"Silence Speaks" is the 976th episode of Casualty and the 15th episode of the 30th series. It was preceded by "Maybe This Year" and followed by "Home for Christmas". The episode was directed by Seán Gleeson and written by Claire Miller.
Jack isn't happy when Big Mac starts to remove most of the Christmas decoration he has put up and seeks revenge. However when Rita eventually tells him that there only allowed approved decorations due to the spread of infection and that Big Mac actually loves Christmas he feels a bit bad for being mad at him all day.
After a teacher with MND called Maddy falls from her chair at work her mother calls an ambulance from a special App. Dixie and Iain find her in her classroom and bring her into the ED where we heard that Connie knows her from helping out at MND events. Maddy starts to deteriorate and asks Jacob to help her but when Connie and Maddy's mother tell Jacob that she didn't want any sort of help he won't believe them and intervenes getting on the wrong side of Connie she reveals that they slept together and the news quickly makes it around the ED. Maddy deteriorates further and when Jacob finds her laptop and some messages that she has recorded, it proves that she does want the help. Her mother takes a little bit of convincing from Jacob but she agrees to let him intervene.
As a boy tries to wake his mother whilst driving down an alley he crashes and has to call the ambulance. They are taken back to the ED and everyone thinks that the mother has been driving drunk but Lofty reveals from bruising that it was actually the boy. The mother freaks out when Cal tells her she is going to need an operation on her leg after talking about her son who died in his sleep it becomes apparent that she drinks to help her sleep as she can't otherwise. The boy runs out from seeing his mum only to collapse in the reception. Dylan takes him to 'small resus which is next to resus and where his mother is. They both become worse but when they need the same piece of equipment they have to decided who needs it more urgently. The boy starts out with the rapid infuser machine and as he comes to the end Cal calls through so the mother can use it. Dylan says they will have to wait but the boy pulls out the tube, so that his mother can have it. Lofty tells the boy to write his mother a letter explaining how he feels about her drinking and he reads it out to her.
Noel, Robyn and Jack all start a fund raiser to get a new rapid infusion machine after the difficulties in resus but Louise isn't convinced it's going to be enough as the machine costs £18,000. Dixie is still suspicious of Nikki with Olivia and Jess and goes over to the HART building to speak to Jess about it. However Jess isn't happy about this and tells Dixie that they are fine and that she needs to stay out of things. Dixie leaves but as everyone heads to the pub she gets the news that Jess had made a complaint of harassment against her.