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Before Night Falls

Slide 1 of 11

Kathleen Fanelli with Philip Arbolino, who, though plagued by physical pain and breathing problems, seemed lucid during her visits. Ms. Fanelli, a hospice nurse, remarked how rapidly a patient’s condition can deteriorate.

Credit...Arthur Nazaryan
  • Slide 1 of 11

    Kathleen Fanelli with Philip Arbolino, who, though plagued by physical pain and breathing problems, seemed lucid during her visits. Ms. Fanelli, a hospice nurse, remarked how rapidly a patient’s condition can deteriorate.

    Credit...Arthur Nazaryan

Death typically appears in photographs as an intruder: an unbidden force that sweeps down on a battlefield or leaves survivors pained and bereft. We see the images and know that just hours or moments earlier, the subjects’ lives were intact, the world complete and in order. In Arthur Nazaryan’s photographs of a hospice nurse and her patients, death plays a different role, shaping the scene by its absence, not its presence. It is the reason the characters are assembled, the order toward which the chaos of life is resolving itself; not just their lives, but ours as well.

Last summer, Mr. Nazaryan accompanied Kathleen Fanelli, a registered nurse at Calvary Hospital in the Bronx, on home visits for five patients and their families. Two patients died in the course of his project. “It made me think about death in a different way,” he said. “It’s not something that just happens to you. It involves the whole family” — sometimes bringing relatives together, other times exacerbating family fissures.

Ms. Fanelli, 51, said the work gave her a certain comfort with death. Patients often began hospice afraid of dying, their families unwilling to accept the inevitable. “You see the patients holding, holding, holding,” she said. “And when they’re finally able to let go, you can see they’re at peace. They’re not grimacing. There’s no more tightness, no more tension in their facial expressions. It is amazing to be part of it. It’s such a reward that I can walk out and say, when I first walked in there they couldn’t breathe, their families were crying, and when I left their families were sitting, smiling.”

She added: “Like the birth of a baby, death is a process. The birth is nine months. With death, you don’t know how long the process will take. There will be different symptoms each day. But like birth, it’s a part of life.”

A version of this article appears in print on  , Section MB, Page 7 of the New York edition with the headline: Before Night Falls. Order Reprints | Today’s Paper | Subscribe

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