Arjun Sharma , 2025-05-13 19:43:00
Earlier this spring, Pope Francis was hospitalized for more than five weeks. A pneumonia riddled both of his lungs, and his doctors thought he was in imminent danger of death.
But he recovered enough to return to the Vatican and appear for one last Easter Sunday Mass before his death the following day from complications related to a stroke. It made me wonder: In its twilight, can the human body hold on long enough to let the person make it to one final moment or action?
As a physician, I often ask myself: What compels a will to survive? Some of my patients who persist on medical wards and intensive care units do so long past when I expected them to die. Famously, so did Jimmy Carter. After entering hospice in 2023, he purposed to live long enough to cast one final voting ballot, which he did, before dying a centenarian this past December. The thought occurred to me, too, after hearing the news of the mother of Derrick Harmon, an offensive lineman drafted by the Pittsburgh Steelers. Ailing on life support, she died only shortly after he told her that he had realized his intention of becoming a professional football player.
The choice — or the ability to choose — to delay one’s death serves as a powerful anecdote. Surely, all of us can recall the story of a friend or relative who outlived the expectations others pressed upon them. Researchers have tried to prove this empirically. In the late ’80s, a pair of sociologists from the University of California observed a depression in deaths in the week before the Passover holiday, followed by a resultant increase in the week afterward among a Jewish diaspora. Likewise, in the ’90s, this dip-peak effect in dying was noticed in a group of Chinese women who celebrated the Harvest Moon Festival, a cultural event centered around the matriarch that gathered family and emphasized togetherness. Neither holiday happens on a fixed date, so the effect could be separated from undue influences caused by seasonal or monthly mortality patterns. Those who conducted the studies also found no comparable outcome in other ethnic groups.
As a result, they reasoned that a person could postpone their death for the sake of living through — for what was to her — one more significant occasion.
But what we understand about this phenomenon is, in fact, far from settled. Some have questioned the methodologies of these studies. A larger analysis, published later, appeared to refute this concept altogether. Reviewing the deaths of more than 300,000 Ohioans who succumbed to their cancer, researchers found no relation in when they died to the time before or after the celebrations of Christmas, Thanksgiving or a birthday. That “death takes a holiday,” they believed, was not a matter of choice.
And yet there are those who argue the contrary. Yes, a life can be prolonged by modern inventions that support its vital functions. But it is our individual motivations that allow us to live.
In no setting, perhaps, is this more evident than in a hospital. There, the stretches of borrowed time are laid their most plain and bare. After I pore over a screen of lab values and vital signs bolded and in red — aberrations from faltering organs — and amid tangles of tubes and the whir of life-sustaining machines, before their illness comes to claim them, a patient may express a circumstance they hope will come to pass.
Desires of all sorts take form: the arrival of a far-off loved one, the birth of a grandchild, even a big baseball game. As a medical student, I found myself at the bedside of an older man with cancer who held the hand of his partner of many years. They were to wed at their lake house before friends and family. But his condition turned, worsening so considerably in the weeks before that he needed to be admitted to our hospital. As time went by, and his lungs filled intractably with more fluid, he knew he might never leave. Still, he wanted to keep the date. That day, the hospital’s chaplain was summoned. And along with a few people close to them, the staff on the ward attended. All of us crowded into their small room to witness the makeshift ceremony. It was the only time I’ve ever seen attending physicians, usually stoic people, steeled by a lifetime of medical practice, moved to tears.
Physicians tend to dismiss these moments of life hanging on without medical reason. In part, that’s because they present an unusual paradox: for they are precisely when most of what we have come to know and learn about medicine becomes least of use. Our toolbox is empty. And so, we lean into a form of healing outside the bounds of our understanding. A way that is not supported by the conclusions of randomized-controlled trials or the edicts of clinical guidelines or that comes wrapped in the casing of a pill or passed down in the murmurings from senior colleagues.
While we bring patients into our thought processes to see the merit of our judgments, here, we are asked to do the opposite. We don’t always agree with our patients’ convictions and know that an overemphasis on them can slip, potentially, into a variant of distrust and skepticism of proven therapies.
But the belief that people can stave off their demise to allow one last thing to materialize holds an undeniable value. And whether this is true or not, in certain instances, above our tangible provisions and against our interpretation of facts, belief is what our patients need.
Where the battle for more time is won, where a body breaks the limits of its biology — it helps place the context of death in a light we struggle to see. Even in dying, there still remains a little bit of this fleeting, mysterious, and beautiful thing left to live.
Arjun Sharma is an infectious diseases physician in Toronto.