The Biggest Bombshells from the Grey's Anatomy Tell-All, From Untold Drama to Shocking Exits

It's a beautiful day to talk about Grey's Anatomy! Here are some of the jaw-dropping moments from Lynette Rice's book How to Save a Life: The Inside Story of Grey's Anatomy.

By Alyssa Ray Sep 21, 2021 3:00 PMTags

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Grab your person, because you do not want to miss the jaw-dropping experience that is Lynette Rice's Grey's Anatomy tell-all book.

Released today, Sept. 21, the tome from Rice, who is Entertainment Weekly's editor-at-large, gives readers an inside look into one television's most beloved shows.

"Some of the best shows in television history came from unremarkable beginnings," Rice writes in the opening line of her book, . "Test audiences notoriously loathed the 1989 pilot for Seinfeld. CSI was one of the last pilot scripts in 2002 to be ordered by CBS, which had far more faith in its remake of The Fugitive, starring Tim Daly."

And while there wasn't a major need for a medical drama at the time, with ER still on the air at NBC, Rice pens that pre-mega fame Shonda Rhimes knew she had something special. Rhimes' gut-instinct was clearly correct, as Grey's Anatomy is about to debut its eighteenth season on Sept. 30.

Of course, this success hasn't been without a few bumps along the way.

Grey's Anatomy's Departed Doctors: Where Are They Now?

Over the course of 14 chapters, Rice provides insight into everything from Patrick Dempsey's headline-making exit to how the original Seattle Grace interns were cast, proving that she is the ultimate Grey's fan. In her author's note, Rice confirms that she spoke to nearly 80 actors, writers, directors, producers, crew members and executives over the course of a year. She also mentioned that, for those who were unavailable to participate, archival EW interviews were included.

How to Save a Life: The Inside Story of Grey's Anatomy by Lynette Rice

Lynette Rice's How to Save A Life is totally unauthorized deep dive into the show that became a cultural touchstone and is a book that no Grey's Anatomy fan should be without.


Participating talent includes, Rhimes, Dempsey, Ellen PompeoSandra OhKatherine HeiglIsaiah WashingtonJustin Chambers and many more.

For some of the bombshells from How to Save a Life: The Inside Story of Grey's Anatomy, be sure to dance it out and keep scrolling through the images below.

Ellen Pompeo Didn't Want to Do a Medical Show

Thanks to her deal with ABC after a failed pilot called Secret Service, Ellen Pompeo was available to speak with Shonda Rhimes, who was interested in the actress after seeing her Midnight Mile. As Lynette Rice's new book revealed, over just one lunch, Rhimes convinced Pompeo to sign onto Grey's Anatomy.

The Other Interns

The hunt for Meredith Grey's intern peers was next, which eventually saw Sandra Oh as Cristina Yang, T. R. Knight as George O'Malley, Katherine Heigl as Izzie Stevens and Justin Chambers as Alex Karev. The audition process was definitely unique, with Heigl donning glasses, a sweater and a bun to look smart for the role. Also, the Grey's team didn't initially want Oh for Yang, they asked her to read for Dr. Miranda Bailey (later played by Chandra Wilson).

Because Oh was more interested in playing an antagonist, she asked to read for another available part. The rest was history.

Patrick Dempsey Was Not the Network's First Choice

Per director Peter Horton, the network initially wanted Rob Lowe to play Dr. Derek Shepherd (a.k.a. McDreamy). Unfortunately, Lowe was unavailable after choosing to pursue a CBS show called Dr. Vegas. (For the record, Lowe said CBS had a better pitch.)

That's when Patrick Dempsey was suggested, but the network was resistant since they felt he already had his career. According to Pompeo, she was involved in Dempsey being selected. While she didn't have the final say, she said their chemistry was "obvious."

Fun fact: Dr. Shepherd's nickname wasn't always "McDreamy." In the original pilot, they called him "Dr. McScreamMeF--kMe."

Isaiah Washington Wanted to be McDreamy

As Isaiah Washington detailed it, he went out for Dempsey's role too. Eventually, his audition birthed his role of Dr. Preston Burke. In the book, Washington claimed there was a rumor that Pompeo didn't want him to play her love interest "because she had a Black boyfriend."

"The context is that she's not into white men," he added. "I guess she implied that her boyfriend may have had a problem with her doing love scenes with me, so she felt uncomfortable. I supported her with that."

Feminist First Scene

Shonda Rhimes and company had to fight to keep the opening scene in the pilot, as ABC executives allegedly didn't like the idea of the heroine being promiscuous. Producer Betsy Beers ultimately saved the day, as "she told the raunchiest story" to the all-male executives proving that women can be sexually liberated and professional, according to Rhimes.

Resentment Towards Rhimes

Director James D. Parriott claimed that some of the actors began to have resentment towards Rhimes around seasons three or four, adding, "When you're servicing that many characters, it's very hard to get all the characters to have big story lines in every episode."

Leaked Story Lines

Season one had a lot of its story lines leaked online. In fact, according to writer Eric Buchman, the fact that Derek was married to Addison (Kate Walsh) was revealed before the episode aired. "The good news is that the show was not on enough people's radar," he added. "So it wasn't ruined for the audience."

The Isaiah Washington Controversy

A source close to Washington alleges that the show was "not well organized or well run." Thus, over time, Washington began to get overwhelmed by the long shooting hours. Things boiled over by Oct. 9, 2006, when Dempsey arrived late to set, reportedly sparking Washington to lose his cool.

"They got into an arguing match, and then before you know it they were physically fighting," writer Mark Wilding claimed. The fight was made even worse by Washington allegedly telling Dempsey, "You can't talk to me the way you talk to that little f----t T.R," per  writer Harry Werksman.

It's said that Heigl and James Pickens Jr. broke up the fight. Washington later apologized for his comment.

The Drama Continued

Although the cast and crew knew that Knight was gay, he was not yet out to his parents, so, when the story leaked to the press, that's how they found out. Knight publicly disclosed his sexuality following the ordeal.

Werksman revealed that the entire Grey's family had to do sensitivity training after this altercation. While things settled on set, a comment at the 2007 Golden Globes brought the issue to the forefront. After being asked several questions about the incident, Washington stated, "No, I did not call T.R. a f----t."

In Defense of Knight

Frustrated by Washington's latest remark, Heigl told Access Hollywood that her co-star "needs to not speak in public" and that she wasn't "okay with it."

Looking back on her defense of Knight, Heigl said it's not that she had "a courageous moment," it's that, "I had a couple glasses of champagne, and I was furious and frustrated for my friend and sick of the whole mess of it."

As for Knight? He recalled being "floored," noting, "How often is someone going to stick their neck out publicly for someone, at the risk of getting slapped in some way, shape or form? That doesn't happen."

He went on to call Heigl "fierce and honest and a great friend."

For the Love of Kate Walsh

Although the introduction of Walsh's Dr. Addison Montgomery character briefly threw a wrench into the MerDer love saga, it didn't take long for audiences to love her. "The writers could've made me just hateable," she said in the book. "They did a great job of humanizing Addison."

So, it's no wonder Rhimes created a spin-off for the character. After being pitched Private Practice, Walsh said she "slowly started to leave my body," as she was "very excited."

Despite airing for six seasons, Private Practice struggled to find its footing, potentially due to Rhimes' demanding schedule. Dempsey speculated in the book that the TV giant was "feeling overwhelming burnout."

The Toughest Part of Playing Dr. Grey

While fans may've always rooted for Meredith and Derek, Pompeo did not. In fact, as she detailed to Rice, the toughest part of playing Dr. Meredith Grey was "the relationship stuff with Patrick," explaining, "It's the most repetitious...I would never let a man treat me that way, or I would never not value myself enough to be put in a situation that was painful."

The Story Behind Katherine Heigl's Exit

Heigl has set the record straight about the details surrounding her shocking exit from Grey's Anatomy. "I started a family, and it changed everything," the 42-year-old star shared. "It changed my desire to work full-time."

The Knocked Up actress, who adopted Nancy Leigh, now 12, in 2008 with her husband Josh Kelley, explained, "I went on family leave...and just got to be a mom, and it changed my whole perspective…that was really the turning point."

According to Heigl, she had a conversation with Rhimes about her desire to move on from the show. Although they tried to figure something out, Heigl's character was nearly gone from Grey's in 2010.

On the public perception of her exit, Heigl said that being perceived as "ungrateful" bothered her. "That is my fault," she said. "I allowed myself to be perceived that way. So much about living life, to me, is about humility and gratitude. And I've tried very hard to have those qualities and be that person, and I'm just so disappointed in myself that I allowed it to slip."

Not So McDreamy

Through interviews conducted with Grey's stars and producers, Rice revealed the alleged origin story of Dempsey's exit, and we need a crash cart. According to Parriott, a former executive producer for Grey's, things were very tense between Dempsey and Rhimes by season 11. "Shonda needed an OG to come in as sort of a showrunner for 14 episodes," Parriott shared in the book. "There were HR issues. It wasn't sexual in any way. He sort of was terrorizing the set. Some cast members had all sorts of PTSD with him."

As Parriott continued, he described Dempsey as having a "hold on the set," since "he knew he could stop production and scare people." 

Jeannine Renshaw said Rhimes eventually issued an ultimatum to the network: Either she goes or Dempsey goes. In episode 21 of season 11, Dempsey's Dr. Derek Shepherd was killed off. Reps for ABC and Shondaland declined to comment to E! News on the above. There's currently no response from Pompeo and Dempsey's respective reps.

Kyle Chandler Didn't Want to Die

In the now iconic Super Bowl episode of Grey's, viewers met the charming bomb squad leader Dylan (Kyle Chandler), only to have him blow up at the end. And, according to Rhimes, Chandler didn't want his character to die. "He would pitch me ideas on how Dylan, his character, could maybe not explode," she said. "And I would show him the line in the script that said, 'Dylan explodes.'"

As Rhimes put it best, Dylan was literally written to die.

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