"If you're not ready to fight, the silences will kill you," Meredith Grey forewarns at the beginning of Thursday's midseason premiere of Grey's Anatomy.
The introduction was intended as a powerful message about the female voice in the workplace, about the importance of speaking up and making yourself heard. But the message proves to be hauntingly telling when the episode, aptly titled "The Sound of Silence," spends a significant amount of time in deafening quiet, after a brutal attack by a patient with brain damage leaves Meredith with her jaw wired shut and damage to her ears rendering her temporarily deaf.
The episode was directed by Denzel Washington and star Ellen Pompeo admitted that having the two-time Oscar winner on board gave her the confidence and inspiration to tackle the difficult storyline.
"I said, 'I don't know if the fans can handle that,'" Pompeo admitted to ET's Nischelle Turner. "Then they hit me with 'Oh, and Denzel is going to direct it,' and I said, 'OK, I'm down, I will do whatever you want me to do."
Most of the episode is told from Meredith's perspective, meaning that the audience spends a good chunk of the first 30 minutes in silence, as the doctor watches her Grey-Sloan Memorial colleagues leap into action, cataloguing and treating her injuries.
"You can't work on your family," Dr. Richard Webber (James Pickens Jr.) warns the surgeons, as Meredith's sister-in-law Amelia (Caterina Scorsone) freezes up, going almost catatonic.
"Everyone in this damn room is her family," Alex (Justin Chambers) snaps in response.
Meredith's hearing returns, but it takes longer to regain her good spirits as she deals with the trauma of the attack and estrangement from her three kids, who are scared by her wired-bound jaw, as well as her fractured relationship with Amelia, who relapses into addiction after blaming herself for not responding to her sister-in-law's page on the day of the incident.
"You need to forgive her, Meredith," Richard tells her finally, wheeling her outside for some fresh air. "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."
The former chief of surgery goes on to remind Meredith that Amelia's not the only one who needs her forgiveness. There's her late husband Derek, who "died too soon," new Grey-Sloan resident Penelope Blake who was one of the doctors who failed to save Derek's life after his car accident last season, and of course, Meredith's attacker, a soft-spoken father of two named Lou, who woke up from his seizure with no memory of the violence he had committed.
Eventually, she agrees to meet with Lou and the two share a silent, solemn moment after he tearfully apologizes. Later, she also reconnects with her kids and gives Alex the push forward he needs to return to the loft with Jo (Camilla Luddington).
"I just spent six weeks in a bed, unable to speak," Meredith tells him. "When that happens, you see things. There'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," she adds. "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."