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.
I really wanted to write the same story from Kevin's POV. Here it is - with even more awesome art by quickreaver !
title: Instinct (Prophet of the Lord remix)
rating: (Gen, PG-13)
warnings: disturbing imagery, language
characters: Kevin, Sam, Dean, Crowley
summary: Sam stopped the trials, but he isn't getting any better. The Winchester's have Crowley trapped in their dungeon, when all Kevin wants is to see the demon-king dead.
(set post season 8)