Earlier in the day, Sorcha Glenn's boyfriend had slipped a promise ring onto her finger — a step, perhaps, leading up to a diamond that would link them together forever. She teased him a bit, making sure it wasn't the real deal.
Then she smiled, he said, for the first time in months.
"She lit up; she was so excited," Matt Lynch, 28, told The Washington Post. "She wrote on Facebook that it was the happiest day of her life."
The day was Oct. 23 of last year — and it was nearly her last.
Glenn, who was 23, had just been moved to hospice care near her Northern Ireland home, in Derry, after a grueling yearlong battle with cervical cancer. Lynch said he had wheeled her around the courtyard and she had been visited by friends. But the day was dwindling, and so was their time together.
Lynch said he tried to help Glenn get up to use the restroom and she collapsed in his arms. He buzzed the nurses who rushed in to take her pulse. "They looked at each other and they looked at me," he said.
Lynch said he grabbed her hand, whispered, "I love you" and held Glenn as she died.
"It was horrific," Lynch said. "It was just horrific."
Since Glenn's death, her family and friends have been working to draw attention to what they call a flaw in the United Kingdom's health-care policy, which they say may have made it more difficult for Glenn to discover her disease in time. The NHS Cervical Screening Programme in England sets the minimum age for pap smears (known as "smear tests" in the United Kingdom) at 25 — three years older than Glenn was when her cervical cancer was diagnosed.
The agency voted to move the minimum age from 20 to 25 in 2003 based on recommendations from an independent advisory committee, which found that because cervical cancer in women younger than 25 is rare, screening them can do more harm than good. Unnecessary procedures can lead to anxiety and other problems, the advisory committee said.
In the United States, pap tests are recommended for women between 21 and 65.
Nearly all cervical cancer cases are caused by human papillomaviruses (HPV), the most common sexually transmitted disease. In most cases, the infections clear up on their own. That's why public health experts in the United Kingdom say there's no point in screening women younger than 25.
Julia Thompson, a senior communications officer with Public Health England, told The Washington Post that abnormalities in women that age "may work themselves out over time" so tests in younger women often cause needless anxiety and procedures that can lead to premature labor later in life.
Cervical cancer in women under 25 does happen. "It's very unfortunate," she said, "but it's rare."
Glenn's family said she had even taken precautions, getting the HPV vaccine to protect against it.
Her relatives and friends now run an awareness campaign called Team Sorcha to draw attention to the need for cervical screening for women ages 18 to 25 — a cause other families across the United Kingdom are also fighting for.
Earlier this year, Glenn's supporters numbered more than 118,000 on a petition intended to persuade the U.K. government and parliament to change its policy position on testing younger women.
"We're not asking for universal smear tests; we're asking that when a young woman under 25 goes to a doctor and requests a smear test, that she not be turned away," Glenn's 58-year-old mother, Christina Glenn, told The Post. "Women are dying every single day, and someone has to listen to us."
Team Sorcha recently released a campaign video chronicling her struggle.
Glenn's nightmare was beginning in summer 2013, her family and friends say. Then 22, Glenn was just settling into her adult life. She had gotten a new job in retail. She and her boyfriend had moved in together. But something wasn't right.
Within a few months, she started suffering severe cramps, abnormal bleeding and back pain. Her mother said she was worried about cervical cancer because both her grandmothers had died from it, though scientists have not discovered any genetic factors that contribute to the disease.
Still, she wanted the test.
She went to a health center near her home, but doctors there refused to do a pap smear because she was too young, citing health-care policy, according to her family and friends. Indeed, pap smears alone cannot diagnose cancer, though such tests can reveal abnormal cell changes on the cervix — a first step in detection.
"She knew it," her boyfriend Lynch said. "She knew her body. She knew before she was told."
Glenn then went to see her general practitioner and pushed again for a smear test, her mother said. The doctor did an exam and suspected Glenn had a cyst, but a biopsy revealed something worse: a tumor.
On Sept. 9, 2013, doctors at a nearby hospital pulled Glenn and Lynch into a private room and asked them to sit down.
"We looked at each other and we knew it was going to be bad news," Lynch said. "They told her, 'You have cervical cancer' and she broke down and cried. She cried for a few seconds and then she asked, 'What's going to happen?' She started asking questions."
Glenn asked for information about further exams and future treatments. She asked how she could beat it. But she never asked what would happen if she couldn't.
"She never really wanted to know," Lynch said.
"It knocked us back a bit. We thought we'd get through it. We thought we were having a rough go of it."
Over the next several months, Glenn went through rounds of chemotherapy and radiation. At her follow-up early the next year, doctors said her lymph nodes were swollen — a sign, her mother said, that the cancer has spreading.
Glenn opted to skip the biopsy and move straight to treatment: a radical hysterectomy to remove her uterus and surrounding tissue. It failed and Glenn's cancer continued to travel, her mother said.
"It just went on and on," Christina Glenn said.
Glenn's lymph nodes continued to swell, putting pressure on her pelvis. She was forced to stop eating solid food and was put on a thick cocktail of painkillers, including morphine. Those around her knew it was the beginning of the end.
In early October last year, doctors told her mother the condition was terminal.
"She never asked them what her life expectancy was. And as a parent, I just couldn't tell her," Christina Glenn said, sobbing. "I don't know. I don't know. I just didn't have the strength.
"How can you go into a hospital room and tell someone they're about to die?"
"There were a few nights she started crying, saying worst thing would be when doctors told her there was nothing more they could do," Lynch added. "She never wanted to know how bad it really was."
So they never said the words.
Glenn was moved to palliative care for one night. She died in late October.
Her mother wants to protect other parents from experiencing that pain.
"I don't want any parent to watch their daughter die as I did from cervical cancer," Christina Glenn said. "You're not supposed to bury your child. I don't want anybody to walk in my shoes and I don't want anybody to walk in Sorcha's."