Plot

In the aftermath of the car crash, the surviving Winchesters go to the hospital, where one is stalked by a Reaper while another must consider sacrificing himself to save the others.

After the collision of the truck with the car, John, Sam and Dean Winchester are sent to a hospital with Dean in coma. He avoids being taken by The Reaper and communicates with Sam using a Ouija Board, while John summons The Demon and negotiates the life of Dean, giving the colt and sacrificing his own life to save his son.—Claudio Carvalho, Rio de Janeiro, Brazil

The Winchesters are injured and unconscious following a collision between the Impala and a semi-trailer. The truck driver is possessed by a demon, and advances on the car but Sam brandishes the Colt and the demon flees, exiting the truck driver's body.

The family is taken to hospital, where Dean, as he tries to find Sam and his father, realizes he is in fact a disembodied spirit. He discovers Sam in a hospital room where Dean's body lies comatose. The prognosis is not good; the doctor tells Sam they do not know if Dean will survive.

John sends Sam to retrieve the Colt from the trunk of the Impala, and obtain some items that John claims are to provide protection from the Demon. Sam meets Bobby at a wrecker's yard, where Bobby doubts that the the Impala can be salvaged. When Sam fiercely counters that it can be repaired, in a way that sounds analogous to Dean's state. Bobby agrees to tow the car to his place. Sam hands over John's shopping list, and Bobby reveals that the ingredients are used for summoning demons.

Back at the hospital, Sam confronts his father over his lie while Dean's spirit watches in dismay. With the energy generated by his frustration, Dean manages to smash a glass but suddenly he dissipates, as his body has gone into cardiac arrest. Sam rushes to his side and watches tearfully as the doctors work to revive him. Dean's spirit sees an apparition over his body that he attacks. As it disappears, Dean's heart starts again.

Dean encounters another spirit wandering the hospital, Tessa, who appears to be in a similar state to Dean. As a code blue is called, Dean rushes to see the apparition present again as a young girl dies and he realizes that it is a reaper who is taking the spirits of people as they die - a natural process.

Sam tells John that he has sensed Dean's presence, and he is determined to contact him. After he leaves, John makes his way to the hospital basement, where he performs a summoning ritual, despite having promised Sam that he would do nothing until Dean recovered. Sam returns with a Ouija board. Dean is skeptical, but he manages to communicate with Sam and informs him that a reaper is after him using the words 'hunt', 'reaper', and answering several of Sam's yes or no questions. Sam rushes to John's room, but finding him gone, he takes the journal to research lore on reapers. Dean reads over his shoulder, and when he reads that reapers can take human form, he realizes that Tessa is in fact the reaper.

When Dean confronts Tessa, she admits her true nature, and explains that Dean's choice is either to stay as a disembodied spirit, and become the type of vengeful spirit that he hunts, or pass from this world with her. Meanwhile, John has successfully summoned the Yellow-Eyed Demon who is surprised that John doesn't want to kill it, but rather to deal with it for Dean's life. As they barter, John reveals that he knows about the Demon's plans for Sam. Finally the Demon agrees to return Dean to his body, in exchange for the Colt and John's life - and soul.

Just as Dean is about to reveal his decision to Tessa, she is overtaken by the Yellow-Eyed Demon, who uses her to return Dean to his body. Dean has no memory of his out of body experience. John and Sam are at his bedside as he recovers, arguing as usual. John tells Sam he is sick of arguing, and sends Sam to get him some caffeine. While Sam is gone, John tells Dean how proud he is of him, and how he regrets that the burden for caring for the family has always fallen to Dean. After asking him to look after Sam, John whispers a secret to Dean which shocks him. John then leaves to face the Yellow-Eyed Demon.

As he is returning with the coffee, Sam finds John collapsed on the floor of his hospital room. He and Dean watch in anguish as, despite the doctor's efforts, their father dies.