episode in season 2), Derek is heading to the airport when he sees spots a speeding car and, shortly thereafter, a two-car accident on the side of the road; as a physician, he naturally stops to help. In the wreckage, he finds mother and daughter Sarah (Che Landon) and Winnie (Savannah Paige Rae) trapped inside of their SUV, and after freeing them, he checks the speeding car and discovers a teenage couple. The girl, Alana (Allie Grant), is shaken but seemingly unharmed, but her boyfriend Charlie (Robby Rasmussen), who was driving, isn't as lucky. (Also, their car explodes, because Shonda Rhimes loves drama.)

Like the good doctor he is, Derek helps everyone to safety and helps them into an ambulance once it arrives, hopping back into his own car. All is well, and he's set to fly to Washington D.C. to give up a job doing medical research at the request of the President of the United States (who is never named, but hopefully, it's Tony Goldwyn's President Fitzgerald Grant from Rhimes' other show "Scandal"). That's when disaster strikes ... yet again.

You can sort of track Patrick Dempsey's real-life obsession with professional car racing through his character's arc on "Grey's Anatomy" — there's a whole subplot at the beginning of season 7 where Derek Shepherd keeps getting arrested for reckless driving — and it does feel sort of pointed that Shonda Rhimes, the aforementioned vengeful god of "Grey's Anatomy," returned to write her first episode since season 8 just to kill Derek in a freaking car accident. As he leaves the scene of the totally unrelated car accident, Derek gets hit by a semi-truck on the driver's side of his car and ends up transported to a small, under-equipped teaching hospital in rural Washington State. 

From the moment the truck hits his car, Derek never says another word out loud on screen again; in voice-over, Dempsey narrates Derek's inner monologue as he begs his staff of (mostly) inept doctors to give him a head CT as soon as possible. They don't, despite the objections of surgical resident Dr. Penelope Blake (Rhimes regular Samantha Sloyan), deciding instead to pay attention to external injuries, and by the time the neurosurgeon arrives, Derek has blown a pupil and is pronounced brain dead. Along with her two children, Meredith arrives at the hospital, tells the staff they should have done the head CT, and agrees to have Derek taken off of life support. (Dr. Blake reappears later in the series, much to Meredith's chagrin.) It's a truly gut-wrenching sequence of events, though the saddest moment is, undeniably, when Meredith tells Derek that it's okay; he can go, and she'll be alright.

"How to Save a Life" aired in 2015, and a year later, Patrick Dempsey spoke to People Magazine to promote his film "Bridget Jones' Baby" –- telling the outlet more about his exit in the process. "I'm very grateful for 'Grey's Anatomy,'" Dempsey said at the time. "It's given me the opportunity to do everything. But at the same time, there was a cost."

"I think after a certain period of time, no matter how much money you make, you want control out of your own schedule," Dempsey said, which makes sense; due to the time commitments required to play Derek Shepherd, the actor rarely got to see his wife and children. "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 also said something interesting, which is that he and Shonda Rhimes made the decision to kill Derek together and kept it a secret from the rest of the cast and crew, to the point where they didn't even hold a table read for Derek's final episode. "It was clear we were both ready. But we kept it very quiet," Dempsey revealed. "I knew he was going to be gone, but I didn't know how she was going to handle it. Shonda just said, 'I'm going to do it in a really good way' and she did her thing. I thought it was really interesting. It definitely woke people up. And it was beautifully symbolic in many ways."

Despite Patrick Dempsey's comments about the "beautifully symbolic" ending that Shonda Rhimes wrote for Derek Shepherd on "Grey's Anatomy," rumors have swirled for years that Dempsey's on-set behavior may have had something to do with it. In an excerpt from Lynette Rice's oral history of the show — "How to Save a Life: The Inside Story of Grey's Anatomy" — obtained by The Hollywood Reporter when the book released in 2021, Dempsey was an absolute terror behind the scenes.

"There were HR issues. It wasn't sexual in any way. He sort of was terrorizing the set. Some cast members had all sorts of PTSD with him," executive producer James D. Parriott said in the book. Interviews with writers, Rhimes, and Dempsey himself explain that thanks to Dempsey's star power and the fact that Rhimes wrote Derek as an idealized man, he was sort of an intimidating presence, but unfortunately, that doesn't appear to be the end of the story. While co-stars like Tina Majorino and Brooke Smith praised him and said he was an amazing colleague, others didn't feel the same way.

Apparently, Dempsey started complaining that he had to stay late on set, which made the other actors irritated, especially star Ellen Pompeo ... and executive producer Jeannine Renshaw said that it was really obvious that Dempsey wanted to be out driving or spending time with his family. Other actors on the show would then complain about Dempsey, and an anonymous "longtime crew member" said it clearly got to him. "He was just shut out in the cold. His behavior wasn't the greatest, but he had nowhere to go. He was so miserable. He had no one to talk to." In the end, Dempsey realized he'd stayed partly for the generous paycheck offered by ABC, and it was time to move on — but he did reappear on the show years after his departure.

Season 17 of "Grey's Anatomy" aired in the fall of 2020, so it's safe to say it was a really weird time for both the show's narrative and the audience at home thanks to the ongoing lockdowns and the raging COVID-19 pandemic. Frankly, the series handled it as well as it could; dressing the characters in full protective medical gear made sense for the story, and a medical drama was, in many ways, obligated to address the real-life pandemic. The show didn't have to put Meredith Grey into a COVID-related coma and create a dream beach in Meredith's mind where deceased characters return to the fray ... but for whatever reason, it did.

That's how Patrick Dempsey returns to "Grey's Anatomy" — in a dream sequence where he appears on a beach and reunites with Meredith (the two even have a real "wedding," something that never ended up happening in real life). In an interview with Variety, Dempsey said that it was extremely emotional (in a positive way) to reunite with Ellen Pompeo, and that he loved the way the then-showrunner Krista Vernoff found a way to bring him back on board. ""I thought it was a beautiful way to close it," Dempsey told Marc Malkin. "The intention was to really give people some hope because they are such an iconic couple. We've lost so many people this year, the thought that we'd have angels hovering around us taking care of us is a good message to send out in such a bleak world that we're living in. So for all of us, it was a beautiful ending to this story. I'm so grateful that I did it and happy that the fans really loved it."

"Grey's Anatomy" is available to stream on both Hulu and Netflix.