For the most part, Dean didn't really understand what Sam was saying. She did understand that they were in trouble and he needed her to be quiet and she did the best she could with that, although any motion that jarred her arms or back wrenched a strangled sound from her.

When he picked her up, she slumped against him, trying to stay awake. Wanted to tell him to be careful and not to get hurt because of her, but she couldn't make the words happen.