Before she drowned Meredith said people were fade away, picture of her mother, and she is disappearing, image of little girl on the dock.
The little girl is Meredith, the Meredith you saw on the merry go round when she was little.
In the hospital that little girl is found by her mother.
Meredith is dead.
Her mother is dying.
Meredith has so much more to say, (to her mother ).
They will have their chance to share their I love yous and their I'm sorries.
Meredith will be brought back to life to find out that it was all a dream.
Then it will be learned Ellis died.
This will allow Meredith to grow up and make decisions for herself without thinking she is doing it because of her mother being in Seattle.
AFYI the book Gray's Anatomy has little to do with the show Grey's Anatomy. The bok is about what makes up a human being. The show is about what makes up Meredith, the main character.