My mother-in-law died about a year ago. Was it unexpected? Yes and no. She was 87 years old, with critical mitral stenosis from a failing 5-year-old bioprosthetic valve and severe congestive heart failure. But she was also cognitively intact, engaged in politics and world events, independent in her self-care, and active in her church, a book club, and a bridge group. She lived near her daughter, my husband’s only sibling, and together they enjoyed the local symphony and other activities.