Two years ago this week, Angelo Merendino’s wife Jennifer died, at age 40, of breast cancer. Merendino, a photographer, documented her journey with the disease, through to the last days of her life, with his camera—not because he had explicit goals about art, or even because he wanted to spark conversation. He was in New York, taking care of his wife; their family was in Ohio. Merendino and his wife wanted them to better understand what was really going on. “We had no intention of showing them to anyone else,” he said.

But last year, Merendino’s pictures went viral. The work appeared on the websites of CNN, BuzzFeed, The Guardian, The Huffington Post and The New Yorker. Merendino was invited to give a talk at a TedX event in Utah; just last week, three of his photos of Jennifer were added to the permanent collection of the Akron Art Museum.

None of this, he says, is what he expected. And none of it was the point. “I wasn’t thinking, like…’You need an establishing shot,’ or ‘You need a closing shot.’ I wasn’t thinking about making a body of work. I was taking care of my wife,” he said, “and the camera was definitely a shield for me. It was an escape.”

To view them, of course, is to do anything but escape. These photographs use a very different vocabulary than popular cancer narratives, couched in what one woman with terminal breast cancer described as “the pink culture that prettifies cancer.” Merendino’s photographs are intense, not just because they expose us to realities of death we generally don’t see in the movies, but because the emotional bond between Jennifer and the man behind the lens is so very palpable. To view these pictures is to step directly into the intimacy of strangers.

This dissolution of boundaries can feel a bit uncomfortable. The photos push in other ways, of course, with their literal story, and watching a woman die is a bit too much for some—especially American—viewers. One cancer support center, in Cleveland, OH, removed an exhibit of his pictures after multiple patient requests. Merendino feels the discomfort in the media, as well. “My photographs have been published in magazines in Canada, Mexico, Japan, Germany, China, England, France, Italy—all over the world. But there hasn’t been a magazine in the States that has published these photographs,” he says. A Japanese magazine explicitly asked Merendino to describe his wife’s last day, something the pictures obviously infer but viewers rarely discuss directly.

“Jennifer’s last day was intense; she didn’t peacefully say, ‘I love you,’ and take her last breath and fade off into the twilight and die. It wasn’t that at all,” he says.

The closeted nature of death in America is something Merendino hopes the photos might change. “I understand that it’s difficult to talk about these things, and I’m not suggesting that every dinner conversation should be about death. On the flip side, it’s something we can’t avoid - we are all going to die - and… if we talk about these things, then we know a little more.”

Merendino’s work has also been criticized by those concerned about exploitation. One writer called the work “death porn,” arguing, “Should I die of a disease, I wouldn’t want to be photographed while dying or have those images tossed into the internet’s maw.”

But Jennifer, it seems, did. “I don’t think these photographs would have been the same if Jen hadn’t been open to it,” Merendino said. “When I look at these photographs, the trust is different from any other photographs I’ve ever made or probably ever will make. When I made portraits of Jen, the way she was looking at the camera is just different. I think she was giving this to me; she knew I wasn’t going to make inappropriate photographs—she trusted me—and that’s had a really heavy effect on me as I get back into making photographs.”

Jina Moore was a 2013 New Media Fellow of the International Reporting Project