I never meant to be so bad to you—Dean living with Sam dead is a physical impossibility (there's plenty of shit walking around with their hearts no longer beating, but spirits and vampires and such aren't exactly alive), and he doesn't give a damn what it costs him (he won't think about what it'll cost Sam) as long as, for a little while longer, nothing has to change—you're only young but you're gonna die—Sam living with Dean dying is more difficult as each day goes by (life is a sexually transmitted disease, a hundred percent fatal, but somewhere there's a cure, a palliative, something), and he'll be damned if he can't (or, probably literally, if he can) find a way to keep everything the same.
You can't concern yourself with bigger things—burned no drowned no stoned no deboned no sliced no diced flayed no fileted no betrayed no no no (yes) break carve tear—I'll give you black sensations up and down your spine—eat shit sleep wake eat shit sleep wake drive hunt drive hunt bury a box at a crossroads eat shit sleep wake eat shit sleep wake drive hunt drive hunt pick the lock of the devil's gate eat shit sleep wake eat shit sleep wake drive hunt drive hunt sun up sun down day in day out remind me which Winchester is in hell?
What were the things you wanted for yourself—he's been to hell and back, and he'll never be the same again—hell's bells, there's no way to fight—he's lived through hell, and he'll never be the same again.