Dean and Sam were tipped off by an old hunting buddy, Martin (Jon Gries), in the (mental) joint himself after something mysterious happened in Albuquerque to send him over the edge. Which we, incidentally, never find out the whole story about. He didn't really seem all that crazy, more like tired. Which is rather poignant for the boys, particularly once we start delving into some of their issues. But I'm getting ahead of myself. Anyway, there have been a bunch of deaths in the hospital made to look like crazy people suicides, but since this is Supernatural, that is clearly not the case. Dean and Sam infiltrate the hospital by basically giving them their true stories: hunt monsters, started the apocalypse, you know, that. Works like a charm. After some rather violating physical entrance exams by one Plucky Nurse (henceforth shall she be named, since I don't remember her given name), they're in.
Their first night in, another patient gets attacked. They head to the morgue to check out his body and discover he's had his brains sucked dry, in a rather gruesome sequence featuring the aforementioned q-tip in the brain and then Sam cutting the top off the guy's head. Luckily we were not subjected to the cutting because, whoa, squick. Dean was squicked too, and waited outside to keep watch. They are, of course, caught at the end of the act, and Dean just pretends to be extra crazy to get out of trouble, yelling "pudding!", pulling down his pants and then, uh, twisting about. Eat your heart out, Plucky Nurse.
At this point they figure out they're hunting down a Wraith, which can be killed by silver, but looks human. Luckily, however, mirrors prove magic once again, because you can see its true form in them. We should keep a tally of how often mirrors show something's true form. 90% of the time, I'd wager. At least things are consistent! Anyway. Dean spots the main Doctor in the mirror looking rather wraith-like, so they hunt him down that night with some silver-plated knives Sam managed to Houdini from who knows where. Sam goes into full attack mode and almost kills the guy before realizing the silver isn't burning him like it would burn a wraith. Some orderlies get him sedated, and he and Dean have a rather hilarious conversation while he's all drugged up. Quotes from that convo at the end of this recap.
Dean heads off to figure out what's going on and that's when he starts to lose his marbles, seeing everyone's faces as the wraiths and starting to talk to himself. Sam, meanwhile, asks the main doctor for forgiveness for trying to kill him, and the doctor basically tells him they'll give him another shot, but he's got some serious rage issues. He was like a man possessed, the doctor says! Home, hit close. Sam heads to find Dean and starts having a hallucination of his own about everyone calling him a freak and it all being his fault the world is ending. The orderlies take him away while Dean watches from a chair, muttering to himself.
Dean is able to pull himself together enough to go talk to Martin again. They figure that crazy is the key. Whatever the wraith is doing, it's making people more crazy, and he and Sam have been infected. He thinks it must have been Kissing Wendy, who, oh right, I forgot to mention her. She randomly kissed both of them earlier on. Details, details. They go to find her but of course, she's now being brain eaten by our Plucky Nurse-Wraith! Yep, it was her all along.
Dean and Martin (ha, Dean Martin), attempt to stick her with one of the silver knives, but she gets away and heads for Sam. She and Sam have a chat about yummy crazy brains and touch more on Sam's inner rage before she goes to eat Sam's lovely brains. Dean enters just in the nick of time to stop her. After some more battling, he kills her dead, and the boys hightail it out of there.
As they're leaving, however, Sam has one of Supernatural's favorite "end of the episode special moments." He confesses that he's angry all the time. He was angry at John and Dean, then Lilith & Ruby and now Lucifer. He has so much rage and he doesn't know what to do with it. Dean, ever helpful with anything remotely involving Sam's feelings, tells him to bottle it back down so they can keep on going. As he puts it, what else can they do? Which is sad, but sort of true. They don't have time for pity parties when the world is ending.
And, I sort of skipped over the stuff with Dean and the fake doctor lady, but I'm going to touch on it here, because it's all very sad. Dean thinks he's talking to a nice young lady doctor assigned to his case, during which he admits to only sleeping 3-4 hours a night, every other night, and estimates that he drinks 50 drinks a week, as he's "gotta sleep sometime." He's never had a long term relationship, and the weight of the world on his shoulders makes it hard to get up in the morning. Even more unsettling is the fact that she turns out to be a figment of his imagination, or probably more like the side of himself he doesn't let surface. Because bottling is what the Winchesters do best, the poor souls.
And now, I shall end this with my favorite lines of the night. Feel free to add yours, along with any other comments, in the... well, the comments. Der.
"No, his name is Castiel. He wears a trench coat." - Sam, correcting the doctor when he thinks the angel is a metaphorical angel on his shoulder
"Dude, you cannot hit that." - Sam, to Dean, after Kissing Wendy does her thing
"So torn." - Dean
"I want him now. He's larger." - Kissing Wendy, about Sam (obviously)
"Oh yeah, they gave me everything. It's spectaculacular." - Drugged up Sam
"You always were a happy drunk." - Dean, about Drugged Sam
"Well come on, you've been at least half crazy for a long time." - Drugged Sam, about how Dean is probably going actual crazy
"It's okay, 'cause you're my brother and I still love you..." Sam then proceeds to "boop" Dean on the... nose? I think it was his nose.
Clearly I liked Drugged Sam. What a hoot.