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Death and All His Friends

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Death and All His Friends
Season 6, episode 24
Meredith talks Cristina into operating on Derek.
Episode Information

May 20, 2010

Written by

Shonda Rhimes

Directed by

Rob Corn

Episode Guide



With You I'm Born Again

The human life is made up of choices. Yes or no? In or out? Up or down? And then there are the choices that matter: to love or hate, to be a hero or to be a coward, to fight or to give in, to live or die... Live or die? That's the important choice, and it's not always in our hands. Yes or no? In or out? Up or down? Live or die? Hero or coward? Fight or give in? I'll say it again, to make sure you hear me: the human life is made up of choices. Live or die? That's the important choice… and it's not always in our hands.

Death and All His Friends is the second part of the season six finale and the 126th overall episode of Grey's Anatomy.

Short SummaryEdit

Cristina and Meredith's surgical skills are put to the ultimate test when Derek and Owen get shot.

Full Summary Edit

The episode opens on Derek Shepherd, who has just been shot, with Meredith, Cristina, and April looking on. The gunman, Gary Clark, proceeds to point his gun at April but changes his mind about shooting her and lets her go after she utters out a panicked speech pleading for her life. Because Derek is still alive, Gary is about to shoot him again and end his life, but runs away when he sees a SWAT team rushing into the main entrance of the hospital.

The scene goes to Meredith and Cristina in a supply closet. They are panicking over Derek being shot. Cristina is trying to protect Meredith from the gunman by preventing her from tending to Derek's gunshot wound. Meredith, however, knocks Cristina into a shelf and runs to Derek.

Meanwhile, Teddy and Owen are tending to a gunshot victim. They are bringing him to the ICU after his surgery. Teddy is still arguing over their brooding romance and love triangle while Owen is trying to blow off the subject. Owen goes off into a ramble about how he will choose no one when he comes across one of the shooting victims at the entrance to the ICU. He realizes this man is dead and decides that he cannot bring his critical patient into the ICU. Owen realizes that he must get his patient out of the hospital and to safety. He calls 911.

The scene cuts to outside the hospital where Richard Webber is demanding details from the police. An officer is explaining protocol to him when they gain access to the 911 calls from the hospital. Richard overhears many of his fellow doctors and friends in panic on the transmitter.

Next we see Meredith by Derek's side trying to help him. Cristina runs out and is in complete terror and at a loss for what to do. She runs to get a wheelchair so she can take Derek to the OR. She comes across April, who is sitting against a wall and is extremely frightened over what she just saw. Cristina brings April with her so they can help Derek.

Back in the conference room, Mark is helping Alex Karev. Alex is not doing well as he begins rambling about meaningless things. At this time, Lexie Grey is getting blood to help Alex. She runs into Gary Clark, who says he has plans to kill her, Derek Shepherd, and Richard Webber. Since Lexie unplugged his wife, Gary blames her partly. He shoots at her but misses because a member of the SWAT team shoots him at the same time. She rushes away while Gary is down.

Lexie makes it back to the conference room where Alex is barely hanging on. She tells Alex she loves him.

Back in pediatrics Callie Torres and Arizona Robbins are tending to a young girl with a ruptured appendix. At this point, Gary walks into the room where they are. Arizona tells him that "there are only children here" and Callie gives him bandages to tend to his gunshot wound. At this point, Gary thanks her and he leaves. Callie and Arizona have a touching moment and Callie reports her new information to the police.

Back outside, the police continue asking Richard questions. Richard remembers who Gary Clark is because of the lawsuit.

Back in the OR, Cristina, April, and Meredith are quickly figuring out a game plan. Meredith is to prep Derek for surgery while Cristina and April find Teddy so she can help, as the wound is in Teddy's area of expertise. Derek is nervous he will die, so he asks Meredith to kiss him. 

Bailey's packing of Charles Percy's gunshot wound isn't holding. She has limited supplies and she knows he needs to get him to an OR. They try to come up with a plan to get him upstairs.

April and Cristina are on the OR floor making their way to the OR they believe Teddy is in. April is hysterial as she believes Gary is on their floor and they will both be shot. Cristina gives April a speech to calm her down. Jackson Avery appears at the OR door and informs Cristina that no attending is on this floor as Teddy and Owen have both left. Cristina realizes she must perform the procedure herself.

Both Meredith and Cristina are questioning Cristina's capability of operating on Derek's wound. Cristina tells Meredith she cannot operate while Meredith is in there, so she orders her to stay out in the scrub room. She tells April to stay with Meredith and keep her calm. 

Back in the conference room, Alex is continuously calling out for his ex-wife, Izzie Stevens. Lexie tries to keep him calm and reassure him. A member of the SWAT team then comes in and evacuates them.

Back outside, Richard is still demanding details from the police. The police decide to shut down the elevators in order to isolate Gary. At this point, Richard rushes into the hospital. Owen and Teddy exit the hospital and load their patient into an ambulance for transport to another hospital. At this point, the police grab Teddy and Owen for questioning. Owen realizes Cristina is still in the building and Teddy tells him that it is okay to choose her. He runs back inside for her. We then see Richard, who is downstairs in the tunnels of the hospital.

Back in the OR, Meredith tells April to stop crying and that she has no right to. April then confesses that she found her best friend Reed Adamson dead today. 

Back outside, Mark and Lexie have been evacuated and load Alex onto an ambulance for transport to another hospital. Teddy and Mark go together with him.

Cristina is in the middle of operating on Derek with Jackson. Cristina locates the bullet and it is right next to the aorta, which is the most complicated procedure. She realizes the extent of his injuries and begins to panic. She figures out what to do and regains some confidence.

Bailey and Mary Portman are dragging Charles to the elevator, in order to get him to an OR and help him. When she realizes the elevators are off, she goes completely ballistic. Mary tries to calm her down. Bailey realizes that Charles will die and breaks down. She holds Charles in her lap and tells him that he will die, but she will stay with him the whole time and that he is not alone.

Owen enters the scrub room, where April and Meredith are still sitting. Meredith informs him of the situation and Owen tells her to stay put. He tells her he will go in and see if he can help. When he enters the OR, we see that Gary is in there, holding Cristina at gunpoint, while she is operating. Gary tells Cristina to let Derek die or he will shoot her. Cristina continues operating while Gary threatens anyone who moves. He starts shouting that the only person he wants to kill is Derek, but he will kill anyone who stands in his way. 

At this point, Meredith enters the OR and tells Gary to shoot her.

Meredith: "Shoot me. You want justice, right? Your wife died, I know what happened. Derek told me the story. Lexie Grey is the one that pulled the plug on your wife. She's my sister. Dr. Webber, he was your wife's doctor. I'm the closest thing he has to a daughter. And the man on the table, I'm his wife. If you wanna hurt them the way that you hurt, shoot me. I'm your eye for an eye."

Cristina: "Meredith …"

Meredith: "Tell Derek that I love him and that I'm sorry."

Gary is about to shoot Meredith until Cristina informs him that Meredith is pregnant. While Gary is considering, Owen attempts to stop Gary and get the gun and Gary shoots him instead. Jackson tells Cristina to her raise her hands and stop operating. They both do this. Jackson informs Gary that because they stopped, his heart will pump all the blood into his chest and he will die. Because Meredith does not know of their secondary motive, she is hysterically crying. When he flatlines, Cristina tells Gary that it is over and Derek is dead. At this, Gary leaves the OR and Jackson and Cristina resume operating. Cristina orders Meredith to check if Owen is dead. He isn't. Cristina tells Meredith to get April and take him across the hall and get the bullet out.

Meanwhile, Charles is dying. He tells Bailey that he doesn't hurt anymore and asks if this is a bad sign. Bailey tells him that it is. Charles asks Bailey to tell Reed that he loves her and he's always had a crush on her. (not knowing that Reed was shot earlier in the day) Bailey tells Charles he is extremely brave and that it was very brave that he didn't lie about the fact that he is a surgeon like she did. He tells Bailey that she was his favorite doctor and dies. 

Owen is back and conscious with a bullet wound in his left shoulder. It has an exit wound. April notices that Meredith had blood spreading down her thighs. Meredith tells her that she is having a miscarriage and continues working.

Richard has entered the ICU where he encounters several dead doctors. He finds Gary in the room where his wife, Alison, died. Gary tells Richard that he has been looking for him and Richard tells Gary that he has been looking for him as well. Gary confesses that when he bought the gun 5 days earlier, he bought extra ammunition. When he was packing it in his coat earlier in the day, he didn't have room for it all because he also wanted to bring his flask. Richard opens the flask for him upon request. Gary asks Richard if he wants any, but Richard declines, as he is a recovering alcoholic. Gary tells him that the reason he needs alcohol now is because he only has one bullet left. Gary says he planned to kill Richard, watch him suffer and die, and then shoot himself. Richard tells him that he has quite the predicament. Gary agrees:

Gary Clark: (offering his flask to Richard over the pointed gun) "You sure you don't want a drink?" (Richard takes the flask and sniffs the contents)

Richard Webber: Vodka, it's nice. (he pours the vodka onto the floor)

Gary Clark: Hey!

Richard Webber: What's it gonna be, Mr. Clark … me or you? You shoot me, SWAT's gonna get you. And they're not gonna shoot you. They're gonna capture you and they're gonna take you to prison. Now you shoot yourself, then you're free, done, maybe get to see your wife again. So you have a choice to make: me or you? A life in prison or an afterlife with your wife.

Gary Clark: S-screw you!

Richard Webber: See, I've lived. I mean I've *really*, really lived. I've failed. I-I've been devastated. I've been broken. I've gone to hell and back... and I've also known joy and passion and I've had a great love. See, death for me is not justice; it's the end of a beautiful journey, and I'm not afraid to die. The question is, are you? A life in prison, or an afterlife with your wife … me or you? Your choice.

The SWAT team enters the ICU. At this, we hear a gunshot with uncertainty of who is dead. 

In the OR, Cristina is still operating on Derek and is finishing up, but there is a slight complication.

At Seattle Presbyterian, Teddy has operated on Alex and he is alive and well. Meanwhile at Seattle Grace, Cristina is trying to restart Derek's heart.

Bailey and Mary have made it out and while Mary is reunited with her husband, Bailey talks to the police and locates Reed's body to deliver Charles's message. Callie and Arizona have also made it out. Callie announces that she doesn't want to have kids if it means she can't be with Arizona. But Arizona tells her that they will have kids, all kinds of kids. Arizona tells Callie that she cannot live without her or their ten kids.

Derek almost dies, but he comes back. Cristina is relieved, as she has saved him. The police are taking pictures throughout the hospital of the crime scenes while Derek has a voiceover. Richard shakes hands with the officer he was speaking to earlier, concluding that Gary shot himself. Meredith is retrieving things from her locker when she finds the positive pregnancy test. Cristina rushes in, smiles, and tells Meredith that Derek is asking for her. Meredith throws out her pregnancy test and walks out of the residents' lounge.

Cast Edit

  • Meredith Grey
  • Cristina Yang
  • Alex Karev
  • Miranda Bailey
  • Richard Webber
  • Callie Torres
  • Mark Sloan
  • Lexie Grey
  • Owen Hunt
  • Arizona Robbins
  • Teddy Altman
  • Derek Shepherd
  • Gary Clark
  • Marty Hancock
  • Charles Percy
  • April Kepner
  • Jackson Avery
  • Mary and Bill Portman
  • Mary Portman
  • Teddy Altman and Pete
  • Ruby Kendall
  • Swat Guy
  • Officer #1
  • Officer #2 (frisking Owen)
  • Officer #3

Main CastEdit

Guest StarsEdit


Medical Notes Edit

Derek ShepherdEdit

  • Diagnosis:
    • Gun shot wound
    • Hematoma
  • Treatment:
    • Surgery
    • Pericardial repair

Derek had been shot in the chest by Gary Clark. He was conscious after being shot despite his blood loss. Cristina, Meredith, and April were able to get him to an OR, but Teddy had left, so Cristina operated on him herself. The bullet was lodged by his aorta and he had a huge hematoma. She was still working on him when Gary Clark returned to kill him. With Jackson's help, she convinced Gary that he was dead, so he left and she was able to continue the surgery. After she was done, he was stable and awake.


  • Diagnosis:
    • Hypotermia
  • Treatment:
    • ICU care

Pete was being transported to the ICU, but when they determined they couldn't get there safely, Owen called out and arranged to have Pete taken out to be taken out of the hospital so he could be taken to another hospital.

Alex KarevEdit

  • Diagnosis:
    • Gun shot wound
  • Treatment:
    • Blood transfusion
    • Lactated ringers
    • Surgery

Alex continued to lose blood and Mark did his best to treat him while they waited for Lexie to bring blood from the blood bank. He lost consciousness, but Lexie returned with the blood. They transfused him and then he was evacuated to another hospital, where Teddy operated on him. He was stable after his surgery.

Gary ClarkEdit

  • Diagnosis:
    • Gun shot wound
  • Treatment:
    • Bandaging

Gary was shot by the SWAT team in an attempt to stop him. He went up to peds, where Callie gave him bandages and told him to leave. He later shot himself to death.

Ruby KendallEdit

  • Diagnosis:
    • Appendicitis
    • Ruptured appendix
  • Treatment:
    • Epidural
    • Appendectomy

Ruby's appendix had burst and they weren't able to get her to an OR, so they gave her an epidural and operated to remove her appendix. Her surgery was successful and she was later taken to another hospital to continue recovering.

Charles PercyEdit

  • Diagnosis:
    • Gun shot wound
  • Treatment:
    • Bandages
    • Supplemental oxygen

Charles started to bleed through his packing, so Bailey, with Mary's help, started to try to move him to an OR. She managed to get him to an elevator, but the elevators had been turned off in an attempt to isolate Gary Clark. Bailey continued her care, but eventually had to tell Charles that he was going to die. She and Mary sat with him as he took his last breaths.

Owen HuntEdit

  • Diagnosis:
    • Gun shot wound
  • Treatment:
    • Antibiotics
    • Irrigation

Owen was shot in the shoulder by Gary Clark. Meredith took him into an OR, where they irrigated the wound, which was a through and through.

Meredith GreyEdit

  • Diagnosis:
    • Pregnancy
    • Miscarriage
  • Doctors:
  • Treatment:

Meredith had a miscarriage while working on Owen after he was shot.

Music Edit

Song Performer Scene
"In My Veins" Andrew Belle
  • During Charles Percy's death.
"Unarmed" Mariah McManus
"The Way It Ends" Landon Pig

Notes and Trivia Edit

Grey's Anatomy 6x23 6x2400:31

Grey's Anatomy 6x23 6x24

  • This episode's title originated from the song Death and All His Friends, originally sung by Coldplay.
  • This episode scored 16.13 million viewers.
    Grey's Anatomy - SEASON FINALE - 6x2300:31

    Grey's Anatomy - SEASON FINALE - 6x23

  • The season six DVD boxset includes an extended cut of this episode which is an hour long. It features 18 minutes of extra scenes, including Callie singing to the appendicitis girl and Lexie getting thrown out of an ambulance.
  • The gun held by Gary Clark was a real gun, only modified to be safer.
  • Sarah Drew revealed on Twitter that this episode, along with Sanctuary, was her favorite season 6 episode to film.
  • Shonda Rhimes revealed in a blog post that she considered Jackson and April to be part of the tribe from this episode on.
  • Teddy Altman is the only surgeon who has not seen the shooter.
  • Extended Scenes:
    • A scene where Callie sings.
    • An extended scene which involves Mark, Lexie, and Alex.
    • There is a scene in which Lexie gets kicked out of a ambulance.
    • A scene where Ruby is put in ambulance with her parents.

Gallery Edit

Episode StillsEdit

Behind the ScenesEdit

Quotes Edit

April: (when Mr. Clark is pointing the gun at her) My name is April Kepner. I'm 28 years old, and I was born on April 23rd in, in Ohio. I'm from C-Columbus. Columbus, Ohio. Um, my mom, my mom is a teacher, and m-my dad is a farmer. Corn. C-corn. He, he, he grows corn. Their, their names are Karen and Joe. (crying harder) I have three sisters! Libby's the oldest. I, I'm next, and then there's K-Kimmie and Alice. I, I, I haven't done anything yet. I haven't...I've barely lived! I, I'm not finished yet. No one's loved me yet. Please. Please. I'm someone's child! I'm a person! I'm a person!
Gary Clark: Run.
(April runs away)

Charles: (to Dr. Bailey before he dies) You were always my favorite doctor. I thought you should know.

Meredith: Hold on, okay? Hold on. I love you. Please don't die.
Derek: Get out of here, Meredith, before he shoots you, too.
Meredith: Don't die. Do you understand? I can't live without you. If you die, I die.
Cristina: I called the police.
Meredith: Okay, good, the police are coming. They're coming.
Cristina: Mer, Mer. They're not gonna get here. They're not coming for us. Not in time. Oh, God, Mer.
Meredith: I picked you. I choose you. You don't die on me!

Lexie: (trembling) Oh, Mr. Clark...
Gary Clark: I didn't plan to shoot all those people.
Lexie: Of course, you didn't.... No, you were sad, you were... You were grieving.
Gary Clark: I only planned to shoot Dr. Shepherd. And Dr. Webber. ... And you. (points gun at her) You unplugged the machines. Your hands killed my Alison.

Ruby: (crying) I want my mommy!
Callie: All right, okay. I know. I know you do and she's gonna be back soon, but you know what, until she gets here, you have the best doctor in the whole world with you right now. (Ruby stops crying, Callie looks at Arizona who is still shaken and crying from seeing Mr. Clark.) Yeah. Dr. Robbins is the best doctor in this entire hospital. I think in the whole world. Yeah, people, feel so much better after she helps them, sometimes people feel better just after she walks in the room. 'Cause she has got this super magic smile. (Callie looks at Arizona.) Yeah, and when she smiles at you, (Arizona finally looks at Callie.) everything gets better. You don't know it 'cause you have your back to her right now, but she is giving you... Wow, she is giving you her best super magic smile. (Callie smiles.) Isn't that right, Dr. Robbins?
Arizona: Right. I am. I am.
Callie: I gotta call the police and tell them what happened, okay?
Arizona: I... I'm good. (Callie puts her hand on her cheek) I'm good.

Jackson: (to Cristina after seeing her bloody scrubs) Is that your blood? Are you okay?
Cristina: No. No... I'm fine. I'll go get Altman.
Jackson: Altman's not down here.
Cristina: Go get Hunt then.
Jackson: They left.
Cristina: What, they left?! Okay, you know what? Someone just shot Derek. He's got a GSW to the chest and he needs surgery right now. Tell me there is an attending on this floor.
Jackson: April, in the OR behind, there are two OR nurses and an anesthesiologist. Get them. Tell them to set up for a cardiac procedure
April: What? What, why? If we don't have a surgeon, what are we going to do?
Jackson: (looking at Cristina) We have a surgeon.
April: W..What? Who's going to operate on Dr. Shepherd?
Cristina: I am.

Cristina: (while operating on Derek, trying to find the bullet) It's right by the aorta.
Jackson: You can do this.
Cristina: I know that! I just wanted it to be easy. Not the hardest freakin' repair in the history of the world.

Gary Clark: (while Cristina is operating on Derek) You stop or I will shoot you. (pointing a gun at Cristina's head)
Owen: Hey! Hey! That is the woman I love. If you shoot her, touch her, I will kill you!
Gary Clark: (turns the gun on Owen) And I said stay back. Maybe I'll shoot you first. I shoot you then I shoot her and I shoot Shepherd. Is that what you want? (Owen shakes his head) I didn't come here for this. My wife is dead. He's responsible. I came here for justice, an eye for an eye. The only person I want in this room is Shepherd. Now back off! You step away from that table. (turns his gun back to Cristina)
Cristina: (crying) Please.
Meredith: (walks in) Shoot me.
Cristina: Meredith.
Meredith: You want justice, right? Your wife died. I know what happened. Derek told me the story. Lexie Grey is the one who pulled the plug on your wife. She's my sister. Dr. Webber, he was your wife's doctor. I'm the closest thing he has to a daughter. And the man on the table, I'm his wife. If you want to hurt them the way that you hurt, shoot me. I'm your eye for an eye.
Cristina: Meredith.
(Mr. Clark points the gun at Meredith and walks toward her.)
Meredith: Tell Derek that I love him and that I'm sorry.
Cristina: Meredith... Wait, wait, wait, wait. She's pregnant. You wouldn't shoot a woman who's pregnant? Please.
(Owen tries to tackle Mr. Clark; Mr. Clark shoots Owen)

Jackson: Raise your hands. Trust me, raise you hands. He's going to shoot again, raise your hands!
Cristina: I'm stopping, I'm stopping!
Meredith: No!
Cristina: See? See? I've stopped.
Jackson: Listen to me. In a few seconds his heart is gonna pump all the blood into his chest and stop beating. You'll see it on the monitor, just wait. Wait for it. Watch the monitor and wait for it.
Meredith: (sobbing) Please, don't stop!
Jackson: (to Meredith) Shut up!
Meredith: (sobbing) No, no. (Derek flatlines) No, Derek! No, no, no. (sobs harder)
Cristina: See? It's over. It's over. He's dead. (Meredith wails as Mr. Clark leaves the OR)

Cristina: Mer, is Owen dead? Dr. Grey, is Owen dead?
Meredith: (checks on Owen) He's, he's alive, he's unconscious but he's alive.
Cristina: Take Owen to the OR across the way and take that bullet out, and get April to help you.
Meredith: Cristina!
Cristina: I can't talk right now I'm trying to save your guy. Now please go try save mine. (Meredith leaves) Remind me to thank you later.
Jackson: I will.

Arizona: I'm gonna go see if kids need help finding their parents.
Callie: People died. People are dead. I, I don't want to have kids if it means I can't be with you.
Arizona: No. No. We'll have kids. We'll have all kinds of kids, and I always thought I wasn't cut out to be a mom, but you'll be a great mom. You'll be an amazing mom, and I love you so much, and I can't live without you and our ten kids...
(Callie interrupts her with a passionate kiss.)

See AlsoEdit

A complete overview of this episode's crew can be found here.

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