BioEd Online

A widespread belief that dying people are able to postpone death until after important dates is simply not true, according to a US study of cancer patients.

Almost everyone knows a story of someone who, through sheer willpower, held grimly on to life until a certain date. And small studies of specific populations seemed to bear the idea out.

But when Donn Young, a cancer researcher at Ohio State University in Columbus took a call just before Christmas last year from a reporter writing a story about cancer patients "defying science", he wasn't convinced.

So he embarked on a study of more than 300,000 Ohioans who died of cancer between 1989 and 2000, using the Ohio mortality database. Using Christmas, Thanksgiving, and the patient's birthday as the three "special dates", Young looked for a dip in deaths the week before, with a corresponding peak in the week after.

He reports in the Journal of the American Medical Association that he didn't see any effect at all¹. "Death never takes a holiday," he says.

Young speculates that the myth springs from selective memory. Stories about loved ones who "held on" until after the holidays are more memorable than those about the uncle who slipped away in mid-November.

The findings may disillusion some, but that's not how Young sees it. "People have said, 'isn't this kind of a Grinch study?'" he says, "but that's not the message I take. People feel pressured to make it to Christmas, and this says that untimely death is not a failure of self-discipline. Death keeps to its own schedule and doesn't show up on your Palm Pilot or Day-Timer."

Strange effect

Young's study does not rule out the possibility that a very few individuals are able, by some unexplained process, to postpone death until it is convenient. But for them not to show up in his study, they would have to make up less than 1% of the deaths, he says.

David Phillips, a sociologist at the University of California, San Diego, who has reported death postponement in specific populations², says that that figure could be about right. He also says that cancer patients are not the best place to look for this strange effect. He says he has seen it most often when looking at those with chronic heart conditions.

Phillips understands Young's scepticism. "Unless you can think of a plausible mechanism it's much harder to believe in a phenomenon. The next step would be to find a biomedical mechanism."

Young says he chose cancer because, unlike cardiac deaths, the rate is generally flat throughout the year. Heart attacks tend to peak in the winter, for reasons no one really understands. However, he says that a quick re-run of his data for chronic cardiac partients doesn't show any postponement pattern either.

If the holidays have any effect on mortality at all, it is on those who die suddenly, with little time to hold on or let go. More people die abruptly of a heart attack on Christmas than on any other day, according to a recent study by Phillips and colleagues in Circulation³.

But the culprit is not the stress of too much revelry, the authors guess. Rather it is that people delay going to the doctor because they don't want to break the holiday mood.