Castiel and Dean try to diagnose Sam in this clip from "Family Matters." They aren't optimistic about his chances once they hear he hasn't been sleeping. At all.

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Supernatural Season 6 Episode 7 Quotes

Gramps threw a barbeque and left us off the e-vite list?

Dean

Dean: I'm sorry. I'm sorry, one more time. Like I'm five. What do you mean he's got no...
Castiel: Somehow when Sam was resurrected, it was without his soul.