In any event, Dean's barely had time to process Tiny's shameful secrets when he happens to glance across the infirmary, and what he sees out in the nurse's station causes his eyes to pop straight out of his head in alarm. "Oh, crap!" he once again mutters as he hops from his cot. "What is it?" Tiny wonders. Poor Tiny. You really don't want to know. Dean peers through the grid of his cage, and the camera switches angles to give us a close-up of what he's staring at: the ghoulish figure of a long-dead nurse, who stares at him dully through her rat's nest of grey hair, her mouth hanging open in a sort of slackjawed and almost reptilian menace. She tilts her head and advances upon him, passing easily through bars and tables and whatnot, as Dean frantically tries to break the lock on his cage. Having no luck with that, he spins and quickly spots the plastic salt shaker that arrived with his dinner, and with no other options, he snatches it up from the tray and braces himself for demonic impact. Meanwhile, poor, doomed Tiny's all, "What's going on?" in the background. Poor Tiny. Nurse Wretched finally squints at El Deano, somehow managing to fling him telekinetically against the far wall. Dean bounces off onto the floor on his back, somewhat dazed and wincing in pain. Nurse Wretched quickly takes advantage of his diminished capabilities and shudders into his cage to hover over him for an agonizing moment before plunging down towards his prone form with her right hand outstretched. She plants her palm on his chest, and Dean writhes his way through a ghost-induced heart attack until he manages to uncap the salt shaker and whip some of the contents into Nurse Wretched's face. Fortunately for him, it works, and Nurse Wretched dissolves into a rapidly vanishing cloud of ectoplasm. Unfortunately for Tiny, she rematerializes on his side of the curtain. Dean screams futilely for a guard as Tiny howls and moans and sinks slowly down into the METAL TEETH CHOMP!, where he dies a miserable death while Verizon tries to sell all of us some phone service.
The next day, Dean fills Sam in on "poor Tiny -- poor, giant Tiny's" untimely demise. The boys realize they've got to figure out who this ghoulish nurse really is, and they've got to figure it out fast, because Sam's already contacted Deacon with the good news that turned out to be wrong, and their foolproof breakout is scheduled for that evening. So, Sam drags Dean over to the bleachers and introduces his brother to Randall, who remains his cagey old self until Dean slips him a couple of packs of smokes, after which Randall fills them in on one "Nurse Glockner's" reign of terror in the prison infirmary a little more than thirty years ago. Seems inmates would enter the infirmary with nothing more than headaches, only to find themselves leaving the infirmary in body bags. Randall passes along the then-current gossip that Glockner "had it out for cons, and she did this Charles Bronson thing with a hypodermic" that made it appear as if they all collapsed from heart attacks. And whatever happened to the dear old thing? Randall hasn't a clue. He finished that particular stint and left, and by the time he found himself back in the joint again, Nurse Glockner was gone.