The Sound of Silence

is the ninth episode and mid-season premiere of the twelfth season and the 254th overall episode of Grey's Anatomy.
==Short Summary==
Meredith is brutally attacked by a patient, and Penny is the one who discovers her. The doctors of Grey Sloan Memorial rush to stabilize Meredith and remain by her side in the harrowing aftermath.
==Full Summary==
Meredith asks her anatomy class to tell her the steps of a partial laryngectomy. Her voiceover talks about men being more likely to speak up in group settings and men being likely to talk over women who do speak. Men's brains have been shown to be less able to process female voices. Isaac explains the steps as Meredith says not being ready to fight will make the silence kill you.
Maggie leans out the window as she, Meredith, and Alex are stuck in traffic. She's upset because they're late. She thinks the bumblebee has passed them twice, circling the earth in between passes. Alex points out that they left late because she overslept. Alex says he doesn't care what she does at night unless she complains about it to him. Maggie feigns ignorance, but Alex points out that they share a wall. Maggie tells him to move out, because no one told him he could crash in Amelia's room anyway. Meredith says it's not Amelia's room. They see fire trucks and ambulances passing and Meredith and Maggie get out to go to the scene. Alex says it's not a good idea, but gets out to join them anyway.
Nathan greets an ambulance and asks April to help him, which she does. As Maggie gets out of an ambulance, Owen says they've been paging her for half an hour. She says she's been busy.
Meredith get out of the ambulance with Lou, who says it's not as bad as it looks. Maggie tells the other doctors that it was a multi-car pileup involving a flipped rig. Penny, Ben, and Meredith take Lou inside.
Meredith, Penny, and Ben continue to examine Lou. After seeing asymmetrical pupils, Meredith orders a head CT and tells them to page neuro. Lou says that he regrets taking the tour of the city. He thought it was a good time because it wasn't raining. He talks about the wall of chewing gum at Pike's and asks Meredith if she knows about it. Meredith says she does because she grew up there. Meredith asks again for neuro, but Ben says there's no response. She sends him to go get them and continues her exam.
Callie treats a patient who has no pulse in his ankle. She warns them to cover their ears and reduces the ankle.
Amelia and Stephanie walk through the ER as Amelia dictates instructions. Stephanie corrects her when she gets a bed number wrong, but Amelia brushes it off, saying they're busy, so she can't keep track. Stephanie says they're being paged to trauma three while Ben comes to say they're needed in trauma one. When Amelia hears that Ben's from Meredith's, she chooses to go to trauma three instead. Stephanie says it'll be less than ten minutes. As Ben goes to return to Lou, Andrew calls him over to help him with a patient who's having trouble breathing.
Lou says he's in Seattle visiting his sister and his kids were out shopping with her. He wanted to see the Space Needle, now he's seeing all kinds of needles. He laughs and then says his kids say he makes the worst jokes. He has two kids, ten and six. They're smart, smarter than he is. He suddenly starts seizing. Meredith asks Penny to talk her through what's happening and what to do. They plan to wait the seizure out, but because it's prolonged, Meredith sends Penny to get lorazepam, which is locked in pharma. Lou stops seizing and Meredith says he'll need fresh sheets and a new gown because he urinated on himself. Nurse Gregory sends the other attendant for an orderly. He then leaves and Meredith tells him to see if he can get neuro there. Alone in the room, she continues to examine Lou's injuries. As she turns away to make a note in his chart, he regains consciousness and gets up out of the bed. When Meredith sees that he's up, she tries to get him back into the bed, but he attacks her, shoving her into the wall. He then throws her around the room.
Gregory is called into a trauma to help April and Nathan, whose patient is coding. They're unable to resuscitate as Meredith is being attacked in the next room. The ER buzzes with activity.
Meredith wakes up on the floor of the trauma room with ringing in her ears. Penny finds her and calls for help. They get Meredith into a bed and start to evaluate her injuries. April asks if anyone has paged the Chief, but Richard says not to because they can handle this themselves and she has enough on her plate. Ben says the patient was stable and non-threatening, but Owen points out that postictal patients can become aggressive in a temporary fugue state. He won't remember the attack. He's been restrained and moved to the next room to be treated. Alex comes in and offers to place the central line. Meredith opens her eyes. The doctors try to talk to her, but she can't hear them. Maggie arrives to help. Amelia comes in, not knowing that Meredith is now the patient. Stephanie calls out to her, but she doesn't respond. Maggie sees that she needs a chest tube. Richard tells her she can't treat family members, but Alex points out that everyone in the room is her family. As Amelia sits on the floor and watches, they continue to work on Meredith. Stephanie sees no neuro deficits, but asks Meredith to move her fingers or toes. When she doesn't respond, Alex figures out that she can't hear them due to barotrauma. They have to reduce her jaw dislocation in order to intubate her. It is painful, but it is also necessary.
Meredith wakes up after surgery. She sees Maggie, Richard, and Alex. They try speaking to her, but she can't hear them.
She wakes again, much later. She sees Callie and Penny. Callie smiles and says something to her, but she still can't hear. Meredith uses her morphine button to re-sedate herself.
Meredith wakes again. She sees Amelia and Richard arguing in her room. Richard forces Amelia out. Meredith sees her leave and sedates herself again with morphine.
Meredith wakes up again on her way to surgery. Alex holds her hand and smiles when he sees she's awake. Callie and Alex talk to her, but she is still unable to hear them. She's wheeled into the OR.
Meredith wakes with her jaw wired shut. She sees Callie, Bailey, and Jackson arguing in her room, but can't hear them. When they notice she's awake, they try talking to her, but quickly return to her scans. Penny uses a swab to moisturize Meredith's lips. Meredith points to her mouth and Penny figures out that she wants to see her scans. She takes the tablet and shows Meredith the scans of her mouth, arm, leg, chest, and brain. Meredith brushes her away and looks out the window.
Meredith is crying in her room. Alex comes in and gets in the bed with her. He tells her to get it all out and then says she has a lot of snot. They both laugh. He gives her a tissue and tells her to blow her nose. When she reacts, he figures out she can hear him. They both laugh as he holds her.
Jackson tells Meredith to continue to rest her voice. She indicates for him to speak louder. Her trachea's not fully healed, but her right ear hearing has almost fully returned and her left is at about 55%. It's only been a few weeks, so he's not concerned about it and expects it to return. Callie starts to give instructions, but Meredith gestures for her to lower her voice. She needs to keep moving her fingers in the cast, but keep weight off her left leg until the cast comes off. Bailey says there's swelling. It's probably local edema. They go to leave, but Meredith stops them and uses a whiteboard to ask about Lou. Maggie says they don't have to go into it, but Alex says to tell her. Bailey says he had an epidural hematoma, which caused the seizure and prompted the attack. After a few minutes, he woke up and had no idea what had happened. He was treated and then discharged and is doing well. He also reached out and asked to see Meredith, which she adamantly declines. Alex then figures out Meredith is kicking them all out of her room.
Outside her room, Callie and Maggie are confused as to why he wants to apologize and why Bailey thinks it's a good idea. She points out that the last time Meredith got hurt working for that hospital, she bought it.
Meredith is asleep in her bed and Alex is asleep in the chair next to her when Jo comes in. Meredith wakes and sees Jo tucking Alex in with a blanket. She then leaves the room.
Stephanie does a neuro exam on Meredith. Owen then asks her to lift her leg. She sees Amelia outside and gestures there. Owen says he doesn't know and leaves. Meredith then silently asks Stephanie, who says Owen has been working a lot of nights and he and Amelia haven't been talking. She has Meredith follow a pen.
Arizona puts makeup on Meredith. It's not the perfect shade, but it's covering up the bruises. Arizona tells her not to try to get up, to let them come to her. She suggests suggests that Meredith smile, but try not to show her teeth because the wires are kind of scary. She wraps a jacket around Meredith's shoulders and asks if she's ready. When Meredith nods, she gestures out the door and Alex walks in with Zola, Bailey, and Ellis. Meredith reaches out for them, but Zola says she doesn't want to go to her, despite asking daily to go see her. Arizona takes Ellis and puts her in Meredith's lap. She starts to fuss and Zola and Bailey refuse to come to her, despite her calling for them. Arizona takes Ellis and says they should do it later. She asks the kids if they want something yummy from the cafeteria. After they've left, Meredith rips off the blankets and starts to panic. Penny comes in and when Meredith says she can't breathe, she gets scissors and cuts the wires. She starts to breathe more easily. Jackson comes in and yells at Penny for cutting the wires, but Penny says that she knows what she's doing. Meredith's jaw can be rewired in the morning, but she needed air.
Penny brings in a smoothie for Meredith, who is itching herself under the cast on her leg. Meredith is not happy by it. Maggie and Alex come in and Meredith throws ice chips at them and then a cup. Alex asks about the pain and discomfort and Meredith merely smacks the bedside table. Bailey comes in. She wants to update Meredith on how her service is going, but after seeing Meredith, she says she'll check in later and suggests the others do the same. Penny puts the smoothie by her bed and they all leave. Meredith sees Amelia at the nurses' station, looking at her occasionally. She smacks the table to get Amelia's attention and gestures at her. Amelia goes to leave, but Meredith throws the smoothie at her and it splatters on the floor. Amelia comes in and says she knows Meredith doesn't want to look at her. She doesn't want to hang out like a rat looking for scraps. She's been trying to figure out how to make amends. She knows she's a mess and that it drives Meredith crazy, but talking a lot is the only way she knows to stay sober. When she tries to be normal, she ends up drunk or on pills. Or at a funeral. When she saw Meredith in the trauma room, she thought she was heading to another funeral. Amelia says she's not sure why she even came and leaves.
Meredith taps her pen on her whiteboard. Richard comes in with Isaac. He sends Isaac to get a wheelchair.
Richard pushes Meredith down the hall singing My Girl. She asks him repeatedly where they're going with the whiteboard, but he ignores her and keeps walking.
Outside, Richard sits on a bench with Meredith beside him. He knows about what happened with Amelia. When he says that, Meredith tries to wheel herself back inside. Richard says she came in the night after Meredith was attacked and was drunk. She was upset because Meredith had called her for a consult, but she went to the other trauma instead, which meant she wasn't there when Meredith was attacked. He says forgiveness is a powerful thing, not just for the other person, but to heal oneself. Meredith needs to forgive Amelia for not being Derek. It's not her fault and Meredith needs to forgive her. She doesn't have to like or love her, but she has to forgive her so she can forgive Penny for being in the room when a decision cost her Derek. To forgive Derek for dying too soon. To forgive herself for hating him for dying too soon. He tells Meredith to let it go and forgive. He sits back and admires the way the sun feels.
Meredith sits up in her bed and messes with her leg brace. Through her window, she sees April upset because Jackson served her papers. April says it's a slap in the face. Jackson just walks away. Bailey comes in and asks if she's ready. She nods.
Bailey wheels Meredith through the cafeteria, toward Lou and his family. He introduces herself to his wife and two daughters, the ones he talked about. He also gives her a pot of flowers. He asks if Meredith has kids and she holds up three fingers. He remembers that they told him she can't talk. He tells her he's sorry. He didn't know what he was doing. He'd normally never attack a woman. Meredith has Bailey push her closer and she reaches out and grabs Lou's hand.
Amelia puts something on Meredith's table and goes to leave. Meredith picks it up and taps it on the table to get Amelia's attention, stopping her departure. It's her 30-day chip. She's sober and going back to work on Monday. She's trying. She goes to leave, but Meredith stops her, saying she knows she's trying. Amelia's surprised she can talk. They took the wires out that morning. Meredith says she's not ready to forgive Amelia yet. Amelia's not ready either. Amelia reaches for her chip, but Meredith puts her hand over it, so Amelia leaves without it.
Meredith uses a cane to help her walk and enters the trauma room where she was attacked. She looks around and remembers the attack. Alex comes in and she says, "Let's go." They leave.
Alex gets Meredith settled in. He asks if he can get her anything. She tells him to sit down. She says she spent six weeks in a bed unable to speak. When that happens, you see things, a lot of things people don't say to each other that they should just say. She says she knows she's needed him a lot lately, but she also knows that Jo loves him, like post-it on the wall loves him. She tells him not to ignore it. She used to think you could only have one person, but now she knows you can have more than one. She found out she has a whole village. He doesn't have to worry about her. She tells him to go to Jo because she'll be fine.
Alex goes home to the loft. He knocks and Jo answers.
Meredith reads her kids a story on the couch.
As Meredith's voiceover says to use your voice, Meredith teaches her anatomy class. As Penny finally raises her hand, Meredith's voiceover says to find your voice and fill the damn silence.
==Cast==
12x09MeredithGrey.png|Meredith Grey
12x09AlexKarev.png|Alex Karev
12x09MirandaBailey.png|Miranda Bailey
12x09RichardWebber.png|Richard Webber
12x09CallieTorres.png|Callie Torres
12x09OwenHunt.png|Owen Hunt
12x09ArizonaRobbins.png|Arizona Robbins
12x09AprilKepner.png|April Kepner
12x09JacksonAvery.png|Jackson Avery
12x09AmeliaShepherd.png|Amelia Shepherd
12x09JoWilson.png|Jo Wilson
12x09StephanieEdwards.png|Stephanie Edwards
12x09MaggiePierce.png|Maggie Pierce
12x09BenWarren.png|Ben Warren
12x09NathanRiggs.png|Nathan Riggs (left)
12x09AndrewDeLuca.png|Andrew DeLuca
12x09IsaacCross.png|Isaac Cross
12x09PenelopeBlake.png|Penelope Blake
12x09Lou.png|Lou
12x09NurseGregory.png|Nurse Gregory
12x09ZolaBaileyGreyShepherd.png|Zola and Little Bailey
12x09ScreamingPatient.png|Screaming Patient
12x09MalePatient.png|Male Patient
===Main Cast===
*Ellen Pompeo as Dr. Meredith Grey
*Justin Chambers as Dr. Alex Karev
*Chandra Wilson as Dr. Miranda Bailey
*James Pickens, Jr. as Dr. Richard Webber
*Sara Ramírez as Dr. Callie Torres
*Kevin McKidd as Dr. Owen Hunt
*Jessica Capshaw as Dr. Arizona Robbins
*Sarah Drew as Dr. April Kepner
*Jesse Williams as Dr. Jackson Avery
*Caterina Scorsone as Dr. Amelia Shepherd
*Camilla Luddington as Dr. Jo Wilson
*Jerrika Hinton as Dr. Stephanie Edwards
*Kelly McCreary as Dr. Maggie Pierce
*Jason George as Dr. Ben Warren
*Martin Henderson as Dr. Nathan Riggs
===Guest Stars===
*Giacomo Gianniotti as Dr. Andrew DeLuca
*Joe Adler as Dr. Isaac Cross
*Samantha Sloyan as Dr. Penelope Blake
*Dohn Norwood as Lou
===Co-Starring===
*Gordon E. James as Nurse Gregory
*Aniela Gumbs as Zola
*Romel De Silva as Screaming Patient
*Chris Cope as Male Patient
*Brody Goodstadt as Little Bailey
==Medical Notes==
===Nathan and April's Patient===
*Diagnosis:
*Doctors:
**Nathan Riggs (cardiothoracic surgeon)
**April Kepner (trauma surgeon)
*Treatment:
Nathan met the patient at the ambulance and called for April's help on the way into the ER. They started working on him, but he coded and was unable to be resuscitated. He was pronounced dead at 11:42.
===Maggie's Patient===
*Diagnosis:
*Doctors:
**Maggie Pierce (cardiothoracic surgeon)
*Treatment:
Maggie rode in with a patient she had treated in the field.
===Lou===
*Diagnosis:
**Head laceration
**Abdominal contusions
**Seizure
**Epidural hematoma
*Doctors:
**Meredith Grey (general surgeon)
**Ben Warren (surgical resident)
**Penelope Blake (surgical resident)
*Treatment:
**Stitches
**Surgery
Lou, 45, came into the ER after a car accident with a head laceration and abdominal contusions. He'd lost consciousness in the field, but was awake upon arrival at the hospital. He had neuro symptoms, so they ordered a head CT. While in the ER, he had a seizure. It was prolonged, so they ordered lorazepam, but before it could be retrieved, he stopped seizing. Meredith continued to exam him, but while her back was turned, he got up in a fugue state. Meredith tried to get him back in bed, but he attacked her. He was then moved to the next room and treated. They found an epidural hematoma, which had caused the seizures, and he had surgery to repair it. He was then discharged to go home and was doing well.
===Callie's Patient===
*Diagnosis:
**Dislocated ankle
*Doctors:
**Callie Torres (orthopedic surgeon)
**Jo Wilson (surgical resident)
*Treatment:
**Closed reduction
Callie reduced a dislocated ankle in the ER.
===Andrew's Patient===
*Diagnosis:
*Doctors:
**Ben Warren (surgical resident)
**Andrew DeLuca (surgical intern)
*Treatment:
**Supplemental oxygen
Andrew called Ben to help him with a patient in the ER who was struggling to breathe. They put a mask on his face.
===Meredith Grey===
*Diagnosis:
**Tinnitus
**Trismus
**Dislocated jaw
**Tibial plateau fracture of the left leg
**Monteggia fracture in left forearm
**Dislocated elbow
**Barotrauma
**Fractured left ribs (5-8)
**Concussion
**Left pneumothorax
**Subcutaneous emphysema
**Traumatic larynx injury
**Panic attack
*Doctors:
**April Kepner (trauma surgeon)
**Richard Webber (general surgeon)
**Owen Hunt (trauma surgeon)
**Maggie Pierce (cardiothoracic surgeon)
**Alex Karev (pediatric surgeon)
**Jackson Avery (plastic surgeon and ENT)
**Ben Warren (surgical resident)
**Stephanie Edwards (surgical resident)
**Penelope Blake (surgical resident)
**Callie Torres (orthopedic surgeon)
**Jo Wilson (surgical resident)
*Treatment:
**Central line
**Intubation
**Chest tube
**Closed reduction
**Casting
**Surgery
**Morphine
**Voice rest
Meredith was attacked by Lou, a patient in a postictal fugue state. She had a broken leg and a broken arm. Her vein was collapsed, so they put in a central line. Her left elbow was dislocated. She had fractured ribs. They put in a chest tube for a partial pneumothorax. She had no focal deficits, but didn't respond to requests to move her fingers and toes. They then discovered a barotrauma, which caused hearing loss. Her jaw was dislocated and clenched, so they had reduce the dislocation in the trauma room in order to intubate her. The first few times she woke up, Meredith re-sedated herself with morphine. She had surgery on her plateau fracture and her jaw was wired shut. She also had surgery on her tracheal injury. During her recovery, Meredith started to regain her hearing. She was then told to continue voice rest while her tracheal injury healed. Hearing in her right ear had almost completely returned and her left was at about 55%. Since it had only been a few weeks, Jackson wasn't concerned about it not returning. Callie told her to keep moving her fingers even while her left arm was casted, but not to put weight on her left leg as long as it was casted. She had some localized swelling in the leg as well. When a visit with her kids didn't go well, Meredith started to panic and have trouble breathing, so Penny cut the wires holding her jaw together to ease her breathing. Because her jaw was not totally healed, Jackson had to go in and wire her jaw a second time. After her jaw had finished healing, the wires were cut a second time. She was then discharged to go home.
==Music==
Song 	Performer 	Scene
"My Girl" (originally by The Temptations)	Cast (James Pickens, Jr.)	
*Richard wheels Meredith down the hall and refuses to tell her where they're going.
"I Surrender" 	Aron Wright 	
*Meredith goes to the trauma room where she was attacked.
*She remembers the attack.
*Alex comes in and she tells him "let's go."
*Meredith settles in at home.
*She tells Alex Jo loves him and he can have more than one person.
*She says she'll be fine, so he can go be with Jo.
*Alex goes home to the loft.
*Meredith reads her kids a story.
*Meredith's voiceover says to find your voice and fill the silence.
"I Surrender" - Aron Wright
==Notes and Trivia==
thumb|right|300 px
*This episode's title originated from the song , originally sung by Simon & Garfunkel.
*This episode scored 8.28 million viewers.https://web.archive.org/web/20160214082920/http://tvbythenumbers.zap2it.com/2016/02/12/thursday-final-ratings-feb-11-2016/
*The table read for this episode took place on October 14, 2015.
*The first day of shooting was October 20, 2015https://x.com/karingleason/status/656955499598876672 and the last was November 3, 2015.
*The cast was only informed a day before his arrival that Denzel Washington was going to direct the episode.
*The episode has Meredith in almost every scene.
*The episode was submitted for consideration in three categories at the 68th Emmy Awards: direction, sound mixing, and single camera picture editing.
*This episode features a black opening title card, which is normally shown at the end of the episode. The last time it was used in the beginning was in She's Leaving Home.
**This time, some of the letters are blurred to reflect Meredith's blurry eyesight after the attack.
*While the press release lists Giacomo Gianniotti as a series regular, the credits of this episode show him as a guest star. As of the following episode, he was credited as a series regular.
==Gallery==
===Episode Stills===
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==Quotes==
:Alex: Everybody in this damn room is her family!
----
:Richard: She came to see you the night after the attack. She was drunk. She was upset because you called her for a consult that day, the day of the attack, and she the choice between coming to you and going to another trauma. She went to the other trauma because she was mad at you. Forgiveness is a powerful thing, Meredith. Not only to make the other person feel good, but to heal you. You need to forgive her, Meredith. Forgive her for not being Derek. For being the wrong Shepherd. Just enough to remind you of what's missing, but not enough to bring him back. That's not her fault. You need to forgive her. You don't have to like her. You don't have to love her. Look, forgive her, okay? So you can forgive Blake for being in that room when a wrong decision cost you your husband. To forgive Derek for dying too soon. To forgive yourself for hating him for dying too soon. Let it go, Meredith, and forgive.
----
:Lou: I wanted to... I didn't know what I was doing. What I did to you... I didn't know... I would never hurt a woman. I just want you to know that I'm sorry. Truly sorry.
----
:Amelia: That's my 30 day chip. I'm sober and I'm starting back at work on Monday, so I'm trying. I'm trying.
:Meredith: I know you are.
:Amelia: You can talk! That's great. They took the wires off?
:Meredith: Yeah, this morning. I'm just not ready to forgive you yet.
:Amelia: I'm not exactly ready either. I'll see you later.
:Meredith: See you later.
----
:Meredith: I just spent six weeks in a bed unable to speak. When that you happens, you see things. It's a lot of things that people don't say to each other that they should just say, so I need you to hear me when I say this. I know I've needed you a lot lately, but I also know and I have known for a long time that Jo loves you. Post-it-on-the-wall loves you. Don't ignore that. You can have more than one person. I used to think you couldn't, but now I know, I mean, turns out I have a whole damn village. So, you don't have to worry about me. Go be with Jo. I'll be fine. I'm okay.
----
:Penny: She couldn't breathe! Look at her! She's been stuck in this room in that bed for weeks! She can't move. She can't talk.
:Jackson: But I'm her surgeon though, right? You can't come in here and just take out her wires.
:Penny: She is my patient. I know what I am doing! You can rewire her jaw tomorrow morning but right now, she needed some air so I got her some damn air!
----
:Amelia: Okay, I got it. You don't wanna look at me. I get it. Do you think that I wanna be out there hanging out outside your door like some pathetic little rat looking for scraps. Do you think that feels good for me? I have been out there trying to figure out how to make amends, as if that would matter to you. I know I'm a mess who talks too much and feels too much and I know it drives you crazy, but that is the one way I know how to stay sober and every time I try to suck it up and shut up and just be cold and normal, I end up drunk or am on pills or at a funeral. Do you know what it felt like to walk into that trauma room and see you on that table and think to myself, "Great, I did it again. Here comes another funeral." You know what? Forget it, I don't even know why I came here.
==See Also==
fr:Un silence assourdissant
de:Der Klang der Stille
Category:All Episodes
Category:GA Episodes
Category:GA S12 Episodes