Over the course of 15 seasons, Grey’s Anatomy has certainly offered up important episodes. Heavy episodes. But “Silent All These Years,” written by Elisabeth Finch and directed by Debbie Allen, is surely one of the most important, one of the heaviest, to date.

Tonight, Grey’s Anatomy devotes its entire hour to dealing with sexual assault. Even in the smallest storyline of the episode, in which Ben has The Talk with Tuck, who is starting to date, the bulk of that conversation is about consent. Still, the majority of tonight’s storytelling falls on a devastated Jo.

Since returning from Pittsburgh, where she went looking for her birth mother, Jo has been spiraling. She’s avoiding Alex, she’s tired and in a daze, she’s not the Jo we know. Something happened, but she refuses to talk about it. In the hospital, she bumps into a woman with a cut across her face, who seems more in a fog than even Jo. This is Abby. Because Abby is so distressed, Jo takes her down to the ER herself and she and Qadri help get her settled in. Fairly quickly, Jo senses that something isn’t right. Abby says she cut her face on the kitchen cabinet. She says her stomach doesn’t hurt, even though she keeps wincing in pain. She jumps when DeLuca walks up. Abby takes Jo’s hand. The woman is terrified. So Jo makes everyone leave, assures her it is just them, and finally Abby reveals her other wounds and bruises all over her body. It is awful. But Jo has her.

Jo makes sure it is only women working on Abby, and has Teddy come to check her stomach. She has a tear in her diaphragm and needs surgery. Teddy can tell immediately that Abby’s been sexually assaulted. If they sterilize her for surgery, they’d get rid of any evidence that may get her justice. Jo pushes a little to have Abby tell them what happened, but Abby refuses. So many scenes in this episode are hard to watch, but this one, in which Jo convinces Abby to do the rape kit, might be the hardest. Abby doesn’t think doing one would even matter because no one would believe her anyway. They’d blame it on the tequila she drank or say she was looking to cheat on her husband after they had a fight. Abby’s fear in this moment is so heartbreakingly real, and Khalilah Joi’s performance is so gutting, it’s a hard one to shake off. It takes Jo telling Abby about her abusive ex-husband, how she wished she had a chance to get justice, and how one day Abby might change her mind about reporting her attack, to get Abby to agree to doing the kit. And in a montage that you’ll remember for a good, long time, Teddy, Qadri, and Jo work on Abby. Abby never lets go of Jo’s hand.

A new problem arises when it’s time to take Abby in for her surgery. She’s scared to be knocked out, she’s scared of every man she sees — she sees her attacker in their faces. And so Jo gathers up all the women of the hospital and they line the hallways that Abby will have to pass through, they fill her OR, they will stand with her so she doesn’t have to be scared anymore. Some scenes from Grey’s stick with you forever, and this is one of those scenes.

After the surgery, and after she and Jo talk about how neither of their traumas is their fault, Abby finally calls her husband and tells him what happened. Abby finally calls the police. It’s only then that she lets go of Jo’s hand.

It’s a brutal patient case to take on for anybody, but it is especially painful for Jo after what she discovered in Pittsburgh.

Jo finds her birth mother Vicki living in a nice suburban house, with two teenagers, a seemingly lovely husband, and a cute dog. The perfect life. Though completely shocked and, let’s be honest, terrified to find the child she left at fire station now on her doorstep, she eventually meets Jo in a nearby diner to have a chat. Jo is angry. When Vicki tells her she gave her up so that Jo could have a better life than what she could give her, Jo laughs. Her life wasn’t better. Her life was full of awful foster homes and living in her car and an abusive husband. She thinks this woman is a monster for being so callous, for simply throwing her away and never once looking for her, for flippantly telling her that her father died 10 years ago in a motorcycle accident, and even that isn’t good enough for her. He deserved to suffer more. Jo’s had enough of the torture until finally Vicki tells her the truth: She was raped by her TA in college while on a date and Jo was the result of that.

I can’t imagine how exhausting it must have been to film this scene. Camilla Luddington and Michelle Forbes rip your heart out over and over again as both women cycle through pain and anger and guilt throughout. And really, there’s no good outcome to this conversation. There’s no healing that will come from it. Vicki will always be dealing with her trauma and with her guilt of resenting Jo, who was and is a reminder of what happened. Jo can never get the happy reunion or any type of closure she may have hoped for from this. It’s all so unbelievably sad, which as you know, is really saying something for this show.

As Vicki talks about how terrified she was during her pregnancy, Jo can finally understand some of her pain. In news to all of us, Jo tells her birth mother that at one point during her marriage to Paul she was secretly pregnant, but refused to let a child grow up in that kind of violence and fear and so had an abortion. She’s never told anyone that, not even Alex.

But the conversation ends as you’d expect for such an impossible situation. Vicki gets that Jo is angry, but leaving her at the fire station was the best she could do then. And this is the best she can do now. And so Jo has to pack up all that trauma and heartache and go home… where she has to face the brutality of Vicki’s situation by way of Abby.

Suffice it to say, by the end of the day, Jo is in even more of a daze than when it began. Alex is still trying to get her to tell him what happened, but she refuses. She can’t. Not yet. She doesn’t even want him to come home with her. She simply wants to be alone. After Paul died, it seemed like a weight was lifted from Jo. Like she was finally free to go all-in with this healthy relationship. To move forward. And then she’s handed an entirely new trauma. Two steps forward, a whole hell of a lot of steps back.

Hey friends, if you need help or just to talk to someone, go to RAINN.org or call the National Sexual Assault Telephone hotline at 800.656.4673.