 When she awakes, she asks Dr. Cox if the surgery works, but Cox replies "you 're gonna have to tell us", and they take a step back; Ms. Miller realized that the surgery was a success, she no longer hears singing, and thanks Dr. Cox and the others. J.D. breaks the moment asking her who was the best singer in her head, much to the rest of the staff's (and especially Dr. Cox's) dismay. J.D. reflects in voiceover that in musicals everyone get what they want, but in reality, after having made a choice we may miss the way things were; as Elliot realizes she misses her roommate, Carla realizes she wishes she spent more time with her daughter, and Ms. Miller realizes she misses the music in her head.
