Well, when Derek addressed Meredith's mother as he did and then, she had the heart attack and Derek tried desperately to save her ~ didn't he say at one point that Ellis was not dying on him, now? Indicating that Derek knew that Ellis was so manipulative that she would have tried to saddle Derek with the guilt of her death. And she did, really. And we don't know yet how that is going to affect Derek.
Definitely not one of Derek's finer moments.
It is interesting to think about how many times I have wanted to say something horrible to someone and have not done it. And how badly I felt about myself ~ about who I was ~ when I do say something nasty just for the sake of the nastiness, just to relieve the anger.
But how much worse would I feel if the person began to die when I did it.
At first, in my secret heart, I would be happy they were dying.
Then, I would try to save them, out of guilt.
Meredith cannot fix that for Derek by telling him everything is okay.
He did what he did.
It was interesting too, that Derek was shown in the waiting room, waiting like any other patient. Not a famous neurologist, not even a doctor, just someone another patient's realtive will pray for.
So there is something in this episode, at least for me, about who we think we are versus who we really are.
That would include George, too. He has grown up, and become someone better.
Derek was first portrayed as someone better, and now is being challenged ~ just as we all are challenged, and just as we all are changed, in our own lives.
Even when Meredith was running around in the death scene demanding something to help stop the bleeding for one of the dead patients ~ that was all about not having what we need to be who we think we are in the world.