Castiel frowned, eyes narrowing into that telltale squint of his that said that he was clearly a little lost on something. He was well within his right to be confused though, considering that not five minutes ago he'd been in Purgatory. And now he was somewhere else and Sam was here and making absolutely no sense.
He looked down at himself, frowned at his own appearance (his beard scratched. The fact that he had a beard was disconcerting), and then gave a half nod before gathering his already depleted Grace and mojo-ing himself clean, proper and in a more suitable outfit. Which was to say, instead of the dirt and blood stained white scrubs, he was once again donning Jimmy Novak's suit and tie combo.
"I don't need to eat," he told Sam, sounding tired. That last trick had taken it out of him. "But I think I could, anyway." Then he licked his lower lip and fixed his gaze fully on his much taller friend. "Where are we? What do you mean he's different? Is he alright? Are you alright?" He wanted to tell Sam to take him to Dean immediately, but -- maybe it would be best to listen and learn first.