Seana lived in the inpatient hospice unit for more than a month, far longer than anyone would have predicted, sustained only on pain medications and Popsicles.

Late March in Chicago is only technically spring. Most of the time it is still cold and overcast. However, this day was warm, 60 degrees and sunny. It was a Saturday and we planned to go outside after I finished rounds. I found Seana back on the unit sitting in her wheelchair, IV pole and pumps in tow, her winter coat partially covering her hospital gown. Her sister-in-law and Carla, her nurse's aide, were ready to go. Everyone was in a great mood.

We went down the elevator, into the brightly sunlit outdoors, and onto the driveway by the women's hospital. Though the initial idea was to just sit in the sun a bit, we were drawn toward the sidewalk. There were the usual smokers outside the hospital, and the smell of cigarette smoke was the first thing I noticed. It seemed horrible to come out here, to have that smell be the first thing to greet Seana. Simultaneous with that thought, though, she said, "What a wonderful smell!" I asked her what smell was so wonderful and she said that it smelled like McDonald's. I was thinking, she really does appreciate everything. We went on to the sidewalk and watched a father pitching a ball to his 4-year-old son. The continuity between generations was moving, almost beyond words. As we got to the corner, an inspiration came: we could make it to Lake Michigan, only a few blocks away. Did she want to try? Did everyone want to try? Of course we did! Carla said that it felt like we were cutting school. So off we went, across Sheridan Road, the four of us quite a motley sight: Seana looking like death warmed over in her wheelchair, I wearing my gray hospital coat, the nurse's aide in an outrageous green leather coat, her sister-in-law in an Ohio State sweatshirt. Cars slowed down; we waved. We walked up the road to the beach, cutting through rutted lawns, the wheelchair bumping in the spring mud. Seana didn't say much, but she seemed translucent in the sun, beaming, lit from within. I imagined it as her farewell tour of the world. I can only fathom the poignant wealth of feelings that were stimulated. For me, it evoked the sense of being a tourist, where everything seems special, a little strange, and very impermanent. I had experienced this same lakefront that way three years before. Then, I had just recovered from my own near death in the form of a myocardial infarction and cardiac arrest and was filled with joy and gratitude that I was still here. The world looked new.

I had been Seana's age.

She taught me that awareness of death and appreciation of life go together: to imagine that you are seeing things for the last time has the same intensity as seeing them for the first.