“Going to the World’s Fair is my only ikigai – my reason for living,” she said clearly, looking straight into my eyes. Her entire body was jaundiced and swollen with edema, and she could barely eat. Making a 6-hour round trip by car to the fairgrounds in her condition would have been a reckless gamble. And yet I found myself wondering: why, at the very end of her life, did she want so desperately to go?

She lay on a nursing-care bed placed in the center of the living room. Surrounded by stacks of her children’s textbooks and magazines, her bed seemed strangely adrift in the room. Until she was diagnosed with liver cancer 10 months earlier, she had worked hard while raising her children and caring for her parents. Life had been so relentless, she once told me, that “sleeping was my only pleasure.” Despite surgery and chemotherapy, the cancer could not be stopped, and she was eventually hospitalized. But she wanted to come home – to the home she had designed herself and built on land she had chosen, her favorite place in the world. She was referred to our hospital for home-based palliative care. “I’m so happy to be back home,” she told me. “Even just once, I want to walk around my house.” In reality, even with help, she could manage only a few steps to the portable toilet beside her bed.

When I asked her, “What do you want to do with the time you have left?” she replied without hesitation, “I was born in 1970 – the year of the first World’s Fair held in Japan – so I’ve always felt a connection to it. My son and I have been talking excitedly about the human washing machine. It was first introduced at the 1970 Osaka Expo as a capsule that automatically washes your body. A new version is being exhibited at the 2025 Expo in Osaka. I’ve already made a reservation for the experience. Just believing I can go is what keeps me going; it’s the source of my will to live.”

When she spoke about her physical condition, she looked down, her expression clouded with anxiety. But when she talked about the Expo, her eyes lit up. Each time she returned to the subject of the Expo, I redirected the conversation, asking instead, “Is there anything else you’d like to do?” or “Have you been able to say what you need to say to your children?” Her husband said quietly, “I don’t think the visit will be possible.” His face was tense. I feared the journey might worsen her pain or lead to a sudden decline. Still, hoping to honor her wishes, we discussed the risks with our care team and reserved a medical transport taxi, deciding we would make the final call on the day itself.

Over the month after I began home visits, she grew visibly weaker. At times she would fall asleep in the middle of a sentence. Yet her hope of going to the Expo only intensified; she believed, to the end, that she would make it. On the day of her reservation, however, her consciousness was clouded, and she could not leave for the Expo site. Her daughter went in her place and planned to film the visit to show her later. That afternoon, before her daughter returned, I received a call from the visiting nurse. When I arrived, the eyes that had been so full of anticipation were already closed. The stethoscope was cold. Only silence reached my ears. Why today? I wondered. Though many relatives had gathered around her, the room felt hollowed out. I could find no words for her stunned son or tearful husband. When her daughter finally returned, her smartphone was filled with the excited cheers and dazzling pavilions of the Expo. But they were swallowed by the smoke of incense, never reaching her mother.

Later, I visited the family. Her husband reflected on her time at home. “When she was hospitalized, she must have had a hard time alone. She was able to spend her final days here, peacefully, with us, in the home she loved. I’m grateful for that.” My own feelings were more complicated. I regretted that we could not make the Expo visit happen. I also felt a sense of relief that I had been spared the guilt I would have carried if she had deteriorated during the trip. I could not stop thinking of how fiercely she had held on to that hope until the very end. I felt that I could not truly understand what it had meant to her unless I went myself.

I visited the Expo with my wife and son. Around me, people from all over the world moved through pavilions filled with humanity’s hopes, as if the future were theirs to enjoy. Then I saw a woman who could have been her, gazing at an exhibit with the same light in her eyes. For a moment, I thought it was her and found myself smiling, before realizing it was someone else. Or perhaps it was a vision conjured by my wish that she might have been there. Only afterward did I realize that I had already decided, without quite knowing it, that someone in her situation should be focused on family and on settling her affairs; that a fairground had no place in what remained. The Expo was her ikigai, even if she never got to go. I still do not know whether I would have encouraged her to go if her condition had been just slightly better. That question remains with me, along with the dazzling afterimage of the Expo.