Meet the Real-Life McDreamy: The Doctor Behind 'Grey's Anatomy'

Illustration by: R. Kikuo Johnson

Showrunning may not be brain surgery, but Shonda Rhimes needed help to create a Derek Shepherd

This story first appeared in the Sept. 19 issue of The Hollywood Reporter magazine.

A year or so before Grey's Anatomy debuted on ABC in 2005 and became one of the most influential medical dramas in TV history, I was contacted by the Hollywood, Health & Society program of the USC Annenberg School of Communication and Journalism. It connects screenwriters, producers and executives with medical, science and health experts. In my case, I am Keck Medicine of USC's chief of neurosurgery, and Grey's showrunner Shonda Rhimes was eager to probe the realities of life as a neurosurgeon and the pressures of the hospital operating room.

I remember first meeting with the writers on a Hollywood soundstage where sets for the show were being created. They were meticulous in wanting every word, every surgical tool, every nuance of the OR to be accurate. They focused on the interaction of the surgical team, which is not unlike an orchestra — the neurosurgeon is the conductor, but every member plays a key role in the patient's outcome. What intrigued me and why I got involved with the show was that Grey's Anatomy is not just about the upside and downside drama of brain surgery, but also showcases a teaching hospital where new and experienced physicians are learning from one another. The characters are not "gods," they are real and sometimes flawed, but at the center they practice passionate care. It's the compassion, not the complex neurological cases, that drives Grey's Anatomy's characters and medical care at Keck Medical Center.

A lot of people have asked me if the show overdramatizes the procedures. The answer is, TV could never overdramatize some of the cases I have encountered. For instance, one day I received a call from one of the writers asking about his own situation, which involved a very serious condition, one that few neurosurgeons have ever seen. Fortunately, I was able to successfully operate, and he recovered nicely. I'm not sure if that storyline ever made it into a script, but it was a great dramatic story with a happy ending.

My colleagues would have to weigh in on whether I was the inspiration for Dr. Derek Shepherd. I may have been the first neurosurgeon the producers and writers spoke to, and I have reviewed some neurosurgery storylines. But I'm sure a lot of physicians helped shape what you see on TV. I do remember one storyline was giving the writers fits, and my phone was constantly ringing. They had a very sympathetic character with a bad tumor in a bad place and wanted Derek to operate. My wife was watching the show the night it aired, and as I headed for bed, I said, "That's my patient." The next morning she confronted me with, "Hey, McDreamy, your patient died on TV last night." Luckily in real life, my patient who inspired this story lived.

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