GREY’S ANATOMY: Looking Back at the Most Traumatic Episodes on Their 10th Anniversary

Over the first 16 seasons of GREY’S ANATOMY, there have been no shortage of traumatizing moments, many of which have occurred in various season finales. Life-altering plane crash? Check. Natural disaster? Check. (More than once.) Heartbreaking death of a loved one. (Again, more than once.)

But for all of the memorable, often deeply soul-crushing hours, few hit as devastating hard as the season 6 double-header “Sanctuary”/”Death and All His Friends,” which aired exactly a decade ago

Earlier in the season, Gary Clark (Michael O’Neill) first crossed paths with the doctors when his wife, Alison (Caroline Williams), was a patient at the hospital. Under the care of Richard (James Pickens Jr.) and Lexie (Chyler Leigh), Alison made it through her surgery, but had complications after and was left brain dead. Gary wanted to leave his wife on life-support, but her previous directive indicated she didn’t want to be kept alive artificially, so he was overruled.

Initially, Gary filed a wrongful suit against the hospital. But in “Sanctuary”/”Death and All His Friends,” he took his revenge to unimaginable heights: he brought a gun into the hospital.

Part of the brilliance of the two-parter (penned by Shonda Rhimes) was the slow-motion devastation of the event. There was first Meredith’s ominous voice over correcting that no, she doesn’t feel safe at the hospital–she felt safe there. Gary’s quick turn from trying to get Reed (Nora Zehetner) to give him directions to Derek (Patrick Dempsey) to shooting her in the head was quick, brutal—as was his subsequent shooting of Alex (Justin Chambers)—but then the world slowed back down again as what went down went unnoticed in the quiet hallway…until April (Sarah Drew), literally, tripped over Reed’s body.

The ripple effect still took a bit to play out. A deeply in shock April went to Derek, covered in blood, as the still-new chief tried to figure out how to handle have an active shooter in the hospital. As the hospital went into lockdown, no one really processed how serious it was…until Gary fired at someone in a crowded area, nearly halfway into the first hour.

Things spiraled, as Gary took refuge in a room with a patient (Mandy Moore) who played dead, Bailey (Chandra Wilson) hid under the bed, and Charles (Robert Baker) was caught, admitted he was a surgeon, and was subsequently shot. (When Bailey was discovered, she claimed she was a nurse and Gary spared her.) A critically-injured Alex was worked on by his current girlfriend Lexie, and her ex Mark (Eric Dane).

But when Cristina (Sandra Oh) realized the gunman had been looking for Derek—which set off Meredith (Ellen Pompeo), who just discovered she was pregnant—things boiled over. Gary found Derek, who didn’t initially place him, and he confronted him, telling Derek he let his wife down, and the doctors don’t get to be God.

Derek tried to reason with the grieving man. “I’m a human being,” he said. “I make mistakes. I’m flawed. We all are.” He tried to express he knew Gary was a good man, and it seemed to work as he lowered the gun…only to shoot him in the chest when April interrupted them.

Much like ER’s “All in the Family,” which notably saw two doctors attacked, part of the brutality of the situation was not only were the doctors in life-or-death situations, but they ultimately knew what was going on. Derek knew the damage the gunshot to his chest was doing to him. Charles, eventually, knew he was dying. Alex thought he was dying.

And, of course, the doctors who were treating the people they cared about knew the gravity of the situation. Cristina knew she wasn’t quite ready to perform surgery on an injury like Derek’s without help. Bailey knew the elevators not working doomed Charles to death, and she had to change courses on treatment from life-saving to comfort in his final moments.

But it was still a GREY’S ANATOMY finale, so there was of course dramatic things that would have been traumatizing even if everything had been perfectly ideal. Gary found Cristina operating on Derek and insisted she stop. Owen also found them and tried to talk Gary out of it…until Meredith offered herself as the perfect revenge for Gary.

Owen attempted to charge Gary, which led to the former being shot, and Cristina and Jackson (Jesse Williams) faking Derek’s death well enough to fool Gary—and Meredith. Meredith was tasked with trying to take care of Owen’s injuries, as she experienced a miscarriage.

Naturally, Gary couldn’t survive the ordeal, and with his final bullet, originally planed for Richard, he took his own life, off-screen. (Thanks to a push from Richard.)

Like most great episodes of television, the emotional impact of what goes on in the two hours isn’t lessened by knowing what’s going to happen. Instead,  upon rewatch, it feels like there’s a cold dread in your body knowing how bad it’s going to get, with no one escaping unscathed—and the ramifications lasting long beyond this single day for the doctors.

GREY’S has always been a delightfully soap-y, twist-filled medical drama, balancing real-world issues with more fantastical storylines. This story, which has only become more like reality in the decade since it aired, was a gut punch because it could (and does) happen. It may have not been a major character death like the brilliantly executed “007” twist or the plane crash which took multiple lives and injured others, but there are no two better crafted hours in conveying this particular kind of terror and trauma.

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