<P> Derek and Meredith's marriage is strained after he accepted an invitation from the President to participate in the Brain - Mapping Initiative . He went back on his promise to her that he would not add to his current workload in order to devote time to their two young children and allow her the chance to establish her career as a full - fledged attending . Eventually he was offered a position at the National Institutes of Health in Washington, D.C., but Meredith puts her foot down and refuses to leave her hometown and uproot their young family . His youngest sister Amelia (Caterina Scorsone) takes over his position at Grey Sloan . Meanwhile, he and Meredith fight bitterly on and off over whether they should move . After a bad argument, he accepts the job in the heat of the moment and leaves for Washington . While there, he and Meredith talk things out over the phone and come to a mutual conclusion that they both did not want to end their marriage . He tells her that just being with her, raising their children and operating on patients was more satisfying than "saving the world". </P> <P> In season 11, Derek is involved in a fatal car accident while driving to the airport for his final trip to Washington . He is able to hear and process auditory input, but unable to speak . He is recognized by Winnie, one of the victims of a crash he assisted in earlier, who tells the surgeons that their patient's name is Derek and that he is a surgeon as well . The hospital he was taken to was understaffed and his head injury was not detected quickly enough by the interns on duty that night . Although the neurosurgeon on call is paged multiple times, he takes too long to arrive and Derek is declared brain dead . Police arrive at Meredith's door and take her to see Derek, where she consents to removing him from life support . At the time of his death, Meredith was pregnant with their third child . She gives birth to a daughter whom she names Ellis after her mother . </P> <P> Derek was mentioned or referenced to a number of times in season 12 as the other characters struggle to cope with his sudden death . In the episode "My Next Life", Meredith had a flashback of their first ever surgery together when a patient named Katie Bryce was admitted to the hospital with a brain aneurysm . Amelia took his death especially hard as he was the sibling she was closest to . At the end of the season, prior to her wedding to Derek's long - time colleague Owen Hunt, Amelia goes on a nervous rant about how Derek was supposed to be the one to give her away, him having given away their three other sisters at their weddings . </P> <P> When Patrick Dempsey auditioned for the role of Derek Shepherd, he was afraid that he was not going to get the part . Creator Shonda Rhimes' first reaction was: "The very first time I met him, I was absolutely sure that he was my guy . Reading the lines of Derek Shepherd, Patrick had a vulnerable charm that I just fell for . And he had amazing chemistry with Ellen Pompeo ." Rhimes admitted that Dempsey's dyslexia threw her at first, particularly at the first few table readings: "I did not know about Patrick's dyslexia in the beginning . I actually thought that he didn't like the scripts from the way he approached the readings . When I found out, I completely understood his hesitation . Now that we all know, if he is struggling with a word, the other actors are quick to step up and help him out . Everyone is very respectful ." Isaiah Washington also auditioned for the part and when he did not get it, he said his reaction was like "I'd been kicked in the stomach by 14 mules ." Washington was, however, later cast as Preston Burke . Rob Lowe was also considered to portray Shepherd but turned the role down . Some of the character's medical cases were inspired by real - life patients of Steve Giannotta, Chair of Neurological Surgery at the University of Southern California Keck School of Medicine, whom Rhimes had consulted in writing for Shepherd's storylines and patients . </P>

When do meredith and derek first get together