inspired by the vaguest of season 9 spoilers we've gotten thus far, and rokhal's prompt over at the ohsam Summer comment-fic meme: After the trials, Sam doesn't get better. Kevin's theory is that it's cancer: the trials are supposed to purge him of all physical and spiritual impurities, so tuberculosis is out, and cancer is the only reason left for Sam to be coughing his lungs up when he's supposed to be the pinnacle of human perfection.
Nope. Sam's falling apart because the demon blood is gone.