In the waking world, Sam watches over his charges in between coughing bouts. He should really look into getting himself some Ricola or something. To his surprise, a teenaged boy walks into the warehouse. The kid looks so much like Boy 1 from the corpse-poking scene that I had to check the credits to make sure it wasn't the same character. (It's not.) "You killed my mom," the kid says, looking down at Djinnifer's body. His eyes glow blue. He'd be a big hit at Dune themed parties.
In the dream world, Charlie and Dean blast mutant vampires and try to figure out how to beat the game. Charlie says she's been through the level countless times and she keeps getting reset to the beginning without winning. "It's an infinite loop, like Pac-Man without level 256," she says. They barricade themselves in the infirmary and find Gertrude Middleton lying in one of the beds. Charlie doesn't understand how Dean could recognize her. He explains he and Sam found Charlie's apartment and saw the payments she was sending to the hospital. "I went and visited your mom looking for you," Dean says. "She's why I'm in Kansas," Charlie says. She says she sneaks into the hospital whenever she can to read to her. "She used to read to me when I was a kid. She'd read me The Hobbit... She's the reason I love the stuff I love." She's just about in tears. "I'm sorry for your loss," Dean says. "She's not gone," Charlie insists. Dean looks around a bit more and finds Sam lying in one of the other beds. Because Charlie isn't the only one having problems letting go of her love ones. Get it? It's not like they've explored that topic a thousand times already, but whatever. The vampire soldiers have reached the infirmary doors and they sound like Cookie Monster on a Chips Ahoy! binge.
In the waking world, Sam is getting his decaying ass handed to him by Djunior Djinn. By now, Sam has figure out that it's Djunior who's been on the killing spree and that his mom was trying to cover for him. While Djunior is busy moping about how awful puberty is for giving him zits and embarrassing odors and compelling him to feed, Sam stabs him in the gut with the lamb knife.
"We've gotta save the patients," Charlie tells Dean in her dream. "We gotta find a way to break this loop," Dean says. But endless loops are what this show is all about! Dean says they need to stop playing. They have to let go of the fear and just stop playing. Charlie ignores him and keeps blasting at vampires through the doors. Dean takes her by the shoulders and turns her around to look at him. She's not afraid of the game, he says, but of losing her mom. "Charlie, she's already gone." Charlie cries and explains how the accident was her fault, because she called her parents to come pick her up from that sleepover. "I just want tell her that I'm sorry and that I love her, and just have her hear it again, one more time, but she can't." Dean understands all too well, and tenderly tells her one more time to let go of her mom. "Game over, kiddo," he says. It could easily sound jerky, but it doesn't. As soon as Charlie stops shooting at the vampires, they disappear. Her mother, too, vanishes from her hospital bed. Charlie wakes up weeping in the real world. Dean says he's sorry for what he did, because he's used to people blaming him for things, but she just throws herself against his chest for a hug.