Holly had died slowly, excruciatingly. It was not expected, but she didn't have a lot of people left at that point, particularly not ones who wanted to watch her die.
She'd spent weeks in a hospital knowing that she was dying. In some ways, those were the most lucid weeks of her last few years. The solid, unmovable fact that she was going to die kept things clear. It allowed her to discount everything said by those who did not acknowledge it, and it allowed her to think. She had felt it walk towards her—she liked to think of it like an army, or a tank, or a river, in that it moved at a pace that wasn't affected much by skittering nurses or the few actions she had left—well into the last hour.
It was the second death that changed her. Eliza's had left her lost and looking for a way to explain or understand or undo, but her own made perfect sense.
This is all to say: when Holly woke up in a half-dark room, alone in her own bed, listening to the soft buzz of a city, she was quite surprised.