Sanctuary

is the twenty-third episode of the sixth season and the 125th overall episode of Grey's Anatomy.
==Short Summary==
Seattle Grace Hospital is hit with a crisis like no other in its history.
==Full Summary==
During Meredith's voice over about how for most people the hospital is a scary place, Derek is standing on the catwalk in the hospital. Meredith's voice over says that it's different for her, as she grew up in the hospital. She loves it here. Correction: loved it here.
Lexie and Alex are sleeping together in an on-call room. A pager goes off, and Alex accidentally pushes her out of the bed when he checks to see if it's his, but it's Lexie's. She takes her lab coat and leaves.
In the ER, a woman is sobbing hysterically. A body is taken away on a gurney. Jackson is on the phone. 
In a coffee place, Richard is having breakfast. He's holding his AA chip, and the waitress comments he can't pay with that. He's now six months sober. "Good for you," the waitress says with a smile.
Cristina and Callie are having breakfast together. Callie is crying, and Cristina yells at her to stop crying while she starts crying herself. "You stop crying!" Callie says. They then both cry together.
Meredith is looking for a pregnancy test in a supply closet. She takes one and goes the restroom, where she crosses Reed, to pee on the stick. In the residents lounge, Meredith is waiting for April and Charles to leave. When they do, she takes the test, which is positive. With a smile, she walks down the hallway, where she crosses Gary Clark. Meanwhile, Meredith's voice over says she loves the hospital; correction: loved it.
Cristina can't believe Meredith is pregnant. When Meredith tells her the pregnancy wasn't planned, Cristina asks if she's planning on keeping the baby, which she is. Meredith tells her she just found out and still has to tell Derek. They get paged by Teddy and Derek. Meredith says she'll go tell Derek and Cristina says she's completely over the Teddy-Owen thing. Cristina lays her hand on Meredith's shoulder. "This is very adult. I'm proud of you, Meredith Grey," she says. "I'm proud of me," she says. They then walk away. Cristina says she hopes it has Derek's hair.
Gary Clark walks into a busy ER. He asks Alex where he can find the Chief of Surgery, but Alex doesn't know and tells him to go find a nurse and ask them to find him. Lexie informs Arizona on a girl with a "very angry appendix". The mother is worried about the surgery, but Arizona says that even a baby surgeon like Lexie could do it. She tells Lexie to admit Ruby to peds and make her feel comfortable while she gets an OR. Alex gives Callie the scans of a 6-year old with a tibia fracture and he tells Callie to be nicer to him, because he cleaned up the kid's pee before she got there. She apologizes, when Arizona joins and greets them. Callie looks angry and walks away.
Owen runs down the hallway and meets Teddy, who got paged too. They walk to the ER together, but she ignores him, just like Cristina is, according to Owen. She is mad at him for telling Derek to give her job away. She doesn't want to hear him apologize; she wants peace. They enter a trauma room.
Bailey and Charles tell Mary Portman and her husband Bill that she can't have her second surgery today as she needs a blood transfusion first. She is disappointed because she wants to get rid of her colostomy bag as soon as possible. She says she's starving, as she hasn't eaten because she was supposed to have surgery. She says she'd eat Percy if she could. "On the plus side, that means no poop in the bag," Bill jokes, while Charles gets set for the blood transfusion. Bailey says that they'll see tomorrow if Mary can lose the poop bag. "Let's get you some food so you don't eat Dr. Percy. I don't like him, but he's useful," Bailey says. Mary asks her husband to pick up a pizza for her, and Bailey reminds her of the bowel prep and enema that'll follow if she has the pizza, but Mary says it's totally worth it. As Bill leaves, she compliments his ass.
A woman is trying to get in a trauma room to see her husband, but Tyler body blocks her. Tyler says the patient has a serious gunshot wound, whlie the wife thought he was in a car accident. She manages to get past Tyler and her husband says this guy hit him, and when he got out of his car to give him his insurance card, he was shot. Owen and Teddy have to take the man up to the OR right away, but Owen allows the wife to say goodbye. Teddy finds this was wasted time. Cristina comes in, and Teddy tells her to cover her post-ops. Cristina asks if she's not going to surgery with them, and Owen calls her name. "I'm talking to Dr. Altman," she snaps. Teddy repeats she needs her to cover her post-ops, and Cristina says she will. Owen and Teddy then take the patient to the OR. While running, Owen looks back at Cristina.
Gary enters the ER again, and he asks Tyler to find the Chief. Tyler asks for a minute and walks away. Gary then walks into a supply closet, where Reed is grabbing supplies. "Excuse me, Madam," Gary says. "It's Doctor, what?" Reed says. He asks where he can find Dr. Shepherd, but she doesn't know. She walks past him, but he grabs her arm. He asks her again for directions to his office, but she says he has to find a nurse and ask them, as she has patient with seizures. "Ma'am," Gary says, and Reed turns around to tell him that he's not even supposed to be there. "I'm not a tour guide, I'm a surgeon, okay?" she says, as he pulls out a gun and shoots her in the head. She falls down, dead, and her blood spreads across the floor. Alex suddenly appears behind Gary. "Dude, what the..." he starts, as Gary shoots him in the chest.
The elevator doors open and Alex drags himself into it. He's heavily bleeding and he's having difficulties breathing.
Meredith enters Derek's office. He paged her, as he'd like to see his wife every now and then. She told him about the case she had the previous night with Shadow Shepherd. Derek is jealous of her, because he only has paperwork to do. "I'd love to have something jammed in my brain, that way I could see the inside of an OR," he jokes, referring to Meredith's case. Meredith says she has something to tell him tonight. He says he'll be there, and she leaves. "I hate that you're so happy," he says, but she tells him to look forward to the sex.
Jackson, Teddy and Owen are operating on the gunshot victim. Cristina comes in to update Teddy on a patient, and Teddy agrees with Cristina's plan to treat him. Owen says that Cristina could help them out and that she has to scrub in, but she says she rather not. Owen walks behind her, and outside, she asks him if he loves Teddy or her. He doesn't reply, which causes Cristina to tell him they're done. She walks away. 
April is writing in her notebook as she walks into the supply closet. She suddenly trips over something and falls onto her face. Her nose is bleeding as she gets up, but she then notices her whole body is covered in blood. As she sits up, she notices she's lying in a puddle of blood, and when she looks behind her, she sees she tripped over Reed's dead body and is now covered in her blood. She starts freaking out.
April enters Derek's office, completely in shock. He sees her covered in blood and knows something is wrong. She starts rambling over how blood doesn't scare her and how much blood a tiny body like Reed's can contain. He snaps her out of it and asks her what happened. "Reed is dead. Someone shot her," April blurts out.
Elevator doors open and Cristina gets in. She's all alone with Gary Clark, who asks her where he can find the Chief. She gives him directions to get to his office. He thanks her and wishes her a nice day as he walks out. Cristina smiles and wishes him the same.
A bleeding Alex is still lying in the elevator. 
Derek is on the phone with the head of hospital security to find the right thing to do now while looking through some papers. Behind him, April is putting on new scrubs. Derek then reads they need to do a lockdown, which means everybody has to stay where they are. He tells April to stay put in the office, as he leaves. She says lockdown means staying where you are, but Derek replies he's the Chief and it's thereby his hospital. 
Richard is reading the paper in the café as several police cars come driving by in the direction of the hospital. Richard lays down money on the table and quickly leaves.
Callie enters the pediatric wing and asks Graciella for her patient's chart. One of the nurses picks up the phone, while Arizona also asks her to call Lexie to get her appendectomy moving. The nurse asks her to hold, and says they're on lockdown. Arizona thinks this is a joke, until everyone gets a page. Arizona gathers everyone and tells them they're sealing the floor. She also asks them not to alarm the makers of the tiny humans. Callie snaps at Arizona, who asks her if it's that hard for her to be on the same floor with her. Callie replies it is.
Bailey asks Mary how she's doing, and she replies Bill isn't back with the pizza yet and that she's full of fresh blood. Bailey tells her she complains too much, but Mary says she's doing it with a smile and that she's one of the best patients. Bailey then also gets the lockdown page and is shocked when she reads it. 
Teddy and Owen's patient is crashing, and Derek comes in to ask for a status. Owen replies it's touch and go. Derek asks Jackson to come over. None of them has checked their pager, so Derek tells him there's a shooter in the hospital. He wants Jackson to tell Owen and Teddy to stay in the OR once they're finished until they're told they can leave. Jackson is shocked,  but he assures Derek he can handle it. Derek leaves, and Owen asks Avery what he wanted. Jackson makes up an excuse and they continue operating, but Jackson has shaky hands. 
Meredith finds Cristina charting on a gurney in the hallway. They don't care about the lockdown page, as they just think it means they can't leave the hospital, which they don't do anyway. They think it's nothing, and Cristina jokes there's maybe an axe murderer on the loose, which Meredith replies would be fun. Cristina asks if Derek cried like a little bitch baby when she told him she was pregnant. Meredith says she'll tell him tonight to make it special, as he was just in a mood. Cristina asks why he gets special as she found out squatting over a stick in the ladies room. Meredith confesses she's eager to tell him and then decides to tell him now. Cristina wants to come with, stating she wants to see the bitch baby tears. She assures she'll stay in the hallway and tells her she broke up with Owen. Meredith then allows her to come.
In the lobby, Lexie asks Mark to sign a document as she needs an attending's authorization. He wants to talk and tells her he misses her, as nurse Vivian yells at Gary, who's walking up the stairs, that he can't leave this area. Gary then pulls out his gun and shoots her. Everyone ducks, and Mark pulls Lexie onto the ground behind the nurses station. Gary leaves, and everyone starts running away. Lexie crawls towards Vivian to check on her, but she's already dead. Mark takes Lexie in his arms and runs through the crowd towards the elevator. The doors open, revealing Alex's bleeding body. 
Outside the hospital, police officers have gathered, guarding the exits. Richard walks over to the officer in charge and asks him what's going on in this hospital. When he hears about the shooter, Richard wants to go in, but the officer body blocks him. Richard asks him about evacuating people, but the officer says the common policy is a lockdown, as they don't know who and where the shooter is. The officer assures him they have it under control. Bill Portman joins them and asks what happened, as the SWAT team arrives. 
Mark lies Alex down on the conference room table. Lexie is behind them with supplies. Alex is pissed because he got shot, and Mark examines him while Lexie keeps on saying they need to him out of here. There's no exit wound, and he instructs Lexie to place an IV while he sets up a chest tube. 
The peds floor is extremely busy and understaffed. Callie then proposes to place all kids together in a big room, so they can watch them all at once. Arizona thinks they can pull it off and instructs Steve to start moving the kids, and then thanks Callie for the idea.
While on their way to Derek's office, Cristina tells Meredith that Owen doesn't know who he loves. She asks to talk about something else, and Meredith tells her she'll be godmother to the kid, which means she'll have to take care of the kid when she and Derek die. "If you and Derek die in a plane crash, the kid is mine?" Cristina asks, and Meredith confirms. Cristina jokes she wishes a little bit Meredith and Derek die, so she can raise the kid with decent priorities. Meredith says she has priorities, like surgery. Cristina then takes back her words, when they walk into Derek. He tells them they can't walk around and he puts them in a closet. He tells them there's a shooter in the hospital, and asks them not to move until he gets them when it's safe. 
Bailey is checking on Mary and keeps on talking, who notices that Bailey keeps on checking her pager. She knows there's something wrong, because Bill is late (which never happens) and Bailey is hanging out with her. Bailey then says there's a situation when Charles comes running in and tells that the shooter is on the floor. Bailey and Mary are shocked to hear that there's a shooter in the hospital. Bailey watches through the window and sees screaming staff members running around and a security guard being shot. As Gary walks up to Mary's room, Bailey tells Charles to hide and tells Mary to play dead. Charles enters the bathroom, and Bailey covers up Mary with a sheet. Bailey herself crawls under the bed just as Gary enters the room. He lifts up the sheet, and breaks down as another dead patient is too much. He then hears a noise in the bathroom, and from under the bed, Bailey sees how Gary opens the door and asks Charles if he's a surgeon. She covers her mouth as Gary shoots Charles to the abdomen. Charles falls down in pain, and suddenly Bailey gets pulled out from under the bed. Gary aims the gun at her, and asks her if she's a surgeon. She has difficulties speaking but finally manages to say that she's a nurse. He apologizes for the trouble and the mess as he reloads his gun. He then leaves the room. Mary finally can breathe again and Bailey is relieved.
Mark needs to put a chest tube into Alex's chest. He doesn't want one and assures Lexie he's fine. Mark has to though, so he tells Lexie to prepare the betadine. He'll do the rest. Alex screams loudly as Mark cuts open his skin. Mark urges Lexie to shut him up, but it doesn't work. Alex keeps on screaming as Mark places the chest tube. Lexie tries to keep him silent by talking to him, but Mark says she needs to do more as the gunman will come this way if he hears the screaming. Lexie gets some gauze and puts it into his mouth while shushing him.
Arizona is wheeling a kid to the big room and almost bumps into Callie, who's doing the same thing. Arizona thought they were going to be friends. Callie doesn't understand she wants to talk about this right now with all things that are going on. Since they're stuck here, that's exactly what Arizona wants. Callie says she tried to rise above and be friends, but she's now going the more traditional round of totally hating her guts. Callie wheels her kid next to another one and introduces them. 
Arizona runs behind her and says she doesn't deserve this, having given Callie nothing but respect and love. Callie replies that that's only what she thinks she did. Arizona thinks it must feel great to act like she's the bad guy. Callie bounces back that she spent last month trying to convince herself she doesn't need kids to be happy. She turned herself inside out to try to want what Arizona wanted, until she stopped and asked herself if Arizona ever tried to imagine what it would be like to change for Callie. Arizona dismissed her dream, which tells her Arizona doesn't care about her happiness. Now she finally figured out who Arizona is, and she doesn't like it. She wants to walk away, but Arizona blocks her. She questions why she should change for Callie. Just for love doesn't seem enough, as Callie falls in love all the time: men, women. They're interrupted by Graciella, who wheels the appendicitis kid from the ER towards them. 
Bailey is trying to stop Charles's gunshot wound from bleeding by applying pressure. Charles keeps on repeating that he was shot. Bailey asks Mary, who's shocked, to hand her surgical pads. Mary wants to go home and starts panicking. Bailey tells her to pull herself together and help her. While Bailey uses the pads to try to stop the bleeding, she instructs Mary to go to the window and see if there's anyone who can help them. Mary only sees a dead security guard as Charles keeps screaming in pain. There's no one out there to help them. Bailey tapes the gauze over the wound while crying. Mary has to wipe her tears so she can keep working. Bailey assures them they're going to be fine.
Teddy and Owen have finished operating and Owen starts instructing Jackson to bring the patient to the ICU. Jackson says he can't and says that Shepherd told them that they can't leave. He informs them about the shooter, but Owen insists this hypothermic patient needs to be warmed up before he starts circling the drain. He starts yelling at Avery for only telling him this now. Owen decides he'll take the patient up to the ICU himself, while the others have to stay in the OR. Teddy decides to come with, as she's a cardiothoracic surgeon and the patient has a penetrating wound to the chest. They take off.
Arizona and Callie are starting to treat Ruby. Graciella comes up with a portable ultrasound. Arizona orders her to check the appendix and runs off to get more supplies. Callie follows her and asks her when she will forgive her for not being a good enough lesbian. Arizona will when Callie convinces her she's in love with her and not in love with being in love. Arizona wants to feel different than George O'Malley, Erica Hahn, Mark Sloan. Callie has a huge heart, which Arizona loves, but Arizona doesn't trust her because of it. Graciella interrupts again to inform her that Ruby's appendix has burst. They return to the patient.
Meredith and Cristina are still in the closet. Meredith has been hurling every day this week, and it's around the same time. This time is right on schedule. Cristina wants to get out, because she doesn't want to stay there when Meredith stinks up this place with vomit. Cristina stares through the window and suddenly sees Gary with the gun in his hands. She ducks and urges her to be quiet. Gary is close as Cristina peeks again, recognizing him as the guy from the elevator. She tells Meredith he asked her for directions to the Chief's office and realizes the guy with the gun is looking for Derek. Meredith throws up after hearing this.
Derek is running towards his office, over the catwalk. Outside, sirens can be heard. Suddenly, Gary appears behind him, covering his gun in his jacket. Derek says he shouldn't be here as it isn't safe. Gary knows the hospital isn't safe, that's the point. "You don't recognize me, do you?" he asks Derek, who then recognizes him as Mr. Clark. Derek apologizes and wants him to go somewhere so he doesn't get hurt, but Gary replies he already is. "You hurt me when you decided to kill my wife," Gary says as he reveals his gun and aims it at Derek.
Mark and Lexie realize Alex needs a blood transfusion. Lexie says she'll go get the supplies, as he knows what to do. She can't sit around doing nothing. Before leaving, Lexie asks him not to die and promises she'll be right back. Alex is mumbling incomprehensible. Lexie leaves and Alex asks Sloan not to kill him. Mark's doing his best.
Cristina and Meredith have left the closet and they're wandering through the hall. They then see Derek being held at gunpoint. Cristina holds back Meredith.
Derek tries to talk to Gary, but he doesn't want to talk. He's the man, he promised his wife he would be, and a man looks after his wife. But he didn't and let Derek decide that she should die. He wasn't a man back then, but he is now. Meredith and Cristina are watching at the other end of the hall in suspense.
Bailey places an oxygen mask over Charles's mouth. She snaps Mary out of her shock again and asks for some more supplies. Charles believes he's dying, which Bailey denies. He tells her not to lie to him. but Bailey insists he's not dying and that she would tell him if he were. Mary has to hold Charles's hand while Bailey continues giving care.
Meredith and Cristina are still watching Derek and Gary, with Cristina telling Meredith to stay here. Gary questions what kind of hospital this is. It isn't safe here, and somebody has to protect people from Derek and his judgment. Gary yells he doesn't get to be God. Derek tries to talk to him again. He acknowledges Gary's loss, saying he lost his father when he was a kid. He tells Gary what happened to his father. He didn't become a doctor to be God, he became one to save lives. He asks Gary to look him in the eye. He's a human being that makes mistakes, is flawed. They all are. This is just a mistake for Gary, who wants somebody to pay for what happened. Derek says he can see Gary is a good man in his eyes. He asks if he can see the same in his. Gary lowers his gun and seems to realize this is all a mistake. Suddenly, the door behind Derek opens and April comes out, glad to see that Dr. Shepherd is back. As Derek turns around, Gary raises his gun again. Meredith screams as Gary shoots Derek in the chest. Meredith tries to break free as Cristina holds her back, while Derek falls to the ground. While Meredith's voice over is repeated, Derek blinks a couple of times and then closes his eyes.
==Cast==
6x23MeredithGrey.png|Meredith Grey
6x23CristinaYang.png|Cristina Yang
6x23AlexKarev.png|Alex Karev
6x23MirandaBailey.png|Miranda Bailey
6x23RichardWebber.png|Richard Webber
6x23CallieTorres.png|Callie Torres
6x23MarkSloan.png|Mark Sloan
6x23LexieGrey.png|Lexie Grey
6x23OwenHunt.png|Owen Hunt
6x23ArizonaRobbins.png|Arizona Robbins
6x23TeddyAltman.png|Teddy Altman
6x23DerekShepherd.png|Derek Shepherd
6x23GaryClark.png|Gary Clark
6x23MartyHancock.png|Marty Hancock
6x23CharlesPercy.png|Charles Percy
6x23AprilKepner.png|April Kepner
6x23JacksonAvery.png|Jackson Avery
6x23ReedAdamson.png|Reed Adamson
6x23BillPortman.png|Bill Portman
6x23MaryPortman.png|Mary Portman
6x23Shelley.png|Shelley
6x23Pete.png|Pete
6x23Ken.png|Ken Kendall
6x23Karen.png|Karen Kendall
6x23Ruby.png|Ruby Kendall
6x23NurseTylerChristian.png|Nurse Tyler Christian
6x23GraciellaGuzman.png|Graciella Guzman and Arizona Robbins
6x23SteveMostow.png|Steve Mostow
6x23NurseVivian.png|Nurse Vivian
6x23Nurse.png|Nurse
6x23Waitress.png|Waitress
6x23SobbingWoman.png|Sobbing Woman
===Main Cast===
*Ellen Pompeo as Dr. Meredith Grey
*Sandra Oh as Dr. Cristina Yang
*Justin Chambers as Dr. Alex Karev
*Chandra Wilson as Dr. Miranda Bailey
*James Pickens, Jr. as Dr. Richard Webber
*Sara Ramírez as Dr. Callie Torres
*Eric Dane as Dr. Mark Sloan
*Chyler Leigh as Dr. Lexie Grey
*Kevin McKidd as Dr. Owen Hunt
*Jessica Capshaw as Dr. Arizona Robbins
*Kim Raver as Dr. Teddy Altman
*Patrick Dempsey as Dr. Derek Shepherd
===Guest Stars===
*Michael O'Neill as Gary Clark
*Tom Irwin as Marty Hancock
*Robert Baker as Dr. Charles Percy
*Sarah Drew as Dr. April Kepner
*Jesse Williams as Dr. Jackson Avery
*Nora Zehetner as Dr. Reed Adamson
*Ryan Devlin as Bill Portman
*Mandy Moore as Mary Portman
===Co-Starring===
*Jeanette Brox as Shelley
*Adam Shapiro as Pete
*Jason Graham as Ken
*Kelsey Scott as Karen
*China Anderson as Ruby
*Moe Irvin as Nurse Tyler
*Gloria Garayua as Intern Graciella
*Mark Saul as Intern Steve
*Ingrid Walters as Nurse Vivian
*Arlene Santana as Nurse
*Sara Giller as Waitress
*Angelina Hong as Sobbing Woman
==Medical Notes==
===Meredith Grey===
*Diagnosis:
**Pregnancy
*Doctors:
*Treatment:
Meredith took a pregnancy test and it came back positive.
===Ruby Kendall===
*Diagnosis:
**Appendicitis
*Doctors:
**Arizona Robbins (pediatric surgeon)
**Lexie Grey (surgical resident)
*Treatment:
Ruby, 9, came into the ER with abdominal pain that was quickly diagnosed as appendicitis. She was admitted to peds, but her surgery was delayed when they were placed on lockdown. While they were waiting, Ruby's appendix burst.
===Jason Perkins===
*Diagnosis:
**Comminuted tibia fracture
*Doctors:
**Callie Torres (orthopedic surgeon)
**Alex Karev (surgical resident)
*Treatment:
Jason, 6, came into the ER with a comminuted tibia fracture, which Callie treated.
===Mary Portman===
*Diagnosis:
**Low hemoglobin
**Low hematocrit
*Doctors:
**Miranda Bailey (general surgeon)
**Charles Percy (surgical resident)
*Treatment:
**Colostomy bag
**Blood transfusion
Mary was in the hospital for a colostomy reversal, but her hemoglobin and hematocrit were extremely low, so she needed a blood transfusion before they could operate. They transfused blood, but any further care was delayed when the hospital was placed on lockdown.
===Pete===
*Diagnosis:
**Gunshot wound
**Seizure
**Hypothermia
*Doctors:
**Teddy Altman (cardiothoracic surgeon)
**Owen Hunt (trauma surgeon)
**Jackson Avery (surgical resident)
*Treatment:
**Chest tube
**Surgery
Pete had been in a car accident and then was shot by Gary Clark. He was rushed into surgery from the ER. Before they could move him, he seized in the ER. In surgery, the found injuries to his pulmonary artery and vein. Despite complications, his surgery was completed. Pete was hypothermic, so they needed to move him to the ICU to start warming him up, which was complicated by the hospital being on lockdown.
===Reed's Patient===
*Diagnosis:
**Seizure
*Doctors:
**Reed Adamson (surgical resident)
*Treatment:
Reed told Gary Clark she had a patient having seizures right before he shot her.
===Reed Adamson===
*Diagnosis:
**Gunshot wound
*Doctors:
*Treatment:
Reed was shot in the head at point-blank range and died instantly.
===Alex Karev===
*Diagnosis:
**Gunshot wound
*Doctors:
**Mark Sloan (plastic surgeon)
**Lexie Grey (surgical resident)
*Treatment:
**Chest tube
Alex was shot in the right side of his chest by Gary Clark. He was able to drag himself onto an elevator to go to another floor. He was found by Mark and Lexie, who moved him into a room to treat him. They put in a chest tube to drain the blood. When he needed a blood transfusion, Lexie left to get the blood while Mark continued to take care of him.
===Meredith's Patient===
*Diagnosis:
**Foreign body impaling skull
*Doctors:
**Jim Nelson (neurosurgeon)
**Meredith Grey (surgical resident)
*Treatment:
**Controlled extraction
Meredith told Derek a man had come in after crashing his motorcycle with rebar jammed in the base of his skull, which she then extracted.
===Mr. Linehan===
*Diagnosis:
**Hemolytic anemia
**Post-op thrombotic thrombocytopenic purpura
*Doctors:
**Teddy Altman (cardiothoracic surgeon)
**Cristina Yang (surgical resident)
*Treatment:
**Exchange plasmapheresis
Mr. Lineman developed post-op TTP, which Cristina treated with exchange plasmapheresis.
===Mark's Patient===
*Diagnosis:
*Doctors:
**Mark Sloan (plastic surgeon)
**Lexie Grey (surgical resident)
*Treatment:
Lexie had Mark sign the order for auditory evoked potentials for one of his patients.
===Peds Patients===
*Diagnosis:
**Various
*Doctors:
**Arizona Robbins (pediatric surgeon)
**Callie Torres (orthopedic surgeon)
**Graciella Guzman (surgical resident)
**Steve Mostow (surgical resident)
*Treatment:
**Various
Callie was looking for Olivia Kagan's chart, Arizona needed an albuterol nebulizer for a kid with asthma, and the kid in 18 needed ceftriaxone. Two other patients were named Tyler and Christopher.
===Charles Percy===
*Diagnosis:
**Gunshot wound
*Doctors:
**Miranda Bailey (general surgeon)
*Treatment:
**Supplemental oxygen
Charles was shot by Gary Clark when he admitted to being a surgeon. Assisted by Mary, Bailey treated the wound as best she could, applying pressure to stop the bleeding.
===Derek Shepherd===
*Diagnosis:
**Gunshot wound
*Doctors:
*Treatment:
Derek was shot in the chest by Gary Clark.
==Music==
Song 	Performer 	Scene
"Holding Us Back" 	Katie Herzig	
*During Meredith's voiceover at the opening of the episode:
**Derek stands on the bridge.
**Alex wakes up next to Lexie as he gets paged.
**Jackson is in the ER.
**Richard has breakfast.
**Callie and Cristina tell each other to stop crying.
**Meredith does a pregnancy test.
*During the closing of the episode as Mr. Clark shoots Derek with Meredith, April, and Cristina watching.
"How the Heart Grows Wicked"	Patrick Park	
*Cristina breaks up with Owen.
*April discovers Reed's body, then rushes into Derek's office to tell him about Reed.
"Holding Us Back" - Katie Herzig
"How the Heart Grows Wicked" - Patrick Park
==Notes and Trivia==
thumb|300px|right
*This episode's title originated from the song , originally sung by Iron Maiden.
*This episode scored 13.93 million viewers.https://web.archive.org/web/20101227171302/http://tvbythenumbers.zap2it.com/2010/05/21/tv-ratings-greys-anatomy-rules-finale-thursday-bones-flashforward-csi-parks-30-rock-ref-all-rise/52027
*During Meredith and Cristina's talk about Cristina being Meredith's child's godmother, Cristina asks, "If you and Derek are in a plane crash and die, the kid is mine?" Two seasons later, Meredith and Derek have a near death experience when they are in a plane crash along with Cristina, Arizona, Mark (who dies in the hospital after they're rescued), and Lexie, who dies after being crushed by a piece of the plane.
*The gun held by Gary Clark was a real gun, only modified to be safer.
*Sarah Drew tweeted that this episode, along with Death and All His Friends, was her favorite season 6 episode to film. She also stated in an interview that she didn't like that April got Derek shot, as fans of the show disliked her character already for having a crush on Derek.
*Originally, Shonda Rhimes wrote in the script that Bailey got shot. However, she changed this because she felt really bad about it, as she felt like Bailey is the soul of the show.
*The café were Richard is having breakfast is called "Rhimes Café", which is most likely a reference to the name of the creator of the show, Shonda Rhimes.
*Teddy Altman is the only surgeon who did not see the shooter.
*The episode was ranked #7 on Huffington Post's The 9 Most Devastating Episodes in Recent TV History.
*Goof: April should've seen from the Chief's office that Derek was at gunpoint. Correction: It is possible that April was on the floor and didn't notice Derek until the gun was lowered or that the blinds were closed and she couldn't see them but ran out after she heard them talking.
*The shooting happened on a Tuesday as Ben Warren was out golfing.
**Goof: When Derek pages Meredith to his office to say hello, she reminds him she trolls for cases every Tuesday night and got to do an extraction with Shadow Shepherd. Meredith's comment implies its now Wednesday morning, which contradicts the storyline of Bailey's struggle with Warren golfing (as he did every Tuesday morning) while the hospital was being terrorized.
*The Grey Matter blog post for this episode was combined with the one for next episode.
==Gallery==
===Episode Stills===
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===Behind the Scenes===
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==Quotes==
:Bailey: Where is this water coming from?
:Mary: Dr. Bailey, you're crying.
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:Cristina: (to Callie) Will you stop crying?! (starts sobbing)
:Callie: You stop crying.
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:Owen: Come on, Teddy. Cristina's not talking to me. You're not talkin' to me. Come on.
:Teddy: I don't want to talk about it. I don't wanna go over again how you told Derek to give my job away. I don't wanna discuss it, or hear you apologize or forgive you or anything. You know what I want? A little bit of peace.
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:Derek: I hate that you're so happy.
:Meredith: Derek, there's gonna be lots of dirty sex for you tonight. Look forward to that.
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:Derek: (seeing April covered in blood) April, what is it?
:April: Did you know I grew up on a farm?
:Derek: What happened?
:April: (rambling in shock) I... I great up on a farm, so you know, blood... blood doesn't bother me, I... I slaughtered a pig once. That was a lot of blood. 'Bleeding like a stuck pig.' That's a saying. To bleed like a pig, you know, it means something. But you don't think of people as having that much blood. I mean, you learn in med school how many pints we all have in us, but you don't realize it until you see it. You don't get how much blood... And a skinny person? I mean, my God, Reed, she's like almost anorexic. She's like, five pounds, you wouldn't think she'd have that much blood in her, but she did. She did.
:Derek: (interrupts her) April, April, April! You're in shock. It's okay. Tell me what happened.
:April: Reed's dead. Someone shot her.
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:Callie: When are you gonna forgive me for not being a good enough lesbian for you?
:Arizona: When you do something to convince me that you're falling in love with me and not being in love. When you do something to convince me that I'm different than George O'Malley, Erica Hahn, Mark Sloan, the girl at the coffee cart... I mean, you have a huge heart, and I love that about you. But I don't trust you. Why would I?
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:Callie: I have spent the last month trying to convince myself that I don't need kids to be happy. Really tried. Giving lectures to myself, saying it out loud to you and to Mark. And turning myself inside out to want what you wanted and then I stopped for a second and I thought: Did you ever try? To imagine what it would be like? To change for me? Because I don't think you did. What you did was dismiss my dream. My dream. Which says to me that you don't give a rat's ass if I'm happy. I never understood squat about who you are and now I do and I don't like it.
:Arizona: Oh, really? Really? I'm supposed to change for you? Why? 'Cause we're in love? I mean, 'cause you fall in love all the time. Men, women...
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:Cristina: You okay?
:Meredith: I've been hurling every day this week, around... (looks at her watch) yep, right on schedule.
:Cristina: Okay, we gotta get outta here, 'cause I'm not staying in here after you stink up this place with your vomit.
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:Derek: Hey, what are you doing here?
:Cristina: Uh... walking.
:Derek: We're in lockdown.
:Cristina: Yeah, we're not walking outside.
:Derek: That's not what lockdown means. It means stay where you are.
:Cristina: Did you know that's what it...?
:Meredith: No, I thought it meant...
:Derek: Look, get in here. (puts Cristina and Meredith in a supply closet) There's a shooter loose in the hospital. Stay in here. Don't move. I'll come back and get you when it's clear.
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:Meredith: Hey. Did you get that page? Lockdown?
:Cristina: Yeah, I mean, whatever. It means we can't leave. I never leave here anyway, so what do I care? (Mer laughs) You know what? It's probably just a drill. Or like, a psych patient got out. Or a baby went missing from the nursery. Or there's an axe murderer on the loose.
:Meredith: Axe murderer would be fun.
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:Gary Clark: Dr. Shepherd?
:Derek: Sir, you shouldn't be here. It's not safe.
:Gary Clark: I know it's not safe here. That's the point. This hospital isn't safe. You don't recognize me, do you?
:Derek: Mr. Clark. Sorry, I... There's a lot going on here. I have a situation. You should go someplace safe so you don't get hurt.
:Gary Clark: I'm already hurt. You hurt me when you decided to kill my wife. (points gun at him)
:Derek: Mr. Clark…
:Gary Clark: Shut up. No talking. You're not the man here. I'm the man. I'm the man! I told my wife I would be. I'm a man, and a man looks after his wife, and I didn't. I let you decide that she should die. I wasn't a man then, but I'm a man now. What kind of hospital is this? It isn't safe here. Somebody has to protect people from you. Handing down judgments like you're God.
:Derek: Mr. Clark...
:Gary Clark: You don't get to be God! (Derek tries to talk) No talking!
:Derek: (long pause; voice shaking) Mr. Clark, listen to me. I know your loss. I lost my father when I was a kid. Two guys killed my father for his watch, right in front of me. Right in front of me. I didn't become a doctor because I wanted to be God. I became a doctor because I wanted to save lives. ... Look at me. Please. Look at me in the eye. I'm a human being. I make mistakes. I'm flawed. We all are. Today, I think... for you, it's just a mistake. You want justice. You want somebody to pay. You're a good man. I can see that in your eyes. Can you see it in mine? Can you?
:(After a long silence, Mr. Clark lowers his gun)
:April: (runs out) Oh, Doctor Shepherd! Thank God you're back!
:(Derek turns to look at April, Mr. Clark holds his gun up again, shakes for a few moments, and shoots Derek right in the chest)
==See Also==
de:Der Tod und seine Freunde (Teil 1)
fr:Je l'aime...
Category:All Episodes
Category:GA Episodes
Category:GA S6 Episodes