In How to Save a Life: The Inside Story of Grey’s Anatomy, author Lynette Rice recounts the ABC medical drama’s eventful 16-year history, revealing new details behind some of the show’s biggest departures.
Included in the unauthorized, 320-page oral history (St. Martin’s Press, Sept. 21, $29.99) is a chapter that offers new insight into leading man Patrick Dempsey’s shocking exit in season 11 of the Shonda Rhimes-created drama.
In the chapter, Rice speaks with Dempsey’s co-stars and exec producers who were present during filming of his final days on Grey’s Anatomy, and reveals claims of “HR issues” that contributed to the death of his alter-ego, Derek “McDreamy” Shepherd.
“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,” recalls exec producer James D. Parriott, who was brought back to the series to oversee Dempsey’s exit.
In more than 80 interviews with current and former cast- and crewmembers, Rice, an editor-at-large at Entertainment Weekly, also explores the show’s early days, recounts the thinking behind some of its more polarizing storylines and offers exclusive details about the show’s behind-the-scenes culture.
“After 17 seasons, fans still can’t get enough of Grey’s Anatomy,” Rice tells THR. But what went down behind the scenes was just as dramatic as what viewers saw every Thursday. I’m excited for fans to read what I learned about those early days, along with what it was like to work for Shonda Rhimes, and why the drama was so freakin’ headline-prone.”
Below, The Hollywood Reporter shares an excerpt — the full eighth chapter — from How to Save a Life, and tune in Friday to TV’s Top 5 for an interview with Rice about her book and the other big reveals she uncovered in her reporting for it.
(Reps for ABC, ABC Signature, Shondaland, and Dempsey declined comment on the reveals in Rice’s book.)
“He’s Very Dreamy, but He’s Not the Sun,” Or, How Grey’s Anatomy Loved — Then Learned to Live Without — Patrick Dempsey
Ellen Pompeo may have played the titular role, but for many fans over many years, Patrick Dempsey was the real draw to Grey’s Anatomy. Some of it had to do with his celebrity: Dempsey was the most famous member of the original cast at the time of the pilot and brought with him quite a cult following from his 1987 movie Can’t Buy Me Love. But a lot of it was due to the way Rhimes wrote her McDreamy and how Dempsey depicted him.
James D. Parriott I would say, “The guy would never say that,” and Shonda would say, “He’s McDreamy. He’s the perfect man. He would say that.” I’d say, “Okay. It’s your show.”
Eric Buchman Shonda had a very clear idea of how important it was to keep Derek as this almost idealized love interest, not just for Meredith but for the audience. Naturally, the writers—especially writers who had been working on one-hour dramas for a while—were like, “Well, maybe have McDreamy make a big mistake in surgery and kill somebody. Or he develops an addiction of some kind. What is his deep, dark secret?” Shonda was very insistent: that’s not the character we do that with. Even when you find out he’s married, that was done in a very sympathetic way that kept him being a hero. He was wronged by his spouse and in spite of it all he was still gonna give his marriage a second chance.
Stacy McKee Shonda was protective of McDreamy, but it was really with an eye toward being protective of Meredith. I don’t think the two were separate from one another. I don’t think she wanted to put something out there that maybe on the surface might seem a little frivolous. At its core, there was something really substantial that she wanted to say. She wanted to be very specific about the type of relationship values that she put out there.
Tony Phelan I was in editing with Shonda once, and it was the scene where Meredith and Derek had broken up. He comes over and she’s like, “I can’t remember the last time we kissed.” And he says, “I remember. You were wearing this and you smelled of this …”
Joan Rater “Your shampoo smelled like flowers, you had that sweater on …” He described their last kiss.
Tony Phelan Typically in editing you start on Derek, then you cut to Meredith for a reaction, and then you’ll go back to him. I noticed that we weren’t ever cutting back to Meredith. I asked why. Shonda said, “Because the woman in Iowa who’s watching this show wants to believe that Patrick is talking to her, and if you cut back to Meredith, it pushes them out of it.” In those special moments, we would just lock into Derek and let him do his thing.
Joan Rater And he was a master at it.
Patrick Dempsey He’s the ideal man, and that’s what Shonda constructed. There’s a projection [of him] onto me when you come in contact with fans, certainly with the younger and older fans. There is a certain amount of expectation. There is a responsibility to it. It made me grow, too. There were good qualities [of his] that you work on to obtain.
Off camera, Dempsey was equally as charismatic to his fellow actors, crew members, and anyone who would come to visit the set.
Lauren Stamile I was going in to meet him, and I remember I had this little cardigan sweater on and I took it off before I got into the room. Dempsey is one of those people—it’s almost like there’s a light shining around his body, and you feel like you’re the only person in the room. I got so hot and I remember saying, “Gosh, I would take off my sweater if I had one on because I’m so hot, but I took it off.” I was just babbling. He said, “You look nice,” and I said, “You look nicer.” I felt so awkward and he was so gracious and lovely. I was having a nervous breakdown. It’s like this “it” factor. I was like, God, whatever he has, I wish I had. I think it was very obvious how nervous I was, and he went out of his way to make sure he introduced me to everybody and made sure I felt comfortable, which he certainly didn’t have to do. But he did.
Joan Rater He knew I had a giant crush on him, and he loved it. And when we’d go to table reads—I was an actress at one point in my life—they would always give me Meredith if Ellen wasn’t there. And I’d be getting my chicken tenders at craft services before the table read and he’d come up behind me and say, “Are you reading Meredith?” in my ear, like, so sexy. I’d be like, Oh my God. I mean, I could barely … I could not look at him.
Tina Majorino I worked with Patrick a ton. I love him so much. We had a really great time working together. I think he’s such a great actor and he really made me laugh a lot. I feel like we had a good dynamic in scenes together, and it was always fun to play opposite him. Yes, he’s that charismatic in real life. Yes, his hair is that awesome. Yes, he is dreamy up close.
Chandra Wilson Patrick Dempsey will forever be known as Grey’s Anatomy’s McDreamy. Derek Shepherd is a permanent part of television history.
Norman Leavitt He is a big, personable guy.
Jeannine Renshaw We all love Patrick. Patrick is a sweetheart. If I saw him on the street, I’d give him a hug. I love the guy.
Mark Wilding I’ve always had a soft spot for Patrick. He really does try to do the right thing.
Brooke Smith, who played Dr. Erica Hahn, remembers how Dempsey defended her when the decision was made to fire her from the show in 2008.
Brooke Smith I remember calling him and saying, “Oh my God, they said they can’t write for me anymore, so I guess I’m leaving.” And he was like, “What are you talking about? You’re the only one they’re writing for.” Which at that time, it kind of did feel that way. But I guess someone didn’t like that. They gave me a statement [to release, about her departure] and I never said it. Patrick said that he actually took it out of his jacket on The Ellen DeGeneres Show and read the statement. He won’t let me forget it. He was like, “I defended you, see?” And it was true.
By season eleven, however, fans saw a disturbing break in MerDer’s once unbreakable bond. Six episodes had gone by without a peep from Derek, who was supposedly in Washington, D.C., where he had apparently made out with a research fellow. Fans began threatening to bolt if their hero didn’t return soon to Seattle. “I have never missed one episode,” wrote a fan on Dempsey’s Facebook page. “But I swear if [Rhimes] kills you off I’m done.” But there was a critical reason for Derek’s strange absence: behind the scenes, there was talk of Dempsey’s diva-like fits and tension between him and Pompeo. To help manage the explosive situation, executive producer James D. Parriott was brought back in to serve as a veritable Dempsey whisperer.
Patrick Dempsey [That] was the first year that I haven’t been in every episode. I [was] in every episode since the pilot— close to 250 episodes. That [was a] huge run.
James D. Parriott Shonda needed an OG to come in as sort of a showrunner for fourteen episodes. 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. He had this hold on the set where he knew he could stop production and scare people. The network and studio came down and we had sessions with them. I think he was just done with the show. He didn’t like the inconvenience of coming in every day and working. He and Shonda were at each other’s throats.
Jeannine Renshaw There were times where Ellen was frustrated with Patrick and she would get angry that he wasn’t working as much. She was very big on having things be fair. She just didn’t like that Patrick would complain that “I’m here too late” or “I’ve been here too long” when she had twice as many scenes in the episode as he did. When I brought it up to Patrick, I would say, “Look around you. These people have been here since six thirty a.m.” He would go, “Oh, yeah.” He would get it. It’s just that actors tend to see things from their own perspective. He’s like a kid. He’s so high energy and would go, “What’s happening next?” He literally goes out of his skin, sitting and waiting. He wants to be out driving his race car or doing something fun. He’s the kid in class who wants to go to recess.
Patrick Dempsey It’s ten months, fifteen hours a day. You never know your schedule, so your kid asks you, “What are you doing on Monday?” And you go, “I don’t know,” because I don’t know my schedule. Doing that for eleven years is challenging. But you have to be grateful, because you’re well compensated, so you can’t really complain because you don’t really have a right. You don’t have control over your schedule. So, you have to just be flexible.
Longtime Crew Member Poor Patrick. I’m not defending his schtick. I like him, but he was the Lone Ranger. All of these actresses were getting all this power. All the rogue actresses would go running to Shonda and say, “Hey, Patrick’s doing this. Patrick’s late for work. He’s a nightmare.” 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. When Sandra left, I remember him telling me, “I should’ve left then, but I stayed on because they showed me all this money. They just were dumping money on me.”
Patrick Dempsey It [was] hard to say no to that kind of money. How do you say no to that? It’s remarkable to be a working actor, and then on top of that to be on a show that’s visible. And then on top of that to be on a phenomenal show that’s known around the world, and play a character who is beloved around the world. It’s very heady. It [was] a lot to process, and not wanting to let that go, because you never know whether you will work again and have success again.
Jeannine Renshaw A lot of the complaining … I think Shonda finally witnessed it herself, and that was the final straw. Shonda had to say to the network, “If he doesn’t go, I go.” Nobody wanted him to leave, because he was the show. Him and Ellen. Patrick is a sweetheart. It messes you up, this business.
James D. Parriott I vaguely recall something like that, but I can’t be sure. It would have happened right toward the end, because I know they were negotiating and negotiating, trying to figure out what to do. We had three different scenarios that we actually had to break because we didn’t know until I think about three days before he came back to set which one we were going to go with. We didn’t know if he was going to be able to negotiate his way out of it. We had a whole story line where we were going to keep him in Washington, D.C., so we could separate him from the rest of the show. He would not have to work with Ellen again. Then we had the one where he comes back, doesn’t die, and we figure out what Derek’s relationship with Meredith would be. Then there was the one we did. It was kind of crazy. We didn’t know if he was going to be able to negotiate his way out of it. It was ultimately decided that just bringing him back was going to be too hard on the other actors. The studio just said it was going to be more trouble than it was worth and decided to move on.
Stacy McKee I don’t think there was any way to exit him without him dying. He and Meredith were such an incredibly bonded couple at that point. It would be completely out of character if he left his kids. There was no exit that would honor that character other than if he were to die.
Patrick Dempsey I don’t remember the date [I got the news]. It was not in the fall. Maybe February or March. It was just a natural progression. And the way everything was unfolding in a very organic way, it was like, “Okay! This is obviously the right time.” Things happened very quickly. We were like, “Oh, this is where it’s going to go.”
So that was that: McDreamy would die in episode twenty-one of season eleven, even though Dempsey was in year one of his recently signed two-year contract extension. Rhimes wrote a script that was befitting of her lead’s heroic persona: she began “How to Save a Life” by having Derek witness a car crash and helping the injured. Once it appeared everyone was out of harm’s way, Derek continues on his road trip but is suddenly broadsided by a truck.
Rob Hardy (Director) The paramedics leave. He’s there by himself. He’s having a moment. The nice music is playing, and all of a sudden, bang. It comes out of nowhere, which, you know, is how accidents happen. So as opposed to watching it as a viewer, we saw the accident happen through Derek’s perspective.
Derek ends up at Dillard Medical Center, a hospital far from Grey Sloan and the talented doctors who work there. His eyes are open, but his brain is severely damaged. No one hears his plea for a CT scan; he can’t speak. To help keep the episode a secret, the scenes were shot in an abandoned hospital in Hawthorne, California, about twenty-two miles from the show’s home studio in Los Feliz.
Mimi Melgaard It was really hard on all of us because it was so secretive and we had so many different locations. We shot at this closed-down hospital that was absolutely creepy haunted. All the scenes there were so sad anyway, and in this yucky-feeling haunted hospital? It was really weird. His whole last episode was really tough.
Patrick Dempsey It was like any other day. It was just another workday. There was still too much going on. You’re in the midst of it—you’re not really processing it.
Rob Hardy Here’s a guy who’s immobile. Now you’re inside of his head. We were trying to make that feel scary from the perspective of a person who’s used to being in control, from a person who usually has the power of life and death in his own hands. But now he doesn’t have the ability to speak on his own behalf.
Samantha Sloyan When I went to audition, I didn’t recognize any of these doctors’ names. I assumed they were just dummy sides so people wouldn’t ruin the story line or anything like that. All we knew is that we were dealing with a man who’s been in a car accident. I had no idea that it was going to be Derek. I just figured I was going to be a guest doctor and that whoever this person was who was injured, was going to be just a character on the show. Once it became clear what we were working on, I was like, Oh, my gosh. I can’t believe this is the episode I’m on.
Mike McColl (Dr. Paul Castello) I signed an NDA before they would release the script to me. I was reading it in my house, and I was like, “Oh, my God.” I didn’t tell anyone, including my agents. I just said, “This is a really great booking. It’s a great role on Grey’s.” And they didn’t know anything until it aired.
Savannah Paige Rae (Winnie) The first scene I shot was actually the sentimental scene when I’m saying, “It’s a beautiful day to save lives, right?” I’m in the hospital room with Derek and talking to him. Even though I never watched the show, I recognized the value of the episode I was in and just really took it to heart. It was so special that I got to be a part of it.
Rob Hardy [Patrick] had a lot of emotions during the whole shoot, which evolved. I think when we first started, he was very calm and cool … the same Patrick that I remembered when I worked on the show a year or so before. With each passing day, he was a lot more emotional. A lot more was on his mind, and that would show itself in different ways. The finality of the episode and for his character was setting in. You’ve become a global icon on this show and then in five, four, three, two, a day … it’s over.
James D. Parriott Patrick was very cooperative and good.
Mike McColl When I met Patrick, he’s lying on a stretcher and we’re rushing him into the ER. I just introduced myself, shook his hand, and was like, “Man, I cannot tell you what an honor it is to be the guy to take you down.” He loved it. He could not have been nicer to me and was funny through the whole shoot. He was on the table in front of me there when I cut his chest open and all that stuff. He gave me a hug at the end. It was a real privilege to be a part of TV history in that way.
Samantha Sloyan I remember him being incredibly kind. They had his neck in a brace, and he’s strapped down to the board, so there wasn’t a ton of chatting. I remember him being really kind, but it was clearly intense for him.
Stacy McKee It was such a beautiful piece of storytelling. I knew this event was going to be a really sad, horrible event for Meredith, but I also knew it was going to be the beginning of such an incredible chapter for Meredith.
Dempsey completed his final hours of shooting on a rainy night. There was no goodbye party, no goodbye cake. Maybe that’s because some cast members were left out of the loop. James Pickens, Jr., told ABC News that the cast “didn’t know a whole lot. It was kind of on the fly. So whatever information we got, we pretty much got it kind of right before it happened.”
Caterina Scorsone (Dr. Amelia Shepherd) I didn’t get to say goodbye to Patrick when he left. I do think that helped, because I’ve been using the character of Derek in my internal landscape since Private Practice. Derek was the stability in Amelia’s life. He became a father figure after they watched robbers shoot their father. When he was suddenly gone from the show, we didn’t have that closure, so I got to play it out. She’s about to use drugs again before Owen confronts her in a way that she finally talks about her feelings about losing Derek. She doesn’t end up using.
James D. Parriott The day he left, that was my last day. There was a certain sadness to it, but I think he was relieved. I mean, I think it took a toll on him, too.
Rob Hardy I didn’t see other actors showing up and saying, “Hey, it’s the last day! Wanted to come and wish you well.” I didn’t get that. It was more the Patrick show. We were in the Patrick world, and then Ellen came, and there was definitely a lot of emotion that both of them had individually … not necessarily together. It was more so her being there on the day that he died. He had his own way of being with that, and the same thing with her. It was like two people who grew up together and … here we are. They had their own way of reflecting.
Patrick Dempsey I very quietly left. It was beautiful. It was raining, which was really touching. I got in my Panamera, got in rush-hour traffic, and two hours later I was home.
Big news like this doesn’t stay quiet for long. Both Michael Ausiello—who left EW in 2010 to launch the news site TVLine—and Lesley Goldberg of The Hollywood Reporter learned two weeks prior to Dempsey’s final episode that he would be leaving the show. No reporter worth their salt wants to sit on a scoop—least of all one as huge as this—but Ausiello and Goldberg didn’t want to spoil the outcome for fans, so they agreed to hold the story until after the episode aired. I eventually found out, too, but in the nuttiest way imaginable: I was standing on the set of CSI: Cyber, watching Patricia Arquette talk about some droll techno-criminal. Unfortunately, the publicist also cc’d Dempsey’s manager and ABC publicist while trying to give me a major story, so I couldn’t immediately report the scoop. But I did use the information to successfully negotiate the one and only exit interview with Dempsey. Two weeks before his final episode, I met him and his publicist at Feed Body & Soul in Venice, California, for a story that would hit newsstands on April 24. He seemed a little shell-shocked and at one point choked up, but at the time he said nothing about how his on-set behavior may have contributed to his ouster. My editor, Henry Goldblatt, wanted to put him on the cover of Entertainment Weekly, but he couldn’t guarantee to ABC that no one would see it before the episode aired. Good thing we didn’t: some subscribers got the issue on the morning of Dempsey’s final episode— and one actually tweeted the story. Our PR department tried to get the tweets removed, but the cat was out of the bag: some fans found out early that McDreamy was about to be McHistory. Outlets like Variety reported how the story got out early, while our PR department released this statement: “We are surprised that an EW subscriber may have received their issue a day earlier than planned. We always try our best to bring readers exclusive news first. We would like to apologize to fans of the show that learned the news ahead of time.” Dempsey’s final episode was watched by 8.83 million viewers—the show’s largest audience since the premiere that season. Variety even pontificated whether the ratings boost was due to my exclusive with Dempsey.
Lesley Goldberg (The Hollywood Reporter) I’m used to working with networks to hold news as part of their efforts to guard against plot spoilers. But the way Patrick Dempsey’s exit was handled involved a layer of paranoia and secrecy that has been unlike anything I’ve seen in my reporting career. News that he was leaving, and his character being killed off, would have been a major story considering how big the show is domestically and internationally. However, it also would have meant spoiling the episode and, more important, damaging key relationships I’ve worked hard to build. At some point, publishing the news of Dempsey’s exit before the episode aired became an ethical question of what was more important—a big story and its subsequent traffic, which would have come no matter what, or the relationships and trust that it took years to craft. Ultimately, I still published early because EW subscribers received the issue with Lynette’s Dempsey interview before the episode aired.
Mike McColl The morning after Derek’s last episode aired, my daughter sent me a link that was on YouTube or Facebook or something. I actually pulled it up to look at it, and it was a Grey’s Anatomy showbiz cheat sheet. It asked the question “Who is the attending doctor who killed Derek ‘McDreamy’ Shepherd?” It included a photo that I posted from the set. I had on a bloody rubber glove and was in my scrubs and mask. I never obviously would have posted this before it aired. I posted it well after the episode aired, and I [captioned it] “McDeadly.” This writer said something like, “Kill McDeadly.” Maybe that’s why the producer didn’t choose a big-name actor to be the one who killed our beloved McDreamy! I want to be ultrasensitive to these hard-core fans because it means so much to them, and I certainly didn’t mean in that case to make light of it. It’s just, I’m an actor, and I recognize it for what it is. Is everybody clear on the fact that this is just pretend and Patrick knew he was going to be leaving the show? It was just like, “God. He’s okay. He really is okay.”
Peter Horton Derek was going to be there forever with Meredith because you went through a whole journey with them. That was incredibly fulfilling. So even if he’s not there, he’s there. I don’t think any of us really worried about that going away because by then you were so invested in it. The show can last as it has for years.
Patrick Dempsey Lots of people [miss him]. “It’s good to see you alive” is the comment I get. I’m like, “Yes, I’m very much alive in reruns.” People were really invested in that relationship. I knew it would be heavy. Very happy to have moved on with a different chapter in my life.
Samantha Sloyan The montage just killed me, when Meredith says, “It’s okay, you can go.” God, I’m getting choked up just thinking about it. The chemistry they have as a pair and the way they were able to build that and sustain it! So many of these relationships are, like, “Will they, won’t they,” and then it wears thin. They sustained it for the duration of their relationship on the show, and it’s just, I think, a testament to what those two created. It was just unbelievable.
Pompeo addressed Dempsey’s departure with a tweet that focused solely on his character, not on how she spent eleven years working side by side with him: “There are so many people out there who have suffered tremendous loss and tragedy. Husbands and wives of soldiers, victims of senseless violence, and parents who have lost children. People who get up every day and do what feels like is the impossible. So it is for these people and in the spirit of resilance [sic] I am honored and excited to tell the story of how Meredith goes on in the face of what feels like the impossible.” Meanwhile, fans futilely created a Change.org petition to reinstate McDempsey, while other, more desperate ones simply tweeted “We Hate You” to Rhimes.
Shonda Rhimes 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. Patrick Dempsey’s performance shaped Derek in a way that I know we both hope became a meaningful example— happy, sad, romantic, painful, and always true—of what young women should demand from modern love. His loss will be felt by all.
Talk about the mother (father?) of all postscripts: In November of 2020 Dempsey reprised his role as McDreamy in the season opener—but only in Meredith’s dreams. Stricken with COVID-19, an unconscious Meredith “imagined” reuniting with her husband on the beach. After talking exclusively to Deadline and saying how it was “really a very healing process, and really rewarding,” Dempsey would return for more beach-based episodes that would ultimately stand out as the best moments of season seventeen. “It was a second chance thing,” one ABC executive told me at the time. “Shonda likes a comeback. Also, they wanted him in their last season.”
Excerpted with permission from St. Martin’s Press