How 'Grey's Anatomy' Pushed the Envelope With Powerful Consent Episode

Grey's Anatomy- Khalilah Joi and Camilla Luddington-Publicity Still-H 2019
Courtesy of ABC

[This story contains spoilers from Thursday's episode of ABC's Grey's Anatomy, "Silent All These Years."]

Moved by Christine Blasey Ford's testimony against Supreme Court Justice Brett Kavanaugh, ABC's Grey's Anatomy explored consent with one of the medical drama's most powerful episodes in its historic run.

Named after a Tori Amos song, "Silent All These Years," the hour featured one of the most in-depth depictions of precisely how a rape kit is administered. The extended scenes in the episode — written by Grey's Anatomy all-star Elisabeth Finch — were met with pushback from ABC's Standards and Practices department.

In the below interview with The Hollywood Reporter, Finch and showrunner Krista Vernoff revealed that creator Shonda Rhimes pushed back and "declined" the network's notes. In a rare and surprising decision, Standards and Practices reversed its stance — and saw the exec who flagged the scenes actually join the women who lined a hallway in support of a rape victim (guest star Khalilah Joi) who was carted off to surgery. The wall of women scene, which also featured many Grey's Anatomy writers and Shondaland executives, was an incredible show of support rarely, if ever, seen before on a hospital drama. (Watch the moving scene, below.)

To hear Vernoff and Finch tell it, the episode was born out of the latter's WGA-sponsored trip to UCLA's Rape Treatment Center, in which she observed firsthand the larger discussion around administering such a kit to rape victims.

The episode — the rare Grey's installment that is driven first by an issue and not by character development — came together after star Camilla Luddington dialed up Vernoff the day of the Kavanaugh hearings and suggested that her character, Jo, be the product of rape. The series was already plotting to introduce Jo's biological mother (guest star Michelle Forbes) who, as Grey's diehards recall, abandoned her at a fire station.

Below, Vernoff and Finch open up about the genesis for the episode, how the "talk" about consent between Ben (Jason George) and his stepson, Tuck (BJ Tanner), is already inspiring others and the amazing women who participated in that powerful hallway scene. (It's also worth noting that women wrote, directed, edited and served as a director of photography, script coordinator and showrunner on this episode.)

Where did the idea of this episode come from?

Vernoff: Many places. I was directing an episode and the Christine Blasey Ford testimony happened and the Kavanaugh confirmation happened. I felt that through my whole body — the way a lot of women did. She got up and told her truth and a lot of pundits questioned whether she knew what she was talking about or if she could be believed or remember the face of someone who attacked her years ago. It was a pretty powerful moment to watch all of that. I felt that the most damaging thing that happened in all that is that young women and men everywhere were told that consent was irrelevant. I don't approach storytelling through issues; we usually approach through character. But I wrote to the writers and said, "We have to find a way to come at this through character. We have to do something about consent and try to do our part to explain what consent is and how impactful rape is and how it can damage people for years, decades and generations." We had to use our platform to do something. The same day, I got an email from Camilla, who was at home crying [amid the hearings] and who also felt like we had to do something. She said, "I know we're introducing Jo's mother this season. What if Jo is a product of rape?" I said yes immediately. I reached out to Finchie and said, "I heard a pitch you had some time ago that included an army of awesome women lining the hallways for a rape survivor. Can you tell me more about that?" And Finchie told me the following …

Finch: Three years ago, the WGA asked certain people if they wanted to go tour UCLA's Rape Treatment Center in Santa Monica. It's world-renowned. I went there and learned more than I could ever possibly could on television. The most fascinating thing to me was how they treated each individual that walked into their center and the respect they gave them and how they tailored what they do as a process to every single person who comes in the door. It's something that had been sitting in me for years and I wanted to do it. Sometimes the stars align and the people that you're working with — and the culture is what it is — and allows you the opportunity to tell something that's been sitting in you that you cannot let go. 

Vernoff: She pitched me this imagining that she had of a bunch of women lining the hallways to support of a rape survivor. I said to please go make an hour of television that is that and Jo's origin story. Finchie had been, at prior times, kind of discouraged from this story — as if the aftermath of rape was not in itself enough conflict to carry an episode. Finchie kept trying to make it smaller; I said it was the whole hour. She wanted to do the whole hour but had been told somehow that it wasn't dramatic enough. The stars aligned and the moment was right. She created, what is for me, the most powerful hour of TV I've ever been a part of in my 20-year career.

Elisabeth, who told you no about this story?

Finch: It wasn't a matter of being told no. My brain thinks in photographs and then my writer brain thinks about how to tell the story and I try to figure out the narrative behind it. I kept seeing this army of women and kept saying that it was a race against time because they knew that there was something wrong that they had to fix surgically but in order to do that, they'd wipe away all the evidence. I think sometimes it's hard to imagine how much people can watch when it comes to this subject matter. Normally our characters are going through something in their medical lives and then it reflects on their personal lives. When you're dealing with issues of sexual assault, it's really hard to go back and be like, "Well, who should I be dating?" It was hard to figure out what to pair it with and who it would impact of our people the most. With Camilla pitching this, it all felt like, "I get why it's her and why now and why this." It felt like the best timing of it. Watching Krista direct an episode while all of these things were coming up with the Kavanaugh hearings and watching her be such a powerful leader through all that — despite her own feelings and all of the feelings of everyone on set at the same time— really helped me understand and see an example of how you can have all the feelings and carry them and also lead. That's where Jo is today. She's carrying all of this collective pain of her, and her mother and all these things and still walking through her day and being of service and helping and making something else better that day. 

Vernoff: I don't think anybody said no to the story. Finchie had pitched this story a couple of times and we tried to find ways to fit it into episodes and it just kept falling by the wayside. It fell by the wayside because it was meant to be born at this moment with this Jo story where it becomes one great, big, powerful hour. As just an A or B story in a traditional episode, it wouldn't have had quite the same impact.

What do you hope viewers take away from this episode?

Vernoff: I hope viewers walk away with a greater understanding of what consent means — and a deeper understanding of how many different ways rape can impact not only the survivor but the generations that follow. I hope that medical professionals come away with conversations about modalities and systems that can be put into place to better help survivors, because many of the things that you see Jo do in this episode are things that Finchie learned from the Rape Crisis Center that she visited. These are systems that can and should be implanted in hospitals everywhere.

Finch: I hope more men watch it not just for the consent — though it's a huge part of it — but for empathy with their partners and friends. I read an article recently that talked about this woman who visits high schools talking about consent and rape and these boys with the sweetest faces and the most empathy you can see in their eyes are talking about their female friends who are hurting themselves because they were raped. And nine times out of 10, those boys will say something like, "I don't understand, it happened two years ago." Even the boys with the most empathy in the world can't understand why the results are so lasting and so strong. That's something I hope makes a dent in our younger generation.

There was a PSA for RAINN after the episode, which is an organization Grey's Anatomy spinoff Private Practice worked with on a rape episode in 2011. What kind of feedback did you get from them?

Finch: We worked closely with RAINN to make sure our language was as current as it could be. They were helpful about looking at the script and were grateful that we included men because so often when we talk about rape we talk about women. Even though the ratio is higher for women, it does exist for men as well—

Vernoff: Particularly for soldiers.

Finch: I was excited to work with them because they were helpful to me when I was in college and a friend came to me and was assaulted. I didn't know what to do — and there wasn't the internet yet. I'd been to a Tori Amos concert and she was the biggest face of that organization when they were initially starting out. I learned about them there and she had a stand with bumper stickers and things and I'd left with one. That's where I knew where to go to help my friend. [Editor's note: The episode takes its name from one of Amos' most beloved songs.]

That's an incredible story. Finchie, you were also in the powerful hallway scene. Was that always the plan? 

Vernoff: No! We forced her to do it. It was the opposite of planned; it was like an intervention. That hallway contains nearly the entire female writing staff [of Grey's]. It contains exec producers on the show, exec producers in Shondaland, most of our female crewmembers. That entire hallway is Shondland women and that is because they wanted to do it. So many women came up to us after the table read and asked if they could be in that scene. They were willing to lose a day's pay to be in that scene. Finchie and I reached out to our line producer and the Shondaland head of production and to Shonda herself and said, "Can we find a way for all these women to do this without them having to lose a day's pay?" The answer was yes. That's not an easy thing to do — to bring other crewmembers in so your female crewmembers can be in a scene. But it's Shondaland and we got a big yes. That hallway is full of women who read that script and wanted to stand there and be a part of this thing. They are not actors. They are holding space in the most beautiful way for the actress — Khalilah Joi, who is everything. Finchie tried to not be in the scene and we basically did an intervention and made her do it. Then she tried to say that she couldn't be in the scene because she had to produce the scene and watch the monitors. I said, "I'll watch the monitors!" I was there and got to be a part of it in my own way. It was really the most powerful day on a set I've ever had. There was a reverence on that day that I've never experienced.

Are you submitting Joi for guest actress in a drama Emmy consideration?

Vernoff: We are. And Michelle Forbes. Khalilah Joi came in to audition for our show four or five times over a period of a year. Every time I saw her, it was for a one- or two-page scene character. I kept saying how much I loved her but the parts were too small. [Casting director] Linda Lowy kept bringing her back and I kept saying that she's amazing but we had to do something bigger for us. She came in to audition for the episode before this one and [director/executive producer] Debbie Allen wanted to cast her. I said there was something else. Then Finchie's script came out. Khalilah got that role as an offer — she didn't have to audition for that role. She'd paid her dues. She's incredible.

Elisabeth, how much research did you do into how much of this had been depicted before? These scenes feel groundbreaking in just how extensive the portrayal was.

Finch: Only one I'm aware of is Private Practice did a truncated version of it, and I can't speak for SVU but PP was one [I was] most aware of, and I did a lot of searching. I did a lot of research to make sure that I was doing it differently. Because it's done so rarely, I wanted to make sure whatever we did revealed a different side of something so that people could be educated. Private was the only one that popped up.

Did you get any pushback from the network or Standards and Practices?

Vernoff: We received notes initially from ABC's Broadcast Standards and Practices. They give these standard notes: "Don't be too gory"; "Don't be too explicit in your language"; "No side boob." But the ones we got on this script included, "Please don't show any fluid on the Q-tips" and "Please don't show any body fluids under the blue lights." Shonda wrote back a pretty passionate response of the myriad ways that networks are willing to show actual violence but that what we were doing here was the medical process that happens in the wake of violence and they were trying to tell us we couldn't show it. She said, "Respectfully, I decline these notes." Ultimately, ABC understood that she was right. I really give them credit that they came back and said, "You're right. You can proceed as scripted." We then extended the invitation to that ABC Broadcast S&P executive to be part of the wall of women, and she came.  

Why was it important to you to have this discussion about consent on a show like Grey's Anatomy that is still one of the top programs on broadcast and is sold all around the world?

Vernoff: It means a lot. As partisan as the Supreme Court situation was and is, this episode is not a partisan episode. As much as the political moment that began the conversation is somehow partisan, rape is a nonpartisan issue. Rape occurs worldwide. The statistics are staggering, and nobody cares what your political affiliation is. It's a worldwide blight. The opportunity to really look at it through so many different lenses that is ultimately deeply humanizing, character-driven storytelling, empathetic storytelling … I feel privileged to be a part of it and so grateful for Finchie, [director] Debbie Allen and Shonda. It feels pretty overwhelming.

Finch: Every woman on the staff wrote some piece of this episode. Because we have such a diverse and amazing and brilliant staff, I wanted that hall of women to have every woman on staff to be a part of it. Krista wrote this incredible scene between Tuck and Ben that describes consent in a way that's so clear and relatable. A woman on our crew who is a single mother told me that when her son is a couple years older she's going to play that scene for him because she's trying to find the best way to get through to him. When I think about that one individual, with that idea and the number of people who will do that — and the parents who will start a conversation with that scene, it breaks my brain and heart open in a way I didn't think possible.

Were you surprised you had the viewer discretion warning or did you ask for one?

Vernoff: We requested it, and ABC watched episode and agreed with us. It's interesting because we're not depicting violence, and yet the experience of watching the episode come together made it very clear that the way we're telling this story is so rare that women are overcome with emotion. At one point, ABC said maybe not have the trigger warning and I told them that I had yet to watch this episode without someone sobbing and felt strongly that we should give viewers the heads up to watch with a friend.

This episode also saw Jo reveal she had an abortion when she was married to her abusive ex-husband. Can you talk about the decision to incorporate that into this episode?

Finch: The abortion came in because I wanted to incorporate as many points of view as possible. Jo's mom talks about how she was trying to keep the baby and other women do that and think, "Why can't I?" Between that and the abortion and what happened with Jo, there are so many different ways that I've personally known people and how they've dealt with it. Some mothers have a baby because they were raped and some are able to raise them. Some are not able to raise them but have them and put up them up for adoption. Some decide that they're in a situation where they want to have an abortion. In Jo's case, she had an abortion because she was in a relationship with someone who was abusive. But it was important to me to show as many choices as we possibly could and one of the many reasons why we should have every choice under the world in the world that we live.

Jo is the child of rape. How will knowing that affect her going forward?

Vernoff: Profoundly. It was a really interesting left turn in our season because we'd planned something different for Jo and then this episode emerged. I watched the shooting of it and it became clear that it wasn't a one-off and "Jo experienced this and now back to your regular programming!" It became clear from Camilla's performance that Jo was going to have to process this in really profound ways that were going to derail the storytelling we had planned for the season — and we and Camilla — were good with that.

It's already affecting Jo's relationship with her husband Alex (Justin Chambers), and since she hasn't told anyone, her friendships, too. 

Vernoff: We're telling a story about trauma and a story about depression. Things tend to get worse before they get better.

Jo knows what it's like to be abused by someone. How will finding that out about her biological mom impact how she copes with this knowledge? Presumably there's a struggle with not being able to get mad because she knows what her mother went through.

Vernoff: Right. This is a deep and complicated well that Jo has fallen into. It's a deep pain. Often what happens in the brain is it looks for linear ways to process information and when it can't find one, it often just gets stuck in the shit. Jo is a little stuck in the shit and is going to have to find her way out. But it's not going to be easy.

This was a bottle episode for Jo, and there's an Amelia (Caterina Scorsone) stand-alone episode coming soon. Will that episode be issue-focused, too?

Vernoff: It's entirely different. The Amelia episode is really funny and not issue-laden. It feels emotionally satisfying for long-term Amelia fans. It's a joy ride. We've been making this romantic comedy for the most part this season and had a couple episodes more exceptions to the rule — like this Camilla episode. The Amelia episode is a straight up rom-com, with some family guts underneath it and with some really lovely emotional resolve.

You're currently in production on the season 15 finale. How would you describe that?

Vernoff: The season finale is funny and dramatic and unexpected.

Finch: I'm a longtime Grey's fan and this is a favorite of mine. 

Given the nature of some of the old Grey's Anatomy finales, will you be saying farewell to any series regulars in the episode?

Vernoff: You know I can't answer that!

Grey's Anatomy airs Thursdays at 8 p.m. ET/PT on ABC.