Paul Castello was a surgeon at Dillard Medical Center who treated Derek Shepherd after his car accident and was later involved in the hearing for Meredith Grey's medical license.


Derek's DeathEdit

Paul is one of the doctors who tended to Derek Shepherd when he came into the Dillard ER. When Penny wanted to run a head CT, he said they shouldn't because he believed the abdominal injuries were more pressing. When he became unstable in the ER, they rushed Derek into surgery.

While they were on the way to the OR, Penny made one final play to get the CT, since he was stable. Paul again declined and they took Derek into surgery and started operating. When he became unstable, Paul finally remembered that he'd had a head laceration and had the anesthesiologist check his eyes, which revealed a blown right pupil. They paged the neurosurgeon, Dr. Cohn, who said he'd be there in 20 minutes because he was at a dinner. Despite this, it took him an hour and a half to arrive.

After the time had passed and they were able to declare Derek brain dead, Paul approached Meredith about what to do. She explained that she knew the process because she's a surgeon, too, and then screamed at him to give her the papers. ("How to Save a Life")

Meredith's HearingEdit

Paul was the panel chair during Meredith's hearing, but didn't seem to recognize her. He questioned Andrew about his relationship with Meredith and listened as the other witnesses were questioned. When he talked to Alex about how Meredith nearly jeopardized Zola's adoptions. While he was talking, Meredith could no longer keep quiet and listed the names of the four spouses of patients she'd lost. She remembered all of them. She told Paul who she was. Paul asked for a recess and shortly afterward, he collapsed and started seizing. Meredith and the others immediately stepped in to treat him. When paramedics arrived, he was taken to the hospital, where a head CT revealed a hemorrhage in his brain. Unable to operate on him herself, Amelia asked Tom to step in and do the craniotomy. Tom agreed and operated. During the surgery, Tom repaired the bleed, but then he had a re-bleed and Tom was unable to save his life. ("My Shot")



He worked alongside Penelope Blake. He seemed to have little to no respect for her, which Derek believed was because she's smarter, younger, and probably because she's a woman.


Paul was a trauma surgeon at Dillard Medical Center. He later went on to work for the medical commission.



Episode StillsEdit


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