...and we're back with Dean, who's currently being dragged towards Sam's room by Old MacDonald and Ms. Pushypants. "Tell us where Castiel is," she says, "or your brother's gonna wish he were dead." Dean gloats about the angel warding, but Old MacDonald grabs an ax and starts hacking through the door like he's Jack Torrance. Ms. Pushypants punches and then kicks Dean in the face a few times. Dear God, what is with the assault on Dean's face?
Sam finally opens that cabin door and finds a man standing in front of the fireplace. Even with his back to us, there's something about the thinness of his frame and sweep of his iron-gray hair that looks familiar. Also, they totally gave it away in the promos. "Hello, Sam," Death says. "I've been waiting for you."
How does Dean have any teeth left? His face is just one, big bloody wound when Ms. Pushypants finally drops him to the floor. Dean waves a hand in surrender. "I'll tell you where Cass is," he says. Old MacDonald stops hacking at the door. "I just have one question... If Heaven is locked, then where do you go when I do this?" He raises himself up off the floor to reveal that he's drawn a symbol on the floor with his own blood. He slaps his hand down on it and consigns them to oblivion in a blinding flash of light.
Dean returns to Sam's room to find that his brother is getting worse, and that Ezekiel has been weakened by all the warding sigils. Dean starts drawing through them, undoing them, but Zeke isn't much improved. "I'm sorry, Dean," he says. He says it's too late. "Are you saying there's no way to save my brother's life?" Dean asks. "No good ways," he clarifies. As for the bad way, he says he might be able to heal Sam from the inside. Dean realizes this means possession. "No way," he says. "It's your call," Zeke says. But it's not. It's Sam's call, as Dean also realizes. He says Sam would never agree to being possessed, forgetting the time he did say yes to Lucifer. "He would rather die," Zeke agrees. He starts to walk away, so that Dean can say his goodbyes to his brother, but Dean calls him back. Also, what happened to asking the King of Hell for help? Is that just off the table for some reason now?
Dean asks Zeke to prove to him just how bad off Sam is, like the coma and the fricasseed organs and the pudding brain aren't enough. Zeke places one hand on Sam's forehead and the other on Dean's, serving as a conduit between their minds.
Death and Sam are having a nice fireside chat. "I must admit, when I heard it was you, I had to come myself," Death says. "I consider it to be quite the honor to be collecting the likes of Sam Winchester." This is just another figment of Sam's imagination, right? This isn't actually Capital-D Death fanboying all over him, is it? The being who says he will one day reap God Himself isn't gushing over Sam, is he? "I try not to pass judgment at times like these," Death goes on, "but you... Well played, my boy." Now here's a Sharpie for you to sign my chest! Eee! Sam just wants a guarantee that he'll be dead for real this time. No coming back soulless or anybody making deals for his return. He doesn't want anybody else getting hurt because of him. Death makes him a promise. Dean finally realizes (again) that things are serious.