The patient’s hair was styled with curls so stiff, they held her head a few inches up from her hospital pillow. She had painted her lips a shade of bright pink that exuded the confidence of age.

Just after her colon burst, she was still awake. She looked around, at me, at the monitors. She asked for pain medication. “Am I dying?” she asked.

“We think so,” I said, touching her manicured fingernails. “I am here with you.”

Later, she kept her eyes closed but opened them when we talked. It was a state that the author and hospice nurse Barbara Karnes described as “one foot in each world.”

“Can I do anything?” I asked.

“No, honey. I’m just tired.” She closed her eyes again.

Still later, she lapsed into a stupor. It was as if I wasn’t in the room at all, as if she’d gotten so close to death that she could no longer see the living world. With each hour, her lipstick appeared brighter as if in defiance as her blood pressure dropped and her skin whitened. Midmorning, she died.