Sam is close to death in the premiere, "I Think I'm Gonna Like It Here"; it is revealed that the trials have severely burned his internal organs as well as cut off oxygen-flow to his brain, and that he has virtually no chance of survival. Having slipped into a coma, Sam has a dream in which he realizes that he is dying and struggles between whether or not he should even try to fight, eventually electing to let himself die with the guarantee that this time he cannot be revived and cause any more damage. However, the angel Gadreel is called in by Dean to save Sam through any means necessary. Disguised as Dean, Gadreel convinces Sam to let him save him and Sam agrees, unwittingly providing permission to Gadreel so that the angel can possess him due to Gadreel's ambiguously-worded question. Gadreel spends the next eight episodes healing Sam from within without Sam realizing it. In fact, Sam is completely unaware of Gadreel's presence, as the angel spends most of this time laying dormant in Sam's subconscious and he and Dean go to some lengths to prevent him finding out about it because Sam could prematurely expel Gadreel if he found out.