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arjorie Severance had lived 91 years, five months, and two weeks when, if you believe such things, she decided she could let herself die.

She had completed all of her funeral and memorial service plans. Her finances were set. “Gramma Marj,” as she was known to her many grandchildren and great-grandchildren, spent the last weeks of her life sprucing up her jewelry collection and choosing beneficiaries.

Her granddaughter, Jan Schultz, who was helping with the jewelry, was dragging her feet getting the two last rings fixed.

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“I had a feeling that as soon as this was done, she’d be done,” Schultz recalled.

When a great-grandson visited her for supper at her assisted-living facility in Madison, Wis., earlier this month, Gramma Marj ushered him out early. The family laughed about it, but the next day she barely woke.

Schultz called Gramma Marj’s son in Texas and told him to get there fast. Then she told her grandmother that her son was on his way and would arrive the following day. Gramma Marj’s eyes stayed closed; she was alive but largely unresponsive.

The next day, her son arrived. She opened her eyes for him. And then, not long after, in the solitude of her room, Marjorie Severance passed away.

The question of whether Severance somehow prolonged her life will forever remain a mystery. But it is hardly a mystery that stands on its own.

Hospice and palliative care clinicians routinely see cases in which people who are nearing life’s end seem to will themselves to hold on until a certain point, after which time they let go.

And while some people hold on long enough to see a loved one, others seem to do the opposite, clinging to life until they are left alone.

Dr. Toby Campbell, an oncologist and palliative care specialist at the University of Wisconsin, Madison, said patients tend not to have a lot of control at the very end of their lives. But that doesn’t mean they don’t have any.

“People in end-of-life care wouldn’t bat an eye if you asked if they think people can, to a certain degree, control those final moments,” Campbell said. “We’d all say, ‘Well, yeah. Sure.’ But it’s inexplicable.”

If these well-timed deaths are anything but coincidental, medical scientists appear unlikely to be able to provide an explanation anytime soon. A body of scientific literature called “the will to live near death” explores questions at the fringe of this topic, but the research focuses more squarely on how one’s will to live might affect life expectancy.

When it comes to extending one’s life by hours, seemingly through sheer will, Campbell believes the dying “probably have some kind of hormonal stimulus that’s just a driver to keep them going. Then, when whatever event they were waiting for happens, the stimulus goes away, and there must be some kind of relaxing into it that then allows them to die.”

In one memorable experience, Campbell recalled three sisters who had gathered in the hospital room of their elderly mother after she’d suffered a stroke. One sister lived nearby and the others joined from out of town, holding vigil for several days.

The mother was unresponsive, and though her prognosis was grim, she wasn’t actively dying. “They were having really a lovely time bonding together, but then life was kind of moving on and in truth they were ready for mom to die,” Campbell said.

One morning, he told them that their mother might actually want to die — but not with them present. Some people deem the dying process too personal to share, while others don’t want to expose family members to the trauma of watching them go.

The sisters, Campbell said, ” immediately grabbed onto the idea, and right then, they said, ‘Mom, we’re going out for breakfast. We’ll be gone for two or three hours, and then we’re going to come back and see you. So if you need to be alone to do this, now’s a good time.’”

Campbell left the room. The sisters left soon after. Their mother died while they were gone.

“They were sad, of course,” he said. “But they felt like they had done right by her.”

Jan Schultz felt that way too. Her grandmother had worked her way from bank teller to vice president over a 40-year career in finance. She was a proud matriarch, both loving and deeply beloved. Schultz said it would have been out of character for Gramma Marj to die before her son arrived, and it would have been equally out of character for her to burden him or anyone else with the sight of her death.

So in retrospect, it was little surprise that when Gramma Marj’s son arrived, her condition noticeably changed.

“I could almost see a sense of calmness over her when he arrived,” Schultz said.

Gramma Marj opened her eyes for him. She heard him leave. And then, after he was gone, her heart went quiet.

 

An earlier version of this story incorrectly identified “Nana” as the nickname by which Marjorie Severance was known to her grandchildren and great-grandchildren.

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