Grey's Anatomy Episode 11.21 How to Save a Life

Meredith hurries out the door accidentally leaving her cell phone behind. She misses a call from her husband. Derek then gives his sister a call. He assures Amelia and a few other friends that he won't miss his flight to DC. He knows a secret shortcut to the airport. Cell reception on this particular back road is virtually non-existent. Moments later, a reckless driver zooms by. Derek watches as the speeder tries to pass a minivan. Then tragedy strikes as the speeding car and the minivan clip and flip in a violent crash.

Derek rushes over to Sarah, the driver of the now-overturned minivan, who says her daughter, Winnie, is in the back. The little girl is okay. Derek proves this to her by teaching her how to check her pulse. He then rushes over to the other car. The passenger, Alana, is in shock. The 17-year-old driver, Charlie, wanders down the road. He has a pretty substantial head wound. Derek gets a first aid kit from the minivan. He manages to free Winnie. Sarah's extraction is tougher, and more painful, thanks to a dislocated hip.

Charlie's car catches on fire. Derek hurries everyone away from this ticking time bomb. BOOM! The car bursts into an inferno of flames. A short time later, Derek realizes Alana has a very serious stomach injury. He makes use of the bags from Sarah's dry cleaning to stabilize the wound. Alana regrets taking the ride which led to her first kiss with Charlie. Derek assures her that your first kiss isn't as important as the "right kiss." He knows something about this. It happened back when he met this girl in a bar.

Derek softly declares, "It's a beautiful day to save lives." He says it to no one in particular, but Winnie overhears it. Then everyone hears the sirens in the distance. Help has arrived. Derek promises to visit Winnie at the hospital. The wounded are taken away. Derek heads back to his car. He's in the middle of making a U-turn when his cell phone rings. He reaches underneath the seat to retrieve it. Derek is about to answer the call when... CRASH! An oncoming truck smashes into his vehicle. It's a ferocious collision.

The driver of the vehicle that crashed into Derek is brought to a nearby the hospital. Another ambulance pulls up. The doctor who meets it wants the medics to take their patient somewhere else. That's not going to happen. The accident victim is in very bad shape. As he had done so many times in the past, Dr. Derek Shepherd enters a hospital—only this time he does so as a patient fighting for his life.

Derek is awake but can't speak. The doctors don't know him. However, one person at the hospital does. Winnie steps over to the man who rescued her just a short time ago. She checks his pulse to let him know that he's alive. Winnie orders him to stay not dead. She lets one of the doctors know that Derek is a surgeon. He's the one who saved them all. It's a beautiful day to save lives. Too bad Derek can't tell the doctors that they are treating him all wrong.

Derek believes he's going to die because the people working on him aren't properly trained. The doctors do their best, but the only person in the room who truly knows what to do is the patient on the table. Finally, the on-call neurosurgeon is summoned. His response time is supposed to be 20 minutes. It's an hour and a half before he finally arrives. It doesn't matter. Derek knows it's already too late.

Meredith is told by the police that there's been an accident. She gathers up the kids and heads out to the hospital. She has flashbacks of the day her mother tried to kill herself. She steps into the room where the doctors who treated Derek express condolences. Meredith looks at her husband's medical records. They should have ordered a head CT. Meredith tells them this. She also lets them know that they did their best.

A doctor approaches Meredith with some papers. She knows what they are. She knows what comes next. Meredith gives the doctor a play-by-play description of what he came there to do. Moments later, the doctor who wasn't strong enough to stand up to her colleagues apologizes for not saving Derek. Meredith agrees that she wasn't good enough today, but that can't stop her from being good enough tomorrow. Derek is her "one." He will haunt her to make her work harder—to get better. Meredith orders her to get back inside to save lives. She can't stay strong any longer. She throws up in the bushes.

Meredith steps into her husband's hospital room. The nurse begins the procedure of taking Derek off all the machines keeping him alive. Meredith stops the nurse. She speaks to Derek, cupping his face with her hand. Flashbacks show a brief history of an incredible love story. Meredith tells her husband that she and the kids will be okay. She's not ready to let him go, but tells the nurse to continue anyway. All tubes are removed. With his wife holding her hand close to his heart, Dr. Derek Shepherd takes one final breath. The nurse shuts down all medical monitors. She exits the room leaving Dr. Meredith Grey alone with the love of her life.