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Content Warning: The following article contains spoilers for the ABC show Grey’s Anatomy.Grey’s Anatomy is a genuine TV juggernaut. TV has changed dramatically since the show premiered in early 2005, but it continues to draw a solid viewership, even if it no longer reaches the impressive peaks of the early seasons. A key part of Grey’s Anatomy’s enduring appeal is its powerful, emotive storytelling. The series is a real tearjerker, with a knack for bringing up all the feels with devastating storylines, solid acting, and, of course, its signature use of sad pop songs.
At times, this recipe veers into melodrama, and Grey’s Anatomy can be quite soap opera-ish but, overall, the show continues to be impactful. The writers know what the viewers respond to, and they’re more than happy to deliver it. Indeed, it sometimes seems as if they take sadistic glee in putting the audience through the emotional ringer. These are the episodes that do it best; they’re bound to have the viewer reaching for the tissue box.
20
“Sweet Surrender”
Season 5, Episode 20 (2009)
Not all of Grey’s Anatomy’s saddest episodes have to include a major disaster or a main character dying; sometimes it’s the patient storylines that cut the deepest, and no episode proves that more than “Sweet Surrender” from Season 5. Season 5 was already heavy as the once-hated character Izzie (Katherine Heigl) was fighting cancer, and her fate was constantly hanging in the balance. It also saw Dr. Bailey deciding if she wanted to join pediatrics. In this episode, she meets Jessica Smithson (Mary-Charles Jones), a 6-year-old girl with Tay-Sachs, a disease that is fatal in children her age. Her father is unwilling to admit that Jessica is dying, though, and he spends all episode avoiding the inevitable, and attempting to gather enough money to bring her to Mexico for experimental stem cell research.
Bailey stays with Jessica all episode, despite it being her day off. She holds her the entire day, and even when Arizona offers to have someone relieve her, Bailey decides to stay with her. When Jessica’s father returns, Bailey tells him that it is time to hold his daughter now, because she needs him for this part. He tells Jessica that they’re going to Mexico, where there are no doctors and the sky is blue and the sand is white, and Jessica dies peacefully in his arms. It’s one of the most gut-wrenching patient deaths in the entire show because she’s so young, yet her death was inevitable and so unfair, and her father’s denial of it and Bailey’s maternal instincts to stay with her never fail to get the tears flowing. —Samantha Graves
19
“Things We Said Today”
Season 9, Episode 10 (2013)
“Things We Said Today” marks Bailey and Ben’s (Jason George) wedding day, but also the tragic death of Webber’s wife Adele (Loretta Devine). Bailey puts her big day on hold in favor of operating on Adele and doing everything she can to save her. With the help of Meredith, they manage to stabilize her and save her, and Bailey and Ben’s wedding commences. But because this is Grey’s Anatomy, it’s not that simple, and the episode doesn’t get a happy ending just like that.
While at the wedding, Meredith notices Richard walk in and approaches him. She immediately notices the tears in his eyes and knows what has happened. She simply asks him when, and what happened, and he explains that it was a heart attack. The surgery fixed the aneurysm she had, but her heart couldn’t take it. He tells Meredith she did everything right, and the pair tearfully look on as Ben and Bailey share their first dance, which reminds Webber of him and Adele’s first dance. The scene then morphs into Adele and Webber dancing together to their song “My Funny Valentine” to really end the episode on one last heartbreaking note. —Samantha Graves
18
“Invest in Love”
Season 6, Episode 8 (2009)
When a Grey’s Anatomy episode heavily involves the pediatric wing, it’s best to bring out the box of Kleenex ahead of time. “Invest in Love” introduces us to Wallace (Khamani Griffin), an 11-year-old boy suffering from Short-Gut syndrome. He’s been in and out of Seattle Grace Mercy West Hospital for two years, and has had over 15 surgeries in his lifetime. His doctor is Arizona Robbins, who absolutely adores him and allows him to come on rounds with her and even present his own case. He’s the sweetest kid. So, of course, Grey’s Anatomy was going to give him the most tragic ending possible.
Wallace’s health deteriorates suddenly, and Arizona tells his parents that he doesn’t have long to live and they need to prepare themselves for it. They’re unable to accept this though and beg for her to do surgery on him anyway, which will extend his life for a couple more months. He pulls through the surgery, but later suffers complications and dies of septic shock. His death wrecks Arizona, as she was apprehensive about doing the surgery to begin with. But she does one final thing for Wallace and in the morgue carries out his bedtime ritual when his mother is unable to, comforting him with a muttering of “Bad dreams, bad dreams, go away. Good dreams, good dreams, here to stay.” —Samantha Graves
17
“Unaccompanied Minor”
Season 7, Episode 22 (2011)
“Unaccompanied Minor” initially presents as a disaster episode when a 757 goes down in the Sound with over 200 passengers onboard. The hospital immediately preps for an influx of patients, but when nobody comes, they realize that there were no survivors and instead have to prepare themselves to deliver life-altering news to the families of the deceased. That is, until they get a call that there is a survivor after all, a young girl named Sarah Gordon (Jaqueline Larsen). When nobody in the waiting room reveals to be her family, the doctors realize she is an unaccompanied minor.
A woman named Gilda (Beverly Todd) overhears this, and when her husband returns from making a phone call, she tells him that she’s staying for the little girl whose family isn’t here yet because she would want someone to do the same for their son. The other families hear this and decide to stay as well, rallying around Sarah while she’s in surgery, with Lexie promising to give them all updates. When Sarah’s mother eventually arrives, Gilda informs her that Sarah is doing well, and that a doctor will be out soon, and that everyone stayed so she wouldn’t be alone. When Sarah’s mother asks about Gilda’s own son, Gilda lies and says he’s in surgery but that he’ll be just fine, not wanting to spoil the happy moment. —Samantha Graves
16
“One Day Like This”
Season 14, Episode 17 (2018)
April is one of the most intricate characters in Grey’s Anatomy, and Season 14 really brought her character front and center, especially with the episode “One Day Like This.” Earlier in the season, April suffered a crisis of faith, and has been struggling to find her faith again all season. But when a Rabbi named Eli (Saul Rubinek) comes into the hospital with a bad reaction to antibiotics, he can tell that something is plaguing her and seeks to help her through it, even as he awaits his death.
He explains to her that faith wouldn’t be real faith if you only believe when things are good, and goes on to tell her that terrible things happen, and she’ll never know why. She just has to trust God’s plan and believe that the bad will pass. In response, April asks if she can take away some of his pain, to which he says she already has. He asks her to tell Dr. Bailey that he forgives her, which she promises him she will do. And as he slowly slips away, he starts to believe that April is his wife, and so rather than deter him, she goes with it and decides to comfort him in his final moments since he just helped her through one of the most challenging times of her life. It’s a beautifully done arc and episode, and an important one for April’s story since her faith was always one of the biggest parts of her character. But it’s heartbreaking to see Eli pass away after delivering such touching words. —Samantha Graves
15
“Leave a Light On”
Season 16, Episode 16 (2020)
There are no deaths or injuries in this episode, but there is heartbreak. Alex Karvev decides to leave Seattle Grace Hospital, and the show, which was controversial for Alex’s character development. Alex decides to leave and return to his ex-wife and children in Kansas.
What makes this episode sad is that Alex leaves not only all of his colleagues who he’s built relationships with throughout the seasons but also because he leaves his wife in Seattle, Jo. He wrote letters to all his friends and Jo, which was heartbreaking to watch as they didn’t want to see him go. It was a hard episode to watch because we all knew Alex was doing something he knew was right for him, but difficult for everyone he left behind.
14
“The Sound of Silence”
Season 12, Episode 9 (2016)
While Meredith is working on a man who’s having a seizure, he lashes out and violently attacks her. The team rushes to her side, but she’s already in terrible condition. The man punched her in the mouth which fractured her jaw and loses the ability to speak.
She winds up in a cast, loses her ability to speak, and on top of everything, her children refuse to see her. She’s left alone to deal with her injuries. The episode is an intense watch and we only get Meredith’s perspective which is heartbreaking and agonizing. Probably the saddest episode of the season.
13
“Drowning on Dry Land”
Season 3, Episode 16 (2007)
Meredith accidentally gets knocked into freezing water by a man who is in a panic. However, nobody sees her as she sinks into the cold water and is unconscious due to hypothermia. While everyone wonders where she is, Derek realizes something is wrong. He ends up finding her and rescuing her from the water, but she’s been in there for quite some time, and her entire body has turned blue. She’s moments away from death, and fans were thinking that the show might actually kill her off.
It’s one of the most intense and agonizing episodes to watch. Meredith is struggling as nobody knows where she is, and everyone is thinking, could this be it? Would they really kill her off? The episode ends with a cliffhanger, and we don’t know her fate until the next episode. Thankfully, she survived, but it’s probably one of the saddest episodes, just thinking about what could possibly happen to the show’s lead.
12
“Helplessly Hoping”
Season 17, Episode 7 (2021)
This episode was another Station 19 crossover episode. Andrew DeLuca, a fan-favorite character, was helping on a case to try to stop human traffickers. While chasing them down to expose their crimes he was stabbed. While this episode focuses on his surgery, he comes to terms with his life and assures his colleagues that it’s going to be okay.
Season 17 saw some of the most heartbreaking character deaths, but Andrew’s hit the hardest. He was on his way to becoming one of the most promising surgeons, he had his whole career ahead of him. Because he was heroic, it cost his life, making this episode one of the saddest in the series.
11
“Suddenly”
Season 8, Episode 10 (2012)
After a car accident involving an entire family requires all ER doctors rush to the floor. The daughter of the family was the only one not in the accident, and with her entire family needing medical attention, she has to possibly make the decision to keep her parents on life support. However, this isn’t even the saddest part of the episode.
Henry, a man in need of surgery, arrives at the hospital. He explains he doesn’t have a lot of money, but he married Teddy to get on her insurance. While they were married out of convenience, they found genuine love with each other. While the surgery was successful, they found a tumor near his heart, which ended his life suddenly. This was an emotional and devastating episode for fans. The sudden death of a heartwarming character affected so many people, including the characters on the show, some of whom took a lot of time to recover.
