After digging out of his burial site, Dean wandered into an abandoned gas station, still confused about how and why he was brought back from Hell. In front of a mirror, he lifted his shirt as he recalled his chest being shredded by hellhounds at the end of "No Rest for the Wicked," but was amazed to find no scars. What he did discover was a raised red scar in the shape of a handprint seared into his left shoulder, but no memory of how it got there.
Still unable to discern who resurrected him after he reunited with Bobby and Sam, they traveled to see Pamela Barnes, whom Bobby regarded as "the best damn psychic in the state." Pamela reported that she had Ouija'ed with several spirits, but that no one knew who broke Dean out, or why. She decided to conduct a seance, just to get a peek. To prepare, Pamela told Dean that she needed "to touch something our mystery monster touched," so Dean revealed the handprint on his shoulder. Pamela placed her hand upon it and began the conjuring. She said the name "Castiel" and demanded that he appear in the circle, in defiance of his demands for her to turn back; she was rendered blind as a result.
Later, Dean and Bobby met Castiel for the first time, and he declared that he was "the one who gripped you tight and raised you from perdition."The handprint was seen again during Anna and Dean's passionate night in the backseat of the Impala. She placed her hand upon it before kissing Dean in "Heaven and Hell".
Dean’s bare shoulder is not seen again until "The Third Man," during a dream sequence in which he and Lisa are making love. He no longer has the scar, possibly because he was in fact dreaming. Dean is again shown without the scar while he hooked up with the Amazon Lydia in "The Slice Girls".
- Destiel fans considered the handprint to be a symbol of Dean and Castiel's romantic relationship. They were dismayed by its removal.
- Though never confirmed, the scar's absence may be due to Castiel healing Dean of all his injuries at the conclusion of "Swan Song", including the ones he received from Lucifer.
- Why Castiel's retrieval of Dean from Hell resulted in a scar while Sam did not receive one is unknown.