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Sacrifice, especially self-sacrifice, is the Winchester Way. In order that Dean may live and either "save or kill" Sam, John sacrificed himself to Azazel. In order for Sam to live, Dean sold his soul to bring back Sam. In order for the world to avert the Apocalypse, Sam sacrificed himself both to Lucifer and to an eternity in Hell. Dean allowed himself to die for a period of seven minutes in order to plead with Death to retrieve Sam's trapped soul. While trapped inside his own mind, Sam accepted both the terrible memories that his Soulless self and his Hell self contained in order to return to Dean.
And so it is, in "Repo Man," that we see Sam make yet another sacrifice for his big brother: his sanity. 

Throughout this season, since "Hello Cruel World, we have seen Sam temper his hallucinations. He has placed his faith in his "stone number one," and worked as many cases as he can to avoid and out run his demons---and Lucifer. The hallucinations are always present, a constant reminder of his sacrifice at Stull Cemetery, but they had been held largely at bay. He has had enough distractions and relied on the management techniques given to him by Dean---and they have largely worked, despite seeing Lucifer al the time, as Leviathan Sam revealed in "Slash Fiction." He's managed to hold it mostly together---until this.
An old case, four years old, comes back to haunt the brothers. Back when the brothers were trying to discern Lilith's whereabouts, they encounter a possessed man named Jeffery. The exorcism is standard, the taunts and barbs exchanged between the brothers and the demon are familiar. It taunts the victim, Nora, "Oh, Nora, Nora... I'm gonna scoop you out like a pumpkin. You know that?" It's all about intimidation while being stuck in a Devil's Trap, hoping for a method of escape. Once she flees in absolute horror, the Winchesters get down to their business. It lets Jeffrey back in control,  and he pleads, "Oh, the things he made me do to those women. Whatever you have to do... You have to do it. Please just stop this evil piece of..."  It's a standard demonic ploy to keep the Winchesters from garnering their much needed information. They take Jeffery's consent, however, and extract the needed information before exorcising the demon back to Hell. It should be a closed case, and yet here the demon is back again to torment the world---or so they're led to think. 
The brothers, in the present, have been consumed by hunting Leviathans and in particular Dick Roman. Dean reminds him that this is their goal, but Sam says, "Yeah, but, no "“ I mean, not right now. This one's ours, Dean. It's unfinished business, apparently." Dean acquiesces and they return to the town where it happened. They find another crime scene complete with sulfur and are lead to a Wiccan shop. There, they meet up with the woman, Nora Havelock, that had fled the scene four years earlier. She is better prepared to face a demon now than she was then, as they must cross a Devil's Trap to enter her private office. 

Nora tells them about Jeffery and informs them that she is worried that it might have taken him over again. They visit him and learn that he has had a difficult time since the exorcism. He has lost his job, been institutionalized, and has to now live at a half way house. It invokes sympathy in both brothers, but it should invoke suspicion and red flags. Demons lie, after all, but humans are simply crazy. 
The brothers split up. Dean agrees to keep watch over Jeffery to prevent and prepare for the demon's return while Sam heads to the library to keep tabs on the demon's slated next victim, Marjorie Willis. All the while, Sam is not alone. He is agitated, stressed, and has a hard time shutting out his resident head buddy. Lucifer flickers in and out as Sam applies pressure to the wound Dean used to cement his brother into reality. It seems to be losing its power over time.  Lucifer even seems bored with the technique, as he remarks, "Don't bother."

As time goes on, however, Lucifer taunts and jabs at Sam, demanding more and more attention. He wheedles and whines plaintively, "Pay attention to me. I'm bored," all the while forcing Sam to see horror. He hallucinates that the other library patrons are smashing their heads into the tables, turning their faces into bloody pulps. Sam manages to shake it off, find his focus, and continue to keep tabs on Willis.
It isn't until Sam cannot reach Dean that this tenuous grasp on reality and sanity starts to slip. He can feel it in his gut that something is terribly wrong, that Dean should have answered one of his many cell phones. Lucifer taunts, shattering Sam's last resolve completely by stating in cold terms, "Big brother's  probably dead." 
Sam snaps, "Shut up," and Lucifer crows, "He said "shut up" to me. "

It is the slippery slope Dean has worried about since finding a lost Sam at the warehouse in "Hello Cruel World." His other shoe has finally dropped, and it has dropped with a resounding thud. 
Dean, meanwhile, tricked by Jeffery, ends up at a secret place where another man is being held. He is tied down and strapped to a chair with duct tape over his mouth. In his compassion to help the victim,  Dean rushes to him. Distracted by untying the injured man, Dean doesn't see the syringe coming for his neck. He is knocked out and tied much the same way. When he comes to, he sees that Jeffery is waiting. 
"Demons, I get, people are crazy," certainly applies here. Jeffery is a serial killer. The killings four years ago may have been due to the demon possessing him, but the victims were all his choosing. He is simply picking up where he left off, and he wishes to regain the power demonic possession provides. He needs Dean to complete the ritual to summon this particular demon from a very deep pit in Hell. After all, it had squealed on its superiors years earlier.

Desperation sets in for Sam as he becomes frantic. He searches Jeffery's room, finding a cell phone scrambler. It raises more alarms for him. Even more chilling, Sam discovers a box containing a summoning spell in Latin. Jeffery, not unlike Howard in "Plucky's Pennywhistle Menagerie," has been the culprit hiding in plain sight all along. Armed with this information, Sam knows he must act quickly, but is stumped by the clues in his hands. He simply can't think clearly enough to string them together, and starts to panic.
Lucifer has been with him this whole time, spurring him on. The moment he told him to shut up, it was over, and whatever banishment techniques Sam may have had have now vanished. Instead, Sam gives in to Lucifer, taking advice and partnering with his hallucination to locate his missing brother. The demonic summoning spell he holds is a big clue, and Lucifer points out that instead of looking at why, he should "start looking at who." Up until now, Sam has seemed to brush off his head buddy's advice or chooses to accept the clues pointed out silently. Here he addresses him directly. He stops in the middle of the street and turns towards his hallucination, asking, "Okay, what do you mean?" 
Lucifer seems eager to please and points out these important clues to Sam. It seems odd that Lucifer's manifestation would be the key for Sam saving Dean. After all, Dean is "stone number one," and is the reason Sam could banish him at all. What would motivate his hallucination to help him return the one thing that could possibly help Sam to ignore him?

Sam knows that he needs to talk through the case. We've seen him use sounding boards before, such as in "The Man Who Knew Too Much" as he tried to put himself back together. He used the bar maid he encountered to talk his way through his situation. Here, all he has is Lucifer. Just as Lucifer was to give him the actual clue about the spell, impatient for Sam to figure it out on his own, Sam exclaims, "I know this handwriting!" Upon returning to Nora's shop, Lucifer whispers to Sam that he should make her talk and make her talk quickly. Sam intimidates her, using his size and his intense desperation to frighten her. She cracks easily, spilling the secret that Jeffery has taken her son as hostage in exchange for summoning the demon. Lucifer is impressed, and quips, "You really knocked the cork out of her piehole."
Armed with this information and a tracking spell, Sam locates her son---and Dean. He rushes to the scene, but arrives too late. The summoning has been completed, and the demon is back. It has taken over the son, not Jeffery however. Jeffery pleads that it repossess him, but the demon refuses. It tells him that he has taught Jeffery everything he needs to be a serial killer. 
As Sam and Nora attempt to deal with her possessed son, Jeffery makes moves to stop them, aiding the "love of his life." Left with little choice, Dean shoots and kills him. He may be human, but he is a monster, and he was invoking black magic to bring even more evil into the world. 

Jeffery, in a way, reflects Dean. He is the star pupil of a demon---in the arts of torture and murder. He relishes this role openly and seeks to pursue it happily. In fact, he is unhappy without his master's guidance and presence. He is what Dean could have become under Alistair if he had not been returned from Hell. Dean has admitted to enjoying torturing other souls and has employed the techniques he learned while in Hell on others since. 
And yet, Dean is not Jeffery at all. He returned to help Jeffery, regardless of his previous engagements in hunting the Leviathan. He may have done so at Sam's behest, but he also could not leave a job unfinished or a victim helpless and open to attack. It is not in Dean's nature to turn his back. In the end, Dean is searching for the good. He is looking to live up to the motto of "saving people, hunting things, family business." His asking of Jeffery four years earlier for permission to torture the demon possessing his body proves Dean's goodness of character.
Jeffery also represents Sam. He relished his demonic possession, he craved the violence the demon invoked inside, as Sam did with his demon blood addiction and infection. He also is a stark foreshadowing of Sam's possible future: insane and institutionalized. His sanity was unhinged, his grasp on reality severed. Jeffery is a metaphor for Sam as so many have been before. Even Dean states in cold terms, "He was a psychopath, Sam. That's what they do all the time is act. Act like they're normal. Act like they're not balls to the wall crazy." Sam, in some ways, has been putting on an act himself, hiding from the truth of his hallucinations. However, unlike Jeffery, he is not evil and he is not faking his compassion for others. He may struggle with reality, but Sam always tries to put others first---even at great costs, as he does here.
Upon return to the hotel, Sam and Dean drag themselves in, exhausted from the job. Dean flops down and prepares to go to sleep, while Sam watches. In the corner of his vision, Lucifer takes up residence. Now that the adrenaline and the rush to save Dean has passed, Sam has no where to run. He is trapped and unable to turn the Devil away. Not even his wound is working. As much as he presses on it, Lucifer refuses to budge. 
In order to return his "stone number one," to his side, Sam has sacrificed the one thing he was ill afford to bargain with: his sanity. 

Lucifer taunts, "You let me in." 
In the end, all the Devil needed was a single foot in the door. 
Russell Sams showed a Jeffery that played bait and switch well. He was a convincing victim, complete with limp and quiet demeanor. His excitement about acquiring a dog made him seem sweet on the surface, but Sams gave him enough edge to make it suspicious. His description of a harrowing experience after the exorcism sucked both the viewer and the brothers into his web of lies. And yet, we could tell that something was very wrong with Jeffery. Sams provides few tells until it is too late, but we can't help but think that his playing the sympathy card doesn't invoke that he's a demon leading the brothers into doom. Upon revelation that he is indeed the bad guy here, he becomes maniacal, twisted, and disturbing. His chilling description of  the demonic possession and how alive he felt was conveyed well with facial expression and tone of voice. It's almost the more disturbing that this is a human and not a demon after all. It is frightening to think that such evil exists in humanity more, and that while a supernatural monster played a factor, it is a human that can be much more monstrous in the end. 

Nicole Oliver played Nora Havelock with conviction. She presented a serious but desperate woman seeing history repeat itself. Her character reflected Sam almost more than Jeffery. Hearing her desperate story, and seeing her break down upon revealing the ear made her performance real. Her anger and desperation upon facing her demonically possessed son, reciting the exorcism herself this time redeemed her fleeing the scene four years earlier. Seeing her recite it, Oliver demonstrated the character's strong and resolute will to finish, despite the possibility that her son could be harmed or worse for doing so. She was a sympathetic foil to Jeffery in every way, a victim multiple times over. 

Mark Pellegrino is always a treat in any episode, and "Repo Man" is no exception. He brings to life a snarky, demanding character with such ease that he adds rich color and flavor to any scene he's in. He brought forth a new side to the character in Lucifer's willingness to help Sam, and it almost seemed like he was acting as mentor rather than tormentor at times. Pellegrino knows how to pull on Lucifer's subtle side, making snide comments that are quiet but effectively devastating. He is more than just a simple hallucination, and it would seem that Sam's psyche has developed him into a more friendly foe than straight foe. Pellegrino shows that off well when giving Sam nudges to spot clues in front of him. His absolutely delight upon capturing Sam in checkmate at the end, complete with fire and the resounding shout, "Good morning, Vietnam!" was delivered with such power it lasts long after the episode ends. 

Jensen Ackles gave us a strengthening Dean. He is resolute in helping the victim, and Ackles conveys that well with gesture and voice. He shows that Dean is in the game when he kills Jeffery without hesitation. Dean has been struggling throughout this season, but Ackles demonstrated that Dean's willingness to help others trumps his own despair. Dean may have had to kill Jeffery, but it is clear that up until it was revealed that he was indeed their perpetrator, he was sympathetic. Ackles showed this in his patience to listen and his promises to help. Once he realizes that he is in danger, he switches effortlessly into hunter mode, and Ackles showed that through facial expressions. Gone was his patience and gone was his sympathy. Ackles knows that Dean sees things in black and white, and while Jeffery may have been human, he knows that he was not, that he was all monster, and that killing him was the only answer. We also see a confidence in Dean when confronted with demons---perhaps because unlike Leviathan, Dean knows just what to do and how to kill or banish them. There is little uncertainty for him when confronted with a creature he has defeated numerous times, and his demonic kill sheet ranges from Azazel to Ruby. It was a comfortable hunt, and while Dean resisted it, it seemed to boost his character. We saw it in the way Ackles would have Dean taunt, or in the manner in which he fell into easy step with what needed to be done when the chips were down. 

Jared Padalecki turned on a dime from last week to this week. Comedic ticks disappeared to be replaced with somber brooding. Sam seemed withdrawn, as Jared would shrink in upon himself or hunch his shoulders tight. He made certain that Sam often kept his eyes downcast or averted from Lucifer, conveying his struggles with the Devil. His crowding of Nora demonstrated Sam's desperation and drive to find his brother. His most heartbreaking scene is at the end, when Sam is finally cornered by Lucifer. We see Jared press hard into the palm, and his face shatter into pieces as Lucifer remains. It is checkmate, and Jared conveys Sam's loss well. The eeriness of seeing the fire Lucifer has unleashed flood the room---and Sam's eyes leaves us haunted and concerned for the younger Winchester brother indeed. Jared has expertly given us a Sam that has been pushed beyond his limits, and we know the descent to the bottom will be hard and painful---but necessary. Much as Sam faced his fear in "Plucky's Pennywhistle Magical Menagerie," he too must finally face his demons---and in particular Lucifer---if he is going to move forward or heal from what has happened to him in the Cage. 

Considering the previews for the show's return in March, it would seem Sam's spiral downward has only begun---and a few favorites might return---but as what or who exactly? 


# purplehairedwonder 2012-02-20 01:31
And so it is, in “Repo Man,” that we see Sam make yet another sacrifice for his big brother: his sanity.

That's beautifully put. Absolutely haunting and heartbreaking, but beautiful.

Really, knowing what Sam's been seeing all these months just makes the fact he's been so functional absolutely astounding. That's the strength of Sam's character and in the bond he shares with his brother. Now we have to hope that those will also be enough to bring him out of his spiral to rock bottom in the coming episodes.

And Mark Pellegrino is just fantastic. No other word for it.
Far Away Eyes
# Far Away Eyes 2012-02-20 07:17
It's what really stuck out to me about the story in this episode. Sam was barely holding his head above water, but while Dean was with him, he could make Lucifer go away. Once the evil seed was planted in his head that Dean might not be safe, kaboom, there went all his grip on sanity.

And to get Dean back, he had to let Lucifer in. It's so tragic. Dean safe for his sanity. Really, that's all it comes down to.

I think Dean will be able to help Sam come back. He can't fix this or do this for Sam, but he will play a necessary role in getting Sam through this.

Glad you liked my take on this one.
# Sylvie 2012-02-20 09:35
You know, the hardest part for me was when Sam looked directly at Lucifer and told him to shut up. I knew at that moment he was doomed. The devil found the chink in Sam's armor, Dean being in jeopardy. And now, Sam has lost the grip on his stone number one. All it took was that one little moment. When Lucifer shouts at him "Good morning Vietnam", it was like, this is it, the beginning to the end. And we have to wait ONE month before we find out any more! I won't be able to stand myself.
Far Away Eyes
# Far Away Eyes 2012-02-20 16:01
I just remember the moment the episode ended, the first thing I thought was, "Sam sacrificed his sanity to save Dean. My God."

And yes, I have to think that the moment he said shut up, that was it. Any hope Sam really had to push Lucifer away ceased.

I think it'll be interesting to see how low Sam has to go before he can truly recover. If he doesn't endure this, I think it was going to forever hang over his head.
# Leah 2012-02-20 13:37
I think the 'Good morning Vietnam' thing had huge signifigance. Sam flinched violently when Lucifer began to say it and before that Lucifer said 'say it with me' suggesting that Sam knew what was coming. I'm paraphrasing what someone on tumblr said but it may have been the way Lucifer used to wake him up in Hell for a new day of torment. Dean said people are able to dream in Hell and i think Sam dreamed of getting out, of being back home, of Dean rescuing him. And the 'Good morning Vietnam' was like a shattering of the dream and the harsh awakening into the reality that he's still in Hell as it kind of is now.
Far Away Eyes
# Far Away Eyes 2012-02-20 16:04
Oh absolutely. I think Lucifer's used that line on him multiple times throughout Sam's time downstairs.

It will be a hard, long descent, but I think Sam will have the strength to overcome. Hell!Sam told him he couldn't before he woke up again whole, but I think that's the line he must hold onto to fight back. That, and Dean.

Doesn't mean I won't want to invest in kleenex before it's over, though.
# jensenRick 2012-02-27 01:22
Thank you SO MUCH for this review! This highlights exactly what I thought the lynchpin of this episode was- Sam sacrificing his sanity to help Dean.
I hope this might be the moment that finally convinces Dean that he is as important to Sam as Sam is to Dean.