On Grey's Anatomy, Derek uses a series of CT scans from some of his early surgeries to offer Meredith the kind of love in an elevator that lasts a lifetime. He never actually pops the question, and she never says yes, but when did they ever stick to convention?
2 of 20 Ron Tom/ABC
Patrick Swayze tells Barbara Walters he discovered his cancer symptoms while trying to celebrate the start of 2008: "I tried to have champagne and it would be like pouring acid on an open wound. And then my indigestion issues got gigantic and constant, and then I started thinking, I'm getting skinny... I dropped about 20 pounds in the blink of an eye."
3 of 20 Kevin Fitzsimons/Comedy Central; Giovanni Rufino/NBC
Best Battle of the Basic Cable All-Stars
With no legal standing to go after big bankers, Jon Stewart uses The Daily Show to prosecute CNBC's Jim Cramer on charges of being a dishonest gasbag. "I understand you want to make finance interesting, but it's not a f------ game," he says, presenting video of the Mad Money host like he's introducing pieces of evidence. He later calls Cramer's hyping of troubled financial firms "disingenuous at best and criminal at worst."
4 of 20 Fox
Most Baffling Send-Off
House viewers only see blood and an obstructed body, but the discovery of Kutner's suicide still leaves our jaws agape. The death sets up a compelling arc for Dr. House, who usually has all the answers — but this time never will.
5 of 20 NBC
A 30 Rock that brilliantly examines the blurred line between entertainment and advertising seems headed to a tidy conclusion: Jack has a new name for his mini-microwave, "The Funcooker," and Jenna is suiting up as a bear for a live TGS skit. Then Dr. Spaceman rushes onstage, warning her that she needs to "sleep or die" thanks to the uppers he's prescribed — and repeatedly slams her head into a table. Liz cuts to commercial, but Tracy has bought the show's ad time — and uses his latest ad to expose his own Funcooker.
6 of 20 Craig Blankenhorn/FX
Rescue Me's Tommy barges into ex-wife Janet's living room only to find her ornery new boyfriend, played by Michael J. Fox. The former Alex P. Keaton is battling Parkinson's, but has as much fight in him as his character. The guy is so tough he challenges Tommy to a fight — then asks for his wheelchair to take that fight outside. It's only then that we realize he's a paraplegic.
7 of 20 Kelsey McNeal/Fox
Least-Expected Triple Cross
24's already stellar season throws viewers for another loop with the revelation that Tony is not a good guy pretending to be bad, but a bad guy pretending to be a good guy pretending to be bad. It's classic 24 to keep us continually guessing about where every character stands — but we sure didn't see Tony's switch coming.
8 of 20 Dana Edelson/NBC
Days before a formal announcement that they'll reunite for The Tonight Show, Andy Richter appears as Conan O'Brien's surprise final guest on a pitch-perfect final episode of Late Night. (If only the pitches had been as solid during O'Brien's visit to an 1860s baseball game.) The return of Andy is just one amazing moment in an episode (and series) filled with them: What other host ends his run by walking into the audience, handing out demolished pieces of the set?
9 of 20 NBC
Best Song About Premature Ejaculation
Are you sick of Andy Samberg and Jorma Taccone's instant-classic Saturday Night Live digital short yet? Neither are we. We just wish it had lasted a little longer.
10 of 20 FX
Best Less-is-More Moment
The Shield's Vic Mackey turns in his badge. Then he turns in his gun. He's not a cop anymore. Nut up, Shane!
11 of 20 AMC
In Mad Men's second-season finale, Peggy Olsen finally tells Pete Campbell she had his baby — and then gave it away. It's the moment that finally brings down the cocky ad man, lower then we ever thought he would go. Beautifully written and acted, the scene perfectly captures the characters in all their awkwardness, ambition, and fear.
12 of 20 Mario Perez/ABC
Lost's Ben saves Locke from hanging himself — but only long enough to pump him for information and strangle him to death. Of course, it's sort of okay, because now Locke's alive again. Can Ben survive much longer?
13 of 20 Danny Feld/ABC
Most Shocking Goodbye
The rumors of Edie Britt's imminent departure from Desperate Housewives swirled for months, but we never expected her to go out like this: After escaping Dave's chokehold and crashing head-on into a light pole, she gets zapped by a downed power line. Edie always was a spark plug.
14 of 20 courtesy Freemantle Media
7. Best Amateur Singer Nope, it wasn't anyone on American Idol. Susan Boyle's reprise of Les Miserable's "I Dreamed a Dream" on CBS's Early Show only adds to the poignancy of her story: a never-kissed, unemployed Scotswoman who until her Britain's Got Talent appearance never had the chance to share her amazing voice with the world. Is the moral of the story that we shouldn't judge others? That everyone deserves a chance to shine? That we should never give up on a dream? Yes, yes, and yes.
15 of 20 ABC
Least Decisive Decision
Bachelor Jason Mesnick elicits national fury (and gets 60 percent of TVGuide.com poll voters to dub him "a bastard") by giving Melissa Rycroft the kiss-off on After the Final Rose, then announcing his plans to date second-place finisher Molly Malaney. All of which only serves as Melissa's springboard to Dancing with the Stars fame.
16 of 20 Dana Edelson/NBC
Biggest Is-This-Really-Happening Moment
After meeting her impersonator, Tina Fey, Sarah Palin appears on Saturday Night Live's Weekend Update. Announcing she's not going to perform the rap she planned, she hands the reins over to the extremely pregnant Amy Poehler, who then delivers a Cypress Hill-inspired rhyme about John McCain's "creepy" smile and seeing Alaska from her house — all with backup from two Eskimos and a stand-in for Alaska's "first dude," Todd Palin. The real Palin does that raise-the-roof thing and has really good rhythm for a governor, which makes the routine feel even more like a crazy fever dream, until a person in a moose suit arrives to get shot, finally confirming there's no way any of this is real.
17 of 20 Carole Segal/Sci Fi
Battlestar Galactica's finale was filled with so many thrilling moments and emotional goodbyes, it's hard to pick just one moment. But we'll go with Chief being treated to a flashback, revealing how fellow Cylon Tory murdered his wife by airlock. In a wild-eyed rage, he grabs her by the throat and chokes her to death. Payback is a motherfrakker.
18 of 20
With a new CSI (Laurence Fishburne) handpicked to join the team, Gil Grissom leaves the lab — and the show — with just a nod to Catherine Willows. But where's he going with such peaceful confidence? To the thick vegetation of a Costa Rican rain forest — and the arms of a smiling Sara Sidle.
19 of 20 NBC
Skipping any "remember the good old days?" moments, George Clooney and Julianna Margulies make a low-key return to ER to convince a grieving woman (guest star Susan Sarandon) to donate her brain-dead grandson's organs. In the final scene, Dr. Ross and Nurse Hathaway learn that their hard work has saved the life of "some doctor" in Chicago — unaware that it's their old pal, Dr. John Carter (Noah Wyle).
20 of 20 Justin Sullivan/Getty Images
Most Blissful Silence
After nearly two years of pronouncements, guesses, and debate, the talking heads of MSNBC and CNN fall silent as Barack Obama wins the necessary votes to claim the presidency. Instead of trying to put the significance of the event into words, they let the cheers of jubilant crowds across the country speak for themselves.