Jim has been shot and survived. He looks at Melinda and waits for her to wake up after falling asleep next to Jim's hospital bed. When Melinda opens her eyes, they have a short conversation:
Jim: You're more beautiful every time I see you.
Melinda: You're awake! I love you.
Jim: Mel, there's a thing that happened. Umm... Uh, it's called an embolism - it's a technical term and you don't need to know about it.
Melinda: Let me go get you a doctor.
Jim: No, please. Just look at me, right here. Please look at me, right now. Look, look at me right here. I want you to remember me this way, please.
By this time Melinda understands there's something wrong, so she looks at the bed where Jim was sleeping when she fell asleep in the chair. His body is on the bed and the heart rate monitor now shows flatline. He's gone.
Jim: I'll always love you, Melinda
Melinda: No.
Jim: Always
Melinda: No, not you. Please, not you.
So, that's Ghost Whisperer for me. Killing Jim was the last episode I'll see.