Question: At the end of the episode, where Melinda helps that lady (who meets the guy who got her dead fiance's heart), what was the man at the end of the episode (who was laughing and seemed to be a spirit) supposed to be about?
Character mistake: When Aiden and Melinda go the the hospital to visit Jim/Sam the picture on the hospital badge is of Jim Clancy not Sam Lucas... Jim has been in Sam's body for many years at this point. You can see the badge multiple times in the episode.
Melinda Gordon: I don't have to love you... I choose to.
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Answer: This "spirit" appears in several episodes throughout the rest of the season including the season finale. He's a "bad spirit" that is intent on keeping souls trapped on Earth. With the death of Andrea (her business partner) he wanted to make a deal with Melinda, to give him HER soul to release everyone else including Andrea to cross over.
Boobra