D is Drowning
He was no more living in the land of dreams, but in the land of the dead. Spike had finally given in to the urge to really see what death was. No more fighting for air, and no more battling away the darkness. It felt like he was drowning in the weight of sins. Every breath was a struggle. Moving was just too much effort for his battered body. So Spike lay on the stairs, drowning in his sins, dying from his wounds.