Grey’s Anatomy opened with Meredith (Ellen Pompeo) recalling in voiceover the day that her mother tried to kill herself after her talk with Richard, as Meredith rode around the carousel. Like Derek (Patrick Dempsey) when he left the house that morning, Ellis Grey had told Meredith that everything would be fine.

Grey’s Anatomy Recap

After leaving the house, Derek called Meredith from the ferry – but rushing to get to the hospital and get the kids out the door, she missed his call. Amelia, Kepner (Sarah Drew) and Bailey (Chandra Wilson) warn Derek that he’s going to miss his flight when he calls into the OR in an attempt to get in touch with Meredith. He’s taking his short cut to the airport when a sports car zooms passed his and then tries to pass another car, but ends up causing an accident. Derek manages to stop in time and to avoid getting involved in the crash.

Springing into action, he assesses the mother and daughter stuck in their SUV, and the teenagers tossed from the sports car. After extracting the young Winnie, Derek sends her off so that he can get her mother Sarah out and pop her hip back into place. After noticing the sports car start to smoke, Derek hurries over and gets Alannah and Charlie over to the other side of the road. Charlie, who’d been driving the car, has a nasty gash on his head and doesn’t know what happened. Though Alannah has been walking about, Derek soon realizes that something is seriously wrong with her and lifts up her shirt to see that her stomach is sliced open. “It’s a beautiful day to save lives,” he says after wrapping up her stomach with the plastic from dry cleaning bags.

Thankfully, with no cell phone service, the smoke from the flaming car drew rescue services to them. Derek managed to keep all four of the crash victims safe and stable. He promises Winnie that he’ll pay them a visit in the hospital the following day. After the ambulances peel out, Derek hops back into his car and starts to do a U-turn to head back home. He stops in the middle of the road, trying to locate his ringing phone and a semi t-bones his car.

As Derek is wheeled into the local hospital, he tries to stay calm and assess his own condition. Having lost his verbal skills, he can’t communicate that he needs a head CT or anything else to help the group of doctor’s who aren’t properly trained to handle trauma. He knows that he has a brain injury that’s of the most importance. Winnie sees Derek before he heads into surgery and informs the doctor that his name is Derek and he’s a doctor, adding to the pressure the doctors feel.

When the police show up at Meredith and Derek’s home, she envisions going to the hospital to find him bandaged but awake and talking. In reality, she goes with the police to the hospital with Zola and Bailey in tow. When she’s brought to his room, she learns that he’s brain dead. Coldly snatching his file, Meredith, disgusted, points out that the call to not get a head CT was a bad call. Sitting in the hallway in the hospital, surrounded by her children, one of the doctors comes over to talk about pulling the plug. “While I sit here with my sleeping children, you want to talk about killing my husband,” Meredith shouts through tears. Catching some air outside, the female doctor who’d pushed for the head CT apologizes to Meredith. “Learn from this, better yourself,” Meredith tells her graciously before hurling in the bushes.

Returning to Derek’s bedside, Meredith watches as the nurse shuts down the machines. Asking her to pause for a moment, Meredith calls Derek’s name as she runs through the highlights of their love story before telling him he can let go.

Grey’s Anatomy returns next Thursday on ABC at 8/7c.