Darling Sammy’s Lucifer-related insomnia has worsened considerably since last we saw him, and it leads directly to a pre-credits car accident that lands him in an insane asylum after the emergency room doctors determine the dear boy’s suffered a psychotic break. Of course, Sam’s Lucifer hallucination comes along for the ride, and the foul fiend quickly devises a series of nuthouse-related torments designed to run Our Intrepid Hero into an early grave. Darling Sammy does his valiant best to ignore the torture, however, and he even finds time to gallantly help a fellow inmate rid herself of the pesky ghost that had been plaguing her for the better part of the last year, so that was pretty nice of him, I guess.
Meanwhile, Dashing El Deano uses Darling Sammy’s hospitalization as an excuse to freak the **** out, and he begins dialing his way through Dead Bobby’s lengthy list of contacts until one of them calls back with news of an actual, honest-to-God faith healer named Emanuel, who just might be able to cure Sam. Dean tracks Emanuel down to the latter’s tastefully-appointed home deep within the lush coastal rainforests of central Colorado, and is shocked and appalled to discover that Emanuel is actually an amnesia-afflicted Castiel. My Sweet Baboo, you see, emerged from that municipal reservoir all those many months ago with no recollection at all of the last several years — no comment — whereupon his adorable self was quickly adopted by some random who is now his wife, and he’s been spending his time since then curing his various friends and neighbors of their various ills and ailments. You know, more or less.
Luckily enough for Dashing El Deano, Emanuel is more than amenable to the idea of a road trip to go restore Darling Sammy to the latter’s typical levels of mental health, but naturally, there’s a problem: Crowley’s cancelled the moratorium he placed on all Winchester-related demonic activity, and so on top of everything else, Dean finds himself under repeated attack by Hell’s many minions. Fortunately, Meg shows up just in time to offer Our Intrepid Hero a crucial assist, and she promptly invites herself along as a sort of bodyguard for both Dean and Castiel on the rest of the journey to the asylum.