On the foot of a hospital bed there's a sticker that reads, "Doe, Jane 45-098-R3." Genevieve Cortese lies comatose, with a respirator down her throat. One doctor tells another (or a nurse, or a someone), "All right, pull it," and he removes the contraption. We hear the monitor's telltale flat line sound. Seven seconds after the respirator was removed (yes, I counted), the girl springs to life and sits up in her bed, gasping for breath. "Who do I have to kill to get some French Fries around here?" Hee.
Sam sits in a darkened, ramshackle cabin. The visible light is from the sun's rays, streaming through broken blinds or shudders -- or a piss poor boarding-up job. A nearly empty bottle of booze sits on the table before him, along with a beer bottle, a pizza box, a crumpled up napkin and some other debris. He's loading or cleaning his gun (not a euphemism) when there's a knock on the door. He opens the door to find Ruby, holding a paper and claiming it as her proof. "This body is 100% socially conscious. I recycle. Al Gore would be proud." Oh my word, she found a personality! She explains that she made sure the patient's spirit was gone before she moved into the empty "apartment." She asks Sam if he's happy, but he ignores her and asks why she's there. She says although she can't bring Dean back, she can help Sam get Lilith. His eyes flicker. "You want me to use my psychic whatever?" She starts to mount her argument, but Sam tells her, "Skip the speech. I'm ready. Let's go." Huh. No foreplay. Well, Ruby wants some. She says that while in Hell, she learned Lilith was brewing up an apocalypse. Ruby doesn't want Sam to half-ass it, like before. They need to get it right. Sam says, "Okay, what do you want from me?" He takes a swig from his bottle as Ruby watches. "Well a little patience... and sobriety. Promise me that, and I will teach you everything I know."