One of my favorite goals of Sukkot is this: That as we dwell for seven days in a temporary, fragile booth, we realize during that process that we are always living in a temporary, fragile booth, even when we move back inside our sturdy home (assuming we are lucky enough to have one).

We are supposed to learn that the strength and resilience of our home has nothing to do with the building materials but everything to do with our permeability, our connections to other people and to the world.

This Sukkot, a very old patient of mine — she has lived for almost a century — took a turn for the worse. She has heart failure but has been quite stable for a long time, still able to garden and go out to lunch and celebrate her family’s simchas. I know that she feels her mortality because we talk about it sometimes, and because she has been going through her belongings this year. Most of our visits are now spent with her showing me photographs of herself from decades ago; as a teacher, a young bride, a scarcely older widow, as a mother and grandmother.

When the heart fails, the blood that is meant for the rest of the body fills the lungs instead. This is what is happening to her now. The delicate balance we have somehow maintained for her between too much fluid and too little has finally been lost, and she is sliding into a flood of her own making, as inexorable in its way as the tsunami or the hurricanes. She goes outside, over and over, in a piteous effort to get air, and the home she has lived in for half of her life is no longer a shelter to her, and no longer provides her with what she needs.

So her daughter and I have arranged for hospice care, with oxygen at the bedside and lots of medicine available to deal quickly — if not definitively — with her shortness of breath, so that maybe she won’t have to resort to the hospital, a place she dreads. As I sat with her and her daughter (and having just finished building our family sukkah) I thought first that we are building a sort of sukkah for her — a temporary, fragile booth of a different sort, made up of love and oxygen and ruby-red bottles of morphine.

But then I had a different thought. I looked at her and how she has changed over the past few years, how she has lost height and weight, how she looks hollow when she walks, as if her limbs are full of the air her lungs lack. One eye is uselessly opaque and her voice is thin and dry. She seems almost transparent in places. But she has not lost one iota of her presence; the room fills with it.

And I felt like I understood, suddenly, that she is the sukkah, and that we are those she has invited to dwell in it, for seven sweet days. The night sky with its stars shines through her skin; I can see, all too clearly, the darkness and light beyond. All the walls of her body are being breached, the levees between her heart and lungs are just too old and the water overwhelms them. She is all too permeable.

We keep her company, and we make small repairs every day (as I have to do, as well, for our family sukkah), but we have no illusions that we are building a permanent home.

In the end, it is a comfort to me to think that she, too, is a temporary dweller in this sukkah, and that her true self is like the wind that stirs the thin walls, comes inside for a moment and then is gone again, to rejoin the larger breath of the world.

Antoinette Rose is a physician at Camino Medical Group. She lives in Palo Alto.