The Walking Dead wasn’t exactly on its zombie A-game during Sunday night’s episode, “Slabtown.” What few walker scares there were came pretty cheap: A sudden cut to a close-up of a walker scratching loudly against a fence could elicit a jump from anyone. But if the zombie stunts were lame, they served as a sharp contrast to the episode’s real source of terror: rape.

The episode finally revealed the whereabouts of Beth, who was kidnapped and stuffed inside a white cross-bearing car last season while traveling with Daryl. It turns out she was taken to Grady Memorial Hospital in Atlanta by a band of cops whose relationship with the “workers” at the hospital makes Pornstache’s “relationship” with the inmates in Orange Is the New Black look like inspiration for a Hallmark card.

The officers—led by a woman named Dawn Lerner—provide food and shelter at the hospital for needy people they find on the road. Then they force those people into indentured servitude to repay the hospital for its resources (“It’s only fair,” Lerner says, half-convincingly). Workers are subjected to verbal and physical abuse along with the menial labor—but for some, it’s implied that enduring sexual abuse is also part of the “job.”

We meet a worker named Joan, who tries to escape but is dragged back in after sustaining a gory walker bite on her arm. Lerner and the hospital’s only doctor, Steven Edwards, attempt an amputation to save Joan from being zombified, but it’s clear Joan would rather die than be saved and continue living at Grady Memorial with her tormentor—a walking messiah complex named Officer Gorman. Gorman calls Joan a “whore” and refers to her as “his.” Beth, bless her, later asks Joan what Gorman has done to her. And in true Walking Dead fashion, Joan demurely responds, “It doesn’t matter.”

Rape, even in the lawless, free-for-all universe of The Walking Dead, has been acknowledged only in offhand references or as an act committed offscreen. This is good—no one needs rape on TV used as a prop, or as background noise, or for shock value. (Lookin’ at you, Game of Thrones.)

But a few instances of sexual violence have played out in front of Walking Dead audiences so far: when Shane attacked Lori at the CDC, when Maggie was forced to strip in front of the Governor, and when Carl was assaulted by a lecherous Marauder (the women of Terminus being pulled out of that cattle car were also raped, as Mary said, but this plays out offscreen). To the show’s credit, it doesn’t typically mishandle these incidents. There were consequences for Shane’s actions, and Maggie and Glenn spent the next few episodes grappling with what the Governor’s attack meant for them and their relationship. But poor Carl is still trudging along as if his assault never happened. (When I interviewed showrunner Scott Gimple last season, he acknowledged only that Carl was being held down in that scene and was reluctant to “say one way or the other what was going on beyond that.” Robert Kirkman is less ambivalent.)

In Joan’s case, and later Beth’s, the threat of rape is unambiguous. Gorman refers to Joan as “his” (Beth “shoulda been mine” too, he says) and doesn’t think twice about shoving a lollipop into Beth’s mouth despite her protests—the same way he doesn’t waver before cornering her in a dark office and threatening to rat her out her unless she gives in to his advances. At this point, Joan has chosen to commit suicide rather than deal with Gorman anymore; her reanimated corpse, along with a well-aimed jar of lollipops, take Gorman down in the end—just as his hands have begun to slide up Beth's shirt.

It all plays into one of the show’s favorite themes: how far people are willing to go to survive. Lerner is perfectly aware of what her officers are doing to hospital workers, but turns a blind eye for the sake of keeping the hospital, a small pocket of civilization, running in an otherwise demolished city. Even good ol’ Dr. Edwards tricks Beth into becoming his accomplice in the murder of a patient who, it turns out, was a doctor who may have threatened his status and power within the hospital. And we all know how long Rick has spent agonizing over how much of his old self to give up in order to stay alive.

For a moment, it seems like Beth is willing to play into the cycle too, hiding a needle and stepping toward Edwards as if to strike—but just then, another patient is wheeled in: Carol. However it is that she got there, we know the reign of the tyrants at Grady Memorial is coming to a close. If anyone can bust out of there and reunite the group, it’s the queen of the zombie apocalypse.