The Most 'Sick and Twisted' Thing Shonda Ever Did on Grey's Anatomy

Her most heart-rending episodes were certainly on Grey's Anatomy. There are not many storylines in TV history that can compete with the show's many deaths that left viewers in tears for days.

One of the most memorable deaths on the show came in the Season 11 episode How to Save a Life. It showed the sudden and devastating death of the beloved character Derek Shepherd, played by Patrick Dempsey. The idea of the main character dying is upsetting enough, but the way Derek's death was handled completely destroyed fans.

Shonda Rhimes once said that there was no real option to keep Derek alive.

Dempsey was leaving the show, and Derek could either be killed off or leave Meredith and their kids, which would ruin his whole arc. So Shonda did her best storytelling by writing Derek's death.

She said she was proud of her and Dempsey's work on the scene. But it had an aspect that many fans found hard to grasp and even called "sick and twisted": Derek narrated his own death.

Minutes after rescuing several people from a car accident he happened to be passing by, Derek was involved in a crash of his own that left him seriously injured. He was taken to a hospital where doctors examined him. And that's when the "twisted part" began.

Conscious but unable to speak, Derek began to narrate the events on screen. As a brilliant neurosurgeon, he knew how to save his own life, but was unable to say so out loud. As a result, the surgeons treating him made a mistake that led to his death.

But the narration didn't stop there.

Even after losing consciousness, Derek continued to comment on the doctors' actions, at one point saying, "It's too late. You're too late," which devastated many viewers who felt that this narration of his own death was too gruesome even for Grey's Anatomy.

However, some fans felt that Dereck's voice-over was not only meant to traumatize viewers, but also to show a tragic, poetic irony to his death.

One of the best neurosurgeons in the country and a world-renowned teacher who dedicated his life to making sure other surgeons were as well trained as possible died from a brain injury he knew how to fix because the doctors who had his life in their hands were poorly trained.