In Tull, Sylvia was impregnated by the Man in Black and was led to believe that her unborn child was that of the Crimson King himself. Roland performed an abortion on the demon-child (though the precise details of the act are left somewhat to the imagination, but it is implied Roland presses his gun into her vaginal tract) and Pittston, out of vengeance, provoked the entire population of the town to attack Roland in an attempt to kill him in The Battle of Tull. She was shot to death in the resulting battle.
Coral remembers Sylvia's visit to Hambry years ago.
She sounded so much like the wandering preacher-woman that had come through town the year before—Pittston, her name had been, Sylvia Pittston—that she laughed again, this time almost naturally.
- Part 3 / Chapter III: Playing Castles