 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 . 
