I choose not to respond to either of the writing prompts but to post my reaction to the story.
Firstly, the opening hook is extremely compelling as noted--but the ending surpasses it.
The short story is a challenging format that denies its writer a lot of the "luxuries" afforded to the novelist. For example, the luxury of taking paragraphs, chapters and subplots to develop and stretch the characters, as well as the imagination of the readers. A short story has to make those characters something like an anomaly image on a radar screen. Its effect on the reader's consciousness is not fully identifiable, but it is formidable enough to be consciously noted. M. Elaine Moore has mastered this technique in this story.
And there is a foreshadowing of the ending within the text (no spoiler; just hear me out...) which does exactly what a well-written foreshadow is supposed to do: be a mind-grenade that detonates after the explosion of the ending, thereby guaranteeing the mind of the reader is thoroughly blown.
This story does one other thing which is probably specific to my reaction. Even though the narrative's tenor bounces from bright to foreboding (due to subject matter) and then back again, I found the reading to be a gently comforting experience. Let me explain.
I am in my mid-60s (yeah, yeah, I know: "ok, Boomer...") and at this point in my life, the possibility of stepping through this final threshold looms larger and more feasible than at any other time I can recall. . . except when I was in a serious auto accident. In some unexplainable, esoteric yet soothing way, this story was reassuring to me. For M. Elaine Moore to achieve that, no matter how personal, is an accomplishment so rare I felt it should be noted.
The ending was totally unexpected--but in my experience of the piece: perfect. I am left wanting to read more from M. Elaine Moore. Two thumbs up.