In the course of looking up an older post I came across what I wrote last year about
hospitalizations in SPN. I realized there had been an important change in S5, namely that Sam has finally been a patient. But I think Sam Interrupted ends up revealing a more audience-directed reason for the pattern.
My conclusion in that meta had been that Dean had been the only brother hospitalized because "it compensates for both Dean's physical vitality as well as his action-orientation." In short, someone else has to take the lead because Dean is out of commission, so it generates a different plot pattern than what typically occurred in the earlier seasons.
I believe though, that this held true only through S3. By S4, I think the primary motivation was character rather than plot related and it had to do, simply, with the audience's desire to see Dean made vulnerable through physical assault. This has become so rampant that it's now being commented on by fans regarding S5, and was a subject of complaint by JA at the Barcelona convention.
Thus, I think the portrayal in "Sam, Interrupted" is rather interesting in the difference between Sam and Dean as patients. The important arc point of the episode was to reveal Dean and Sam's character flaws (though as I commented
in my meta for that episode, these were hardly revelations). In that regard, we were supposed to be shown that Sam was subject to out-of-control fits of rage, while Dean was supposed to have an overdeveloped sense of responsibility and an unhealthy lifestyle (even apart from hunting).
However, it's rather curious that, while we see Sam get angry and assault people, Dean is rendered fearful and confused. In other words, even though his flaw doesn't directly deal with fear (unlike Martin's reason for being at Glenwood Springs), his hallucinations serve to weaken him rather than strengthen him as did Sam's. In fact, even when Sam is restrained and doped up after his attack, this is played off as humorous rather than angsty. We see Dean worry over Sam plenty in the series, but the closest we come to a hospital bedside scene for Sam is when Dean is weeping over his dead body in AHBL2.
I had to laugh that in the comments to the original post I had speculated we'd see Sam in a "psychiatric hospital? Somehow that seems more apropos, with Sam being the more cerebral character." And indeed, this seems to have been the way they went, with Sam losing that rationality beneath rage. However, he could just as easily have lost that rationality through the sort of fearfulness and confusion we saw in Dean. But this is not the route the writers took. We did, however, see Sam's mind under assault in yet another episode, namely Levee. There he was far more vulnerable than we saw at any time in this episode. But again, there was no bedside comfort from Dean -- what little of it was there came from Mary.
In my last post, ariadnes_string mentioned then that Sam's lack of hospitalization could be seen as the parallel to Dean's lack of possession, which I speculated was occurring because it hit each character's strength - Dean's physicality and Sam's mind. Indeed, Dean continued to evade possession all the way through S5. This, too, was a deliberate choice on the part of the writers, and not just because he was to turn Michael down. Another revelation from the Barcelona con was that Meat Swap originally featured both brothers being body swapped - twice. However due to time constraints the script was rewritten and we only had Sam swapped.
One last comment I'm going to make about that post, was something I'd noted about how often someone "saved the day" in the episode. Increasingly in each season, the episode's hero had been neither Sam nor Dean but someone else. Considering how often I complained about how peripheral and passive Sam and Dean were becoming within their own story, I suspect that number was higher than ever in S5.
Comments at Dreamwidth
.