<P> Following his rescue from the plane crash that killed Mark and Lexie, Shepherd learns that he may only regain eighty percent of his hand's function . He comes to terms with the fact that his career as a surgeon may be over and is grateful that he is alive, in light of the deaths of his best friend Mark and sister - in - law Lexie . However, when head of orthopedic surgery Callie Torres (Sara Ramirez) tells him a more risky surgery could give him back full function of his hand or reduce its function if it goes wrong, Shepherd agrees to the surgery . He accepts the possibility that he may never hold a scalpel again . His hand recovers well and Torres clears him to return to work, but it is only weeks later that Shepherd feels he is ready to operate . Shepherd, Callie and Jackson decide to do nerve transplant for his hand . Meredith, newly pregnant with their second child, goes behind his back and calls his sisters so they can donate a nerve to him . Lizzie (Neve Campbell), Derek's younger sister, agrees to donate a nerve and the surgery is a success . </P> <P> Shepherd 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 Shepherd suffers an accident while driving to the airport for his final trip to Washington, D.C. 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 Shepherd is declared brain dead . Police arrive at Meredith's door and take her to see Shepherd, where she consents to removing him from life support . He is now dead . At the time of his death, unbeknownst to him, Meredith was pregnant with their third child . She gives birth to a daughter whom she names Ellis after her mother . </P> <P> Shepherd 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 has a flashback of their first ever surgery together when the patient Katie Bryce returns 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, she 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>

Episode of grey's anatomy when derek died
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