Patrick Dempsey may now be starring in Fox’s Memory of a Killer on the 2026 TV schedule, but the actor will forever be known as Derek Shepherd, a.k.a. McDreamy, on Grey’s Anatomy. He spent the first 11 seasons of the medical drama saving lives and making fans swoon like Meredith Grey. It’s truly a defining role in his career, so it's hard to imagine anyone else playing him. However, it turns out Rob Lowe was up for the part and turned it down.
How to Save a Life: The Inside Story of Grey’s Anatomy by Lynette Rice digs deep into the behind-the-scenes stories of the longest-running primetime medical drama, including casting. In an excerpt from the book, per EW, executive producer Peter Horton revealed that Dempsey was not ABC’s first choice for Derek. They wanted Lowe first:
