Not everyone makes it out of Grey’s Anatomy unscathed. We rank the top 10 deaths over 10 years on Grey’s Anatomy.

Before they move on to Shonda Rhimes’ other network sensation, Scandal, the doctors and patients must exit the doors of Seattle Grace, or Grey Sloan Memorial, never to return. Unless, of course, a flashback demands it!

Here is a ranking of the 10 most memorable departures the show has seen over 10 years and 11 seasons.

10. Reed Adamson

The feisty red head from Mercy West survived the first round of cuts during the merger of Seattle Grace and Mercy West in season 5. Audiences did not have a lot of time with Reed, but her death was shocking nonetheless. It served as the first look at how merciless the loose gunman bent on finding Derek Shepherd truly was. Aside from a one night stand with Sloan and an unrequited crush on Karev, Charles Percy was the only one with eyes for the resident.

9. Meredith Grey

Is this cheating? Meredith technically died and viewers watched every heartbreaking scene of Derek Shepherd crying in the hallway as Cristina paced behind closed doors. We wanted to throw heating packs on her and tell her to walk away from the light. Denny was there to help guide her to the decision to keep breathing, but we weren’t spared the emotional turmoil that followed as fans. It was two episodes where at some moments, you just weren’t sure if Meredith, the namesake of the show, would make it to see the season 3 finale. As a fledgling show, with 57 episodes under its belt, it was too early to tell if the series would go on to see 11 seasons and well over 200 episodes.

8. Charles Percy

Poor Charles not only lost any shot with Reed, but he also lost his life to the gunman’s rampage. His death brought Grey’s Anatomy fans one of Bailey’s most emotional scenes of the series to date. As she drags Charles to the elevators to get him to the OR, she realizes that they are not running in the lockdown. Breaking down, she drags his head onto her lap and comforts him in his final moments of life.

7. Adele Webber

Sure, Adele did not need Alzheimer’s to make her death any more heartbreaking than it would be without it. Having Richard suffer through a second relationship, with his wife reliving her own past and putting him though the emotional turmoil he must have caused her over the years, was tough to watch. Adele’s sass and ability to make Richard and the other doctors of the hospital squirm was always welcome. Her eventual passing came during one of the happiest days of another doctor’s life — Bailey’s wedding to Ben. After operating on her wedding day, Adele woke up and spent a final few moments with Richard before succumbing to a heart attack.

6. Lexie Grey

Lexie came into Grey’s Anatomy like a bull in a China shop. Her brain never caught up to the words that spilled from her mouth, but luckily kept perfect time with what her hands were doing in the OR. Lexie took her time working her way into the lives of not only her half sister Meredith, but the rest of the doctors as well. Her death arrived in the plane crash of season 8 and her final moments were spent with Mark holding her hand, building a future they would both not live to see.

On the next page: The death that still haunts us 10 years later, ‘Scandal’ gains a few bodies

5. Henry Burton

Henry Burton’s death was probably all a cover for a B6-13 operation. Henry came into Seattle grace in a whirlwind of insurance fraud masked by marriage to cardiothoracic surgeon, Teddy Altman. After receiving his treatment, Henry hung around the Grey’s Anatomy crew. But no matter what century you live in, coughing up blood is never a good sign. Teddy insisted that Cristina operate on the tumor in Henry’s chest, without giving her the name of the patient until it was over to reduce her nerves. There was simply too much damage and bleeding and Henry died on the table.

4. Mark Sloan

McSteamy left Grey’s Anatomy with the same snark and sly smile that he entered with. We bet he would rather have been punched in the face this time instead of meeting his end, but after surviving the plane crash that took away his one true love, it was time to bid adieu to founder of the Plastics Posse. After seeming to be alright following the crash, he waits with Lexie through her own departure and slips into a coma following a cardiac episode. His two best friends, Callie and Derek, take him off life support and let him die in peace.

3. Ellis Grey

Ellis Grey was a powerhouse of talent, full of biting remarks, and deep, deep down a romantic at heart. Her visits to Seattle Grace were never met with any joy, unless she was lucid and in the company of Richard Webber. Alzheimer’s kept the brilliant surgeon active in a nursing home operating on the meal of the day, rather than building upon her astounding career. Ellis has made her way back into Grey’s Anatomy over the years, especially in season 11, as flashbacks connected Maggie and Meredith. Her death was comforting to Meredith as she passed while Meredith worked to fight for her own life.

2. George O’Malley

The 007 franchise makes some scars from George’s departure ache with the faint memory of the sweet doctor who just wanted to make everyone happy. George O’Malley’s exit was shocking to most fans, who came to the realization that he was the John Doe as Meredith figured it out. Casting news made his departure known to fans weeks before the finale, but his death provided one of the most shocking moments of the series.

He wanted to save more lives. He was good. And he was thoughtful and generous. I think in the end, I think he was heroic and noble. And I liked him very much. And I think he gave you a good reason to be very very proud.

1. Denny Duquette

Perhaps Denny’s death is the most memorable because it launched Snow Patrol’s “If I Lay Here,” to notoriety, or because it was the first major death in the series. It was someone fans were rooting for, it was someone who put all the doctors in danger because they were still a team, and it made everyone remember the word LVAD wire, even if you don’t exactly know what it does. Denny appeared to Meredith in her purgatory state and again to Izzie as she hallucinates over two more seasons of the show.

Watch Grey’s Anatomy season 11, episode 18, “When I Grow Up,” Thursday at 8:00 p.m. ET on ABC.