Last night, ABC Television’s hit drama, “Gray’s Anatomy” presented one of the most compelling depictions of an active shooter scenario ever captured on film. It was dramatic, frightening, and chaotic…exactly like the accounts of real-life mass shootings witnessed over the years.
Unfortunately, the horror of the event was about the only thing accurately depicted in the program. The season finale episode called “Death, and all his friends” centers on one man’s rage and grief over the death of his wife, boiling over into a mass killing spree inside the Seattle hospital.
The incident begins simply enough. A man wanders around the hospital, asking directions to the Chief of Surgery office. The focus of his rage is “Dr. Derek Shepard”, who he blames for his wife’s death. In reality, Dr. Shepard had simply followed the woman’s advanced directive, and removed her from life support when nothing more could be done for her.
Her husband, “Gary Clark”, seeks justice first with lawyers, and then failing that, decides to take matters into his own hands. He purchases a handgun, and goes to the hospital looking for three victims, “Dr. Shepard, Dr. Webber, and a young surgical resident, Lexy Gray”.
Clark enters the hospital, but gets turned around in his confused state. Unable to find Shepard’s office, and starts asking directions. He enters a restricted area, where a young surgeon is gathering supplies. She’s in a hurry, and is more than a bit rude to Mr. Clark. He responds by snapping, and shooting her in the head, killing her instantly.
Unauthorized visitors in restricted areas should be reported immediately to security.
Within moments, Dr. Shepard, the Chief of Surgery is alerted to the fact that a shooter is present in the hospital and that a member of his staff is dead. The details are realistically sketchy at this point. Shepard responds by calling his head of security. The head of security tells Shepard that he doesn’t know what to do, since an incident like this has “never happened before”.
It’s inconceivable that a modern hospital would fail to have an Emergency Action Plan that deals with active shooter scenarios.
Shepard leafs through the hospital’s Emergency Action Plan, and finally decides that the correct course of action is to institute a lockdown. Each floor is isolated, with a strict policy of “nobody in-nobody out”. This information is relayed by telephone and pager to the hospital staff.
While the lockdown policy is fairly standard, no attempt is to made to block access to the shooter by locking doors, no one is shown barricading themselves inside rooms, or other recommended actions in an active shooter response.
Hospital staff find safety hiding in storage rooms, and other places, but endanger their own life by leaving their hiding places and roaming the halls. While this makes for great television, in real-life it would only add to the body count. Lock the door. Turn off the light, and stay put. Barricade interior doors with heavy furniture or other obstacles. Escape through windows, etc. if possible.
Mr. Clark, grief stricken and confused, continues to wander the hallways, shooting a nurse, a security guard, and other random victims. He is shown reloading his weapon on several occasions. We learn late in the episode that he bought a lot of ammunition because “it was on sale”. The firearm, which appears to be a standard 9MM automatic was purchased a few days before the shooting in a “Super-Saver” on Aisle 8. What isn’t explained is how he managed to also buy several additional magazines, since this are not sold outside of gun store specialty shops.
Police arrive, and immediately establish a perimeter around the hospital. The “incident commander” appears to be a beat cop, takes charge and waits for SWAT units to arrive. When they do, a five man team enters the building and begins to clear each floor one at a time, evacuating patients and doctors as each floor is swept for the gunman.
Pure fiction. The correct response to an active shooter situation would be for arriving units to immediately enter the building in small units and seek out the gunman. Police are now routinely trained to deal with Active Shooter scenarios. Loss of life is minimized if the gunman is actively engaged and neutralized by arriving officers.
It’s also true that the first officer on the scene would assume control, and become the “Incident Commander” under the standard ICS response. But he would quickly pass that duty off to a superior officer as the incident progressed and other units arrived.
Clark finally finds the object of his rage, “Dr. Shepard” in the interior breezeway of the stage. Shepard attempts to calm the shooter, and seems to be reaching him. But their moment of calm is interrupted by a young resident, and Shepard is promptly shot in the chest. The gunman then turns the gun on the young surgeon. She rattles off a description of her life, telling Clark the names of her father, mother, and sisters. She describes her life on a farm, growing up as a child, and doing anything in her power to make herself seem like a human being to the attacker.
Well, at least they got this part right. Accounts of several active shooter incidents have demonstrated that these killers tend to dehumanize their victims, and that they can sometimes be convinced not to shoot if the victim can make themselves seem “human”. Another effective technique is to simply verbally confront the shooter, and order them to stop the rampage.
Several times during the show, potential victims are within easy reach of the killer, and even when they have an opportunity, no one physically confronts Clark or attempts to disarm him.
At one point in the show, Clark is preparing to kill young surgical resident, Lexy Gray, who actually “unplugged” his wife from life support. Clark holds Dr. Shepard, Dr. Webber, and Gray most responsible for his wife’s death. He calmly explains to her that he never meant to kill those other people, that he only wanted to kill the three of them.
A shot rings out, and Gray falls. We then see a highly armored SWAT officer, holding a HK sub-machine gun. Clark has been hit, and is down on the floor, still clutching his weapon and pointing it towards the young doctor. The SWAT officer motions for her to move away, and she runs down the hall. Clark struggles to rise, and move away.
Policeman are trained to “double tap” an attacker, firing two quick shots at the COM (center of mass) in this situation. It’s unlikely that anyone would still be able to continue their rampage after being shot by such a weapon. The officer would also continue to engage the suspect if they were still attempting to take more victims. The officer would not have taken the time to instruct the doctor, he simply would have advanced, and fired again.
Despite his gunshot wound, Clark continues his rampage for another half hour or so, ultimately shooting one more victim, “Dr. Owen Hunt”. Hunt is an Iraq war veteran, and is the only character who ever attempts to confront the shooter despite the immediate danger of further murders.
Throughout the show, the police perimeter is shown as being very poor. Characters enter and re-enter the hospital several times. “Dr. Richard Webber, the former Chief Of Surgery” is trapped outside the perimeter for most of the show, but somehow manages to slip past police and enter the hospital. He also manages to find and confront the gunman before the SWAT officers can manage to end the situation.
The show ends with the gunman committing suicide, shooting himself with his last bullet. This detail is also all too common in real life Active Shooter incidents. Suspects are often resigned to their own death, and have intentions to kill themselves if police do not accomplish the task for them. This self-destructive intent is the prime motivator to changing the response protocols from similar hostage scenarios, which can often be resolved through negotiation.
Despite the show’s flaws in depicting the response to this incident, it provides a great opportunity for Public Information Officers. The show’s portrayal of the shooting is frightening, dramatic, and realistic in it’s depiction of the horror of these types of incidents. The show is one of the most highly rated on television, and was watched by an audience of tens of millions.
PIO’s should consider contacting their local ABC affiliate stations, and suggesting a news segment that could address how real life incidents in your own local hospitals would be handled by your department. You can use this as an opportunity to educate the public on steps that they can take to help themselves in such an event.
The episode would also make a great starting point for Active Shooter discussions with hospital emergency managers, and safety officers. Make it the highlight of your next PowerPoint talk to your LEPC group, or briefing for school administrators.
In the end, Gary Clark’s fictional rampage may end up saving real lives. If we can look past the show’s errors and instead focus on it’s unique ability to get people thinking about an incident that has “never happened before”.





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