"This is my brother, my blood, the only thing in this world created from that which I was created from, the person in the world who knows me best, the Person who would miss me the most if I was gone. That he cared enough to come here and that he cares enough to nearly break in front of me means something, but in the end, I know that it means only so much." pg 133
In this passage James realizes that if he leaves and decides to kill himself, he would be hurting his brother and friends very much. He realizes how much his brother and everyone cares for him even though he has done and said some pretty bad things when he was 'fucked up'. Also, after the visit from them and seeing Lily, he starts to think that he actually has things to live for. He knows what he wants and will probably end up doing the 12 steps to become sober and start his life over again.