SEATTLE — By all accounts, Aurlo Bonney should have been the first to die.
Once a formidable middle school principal, he had a series of strokes over the last few years. The last one, in March, stole the 92-year-old’s final vestiges of independence, trapping him in bed and robbing him of his once clear and confident voice. But Virginia, his wife of 65 years, was in relatively good physical health. It was her mind that was losing ground to Alzheimer’s disease. But even as her past and future faded around her, Aurlo remained at the heart of her life, crystal clear.
In hindsight, says their family, it makes sense that on June 11, 2008, when Virginia died, Aurlo was there to watch over her, just as he always had. And, though no one expected it at the time, it also made sense that just eight days after Virginia passed, after Aurlo had laid her to rest and done all the last things he could for her, he also quietly died.
Their obituary in the Seattle Times began, “[They] were inseparable in life. Nor could they be separated by death itself.”
Their death certificates say that Virginia died of a stroke complicated by diabetes and dementia and that Aurlo’s cause of death was atherosclerotic cardiovascular disease and senescence, deterioration due to old age.
But their son Bill Bonney has a different answer as to why Aurlo died: “a broken heart.”
He may be right. Dying beside the love of your life and passing into eternity together is the stuff of legends, but it’s also a documented phenomenon among longtime couples.
Studies around the world have shown that the rate of mortality spikes among bereaved spouses soon after their beloved has died. One study published last year by researchers at the University of Glasgow followed more than 4,000 couples and found that, on average, widows and widowers were at least 30 percent more likely to die of any cause in the first six months following a spouse’s death than those who hadn’t lost a partner. Another large study in Jerusalem found the bereaved spouse's risk of death during those first six months rose by up to 50 percent.
“We see it all the time,” says Dr. Hope Wechkin, the medical director of Evergreen Hospice in Kirkland, Wash. “Often a patient will come on to [hospice] service and we find out their spouse has died six weeks earlier or so. … I think it’s about connection. For many people, their spouse represents their greatest sense of connection to this world.”
After six decades together, being apart even briefly was agonizing for Aurlo and Virginia, their friends and family say. A year before Aurlo’s last stroke, Virginia suffered one as well, causing her to have to leave their apartment and move downstairs to the health center at Hearthstone, a retirement center in Seattle where the couple lived for nine years. While she recovered physically, her dementia progressed, keeping her from being able to move back. So, each morning, Aurlo took the elevator three floors down to bring her home until nightfall came and he was forced to return her.
Sometimes, the nurses would look the other way when he’d slip her out her for a drive to the drugstore or out to eat, anywhere they could pretend their lives were normal again. All the while, he tirelessly — and futilely — lobbied to have her move back home with him until he had his stroke and was moved into the bed next to her in the health center.
Don't miss these Health stories
More women opting for preventive mastectomy - but should they be?
Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring.
- Larry Page's damaged vocal cords: Treatment comes with trade-offs
- Report questioning salt guidelines riles heart experts
- CDC: 2012 was deadliest year for West Nile in US
- What stresses moms most? Themselves, survey says
- More women opting for preventive mastectomy - but should they be?
Two hearts beating as one
Some theorize the toll of grief can be too much for those who are already aged and physically fragile. The more spiritually minded believe that the bond between some couples may be so strong that when one soul departs, the other chooses to follow.
Others say there are medical causes at work. The No. 1 cause of death of a bereaved spouse is heart disease and sudden death, meaning the heart stops, says Dr. Lee Lipsenthal, an internist and expert in cardiac rehabilitation who founded Finding Balance in a Medical Life, a Marin County, Calif., organization that focuses on physician well-being.
"Generally within 18 months is the risk period," says Lipsenthal, "It's relatively close to the death and it diminishes over time."
Those who are elderly and physically fragile are more likely to die after the death of a spouse than a younger widow or widower, says Wechkin, whose own grandparents died less than two weeks apart.
“The death of a spouse places you at risk … but context matters a lot,” she says. “If you’re perfectly healthy, your risk is very low.”
Doctors have long known that stress hormones such as cortisol, epinephrine and norepinephrine that are raised by grief can take a damaging toll on the body.
But there may be other forces at play as well. Research shows that in some cases, one person’s heartbeat can affect, even regulate, another’s, possibly acting as a type of life support.
In one such study, Rollin McCraty, research director at the Institute of HeartMath in Boulder Creek, Calif., looked at what happened to six longtime couples' hearts while they slept. Heart-rate monitors revealed that during the night, as the couple slept beside each other, their heart rhythms fell into sync, rising and falling at the same time. When the printouts of their EKGs were placed on top of each other, they looked virtually the same.
“When people are in a relationship for 20, 30, 40, 50 years, they create sort of a co-energetic resonance with each other,” says Lipsenthal, who is the past director of Dr. Dean Ornish’s Preventative Medicine Research Institute in Sausalito, Calif. “A simple analogy is two tuning forks, put next to each other. They create a co-resonant pitch. What happens when two people sleep together for 50 years? What happens when one goes away?”
In recent years, another condition has come to light: Takotsubo cardiomyopathy, also known as “broken heart syndrome.”
The condition nearly always follows a traumatic emotional loss, such as death of a spouse, parent or child and it primarily affects women. It causes chest pain and sudden heart failure, believed to be brought on by a surge of fight or flight hormones, says Dr. Barbara Messinger-Rapport, a geriatrician at the Cleveland Clinic in Ohio. Patients with the condition tend to recover faster than most other heart patients, says Messinger-Rapport. And if they survive the initial bout, it almost never recurs.
“Is it possible to die of a broken heart?” says Wechkin. “Absolutely.”
Boxes of memories
Back when Aurlo met Virginia Coombs, he had to work to woo her.
Her little sister was in the English class he taught and her mother was the president of the Parent Teacher Association, giving him plenty of excuses to call or stop by their home.
“He went over to the house for any reason he could think of,” says their son Bill Bonney.
After four years, Aurlo persuaded Virginia to start dating him — and she soon fell head over heels. They married in the midst of World War II, right after he’d been sent to the East Coast for training before going overseas. Immediately after he left Seattle, he realized he couldn’t stand to be away from her and proposed over the phone.
She took a train across the country to join him and they were married on July 3, 1942, at Fort Monmouth, N.J. At 9:30 the next night they sent a Western Union Telegram to her mother that said, “Celebrating our first anniversary of twenty four hours all went well … Virginia and Aurlo.”
The telegram is now faded, but still crisp, a relic the couple carefully saved for six decades. It’s in a box of papers now that Bill Bonney and his wife, Kathleen, inherited after his parents died, along with a stack of photo albums documenting nearly every aspect of their life together.
“It was nearly impossible to find a photo of one without the other,” says their granddaughter Tara Coffland, now 26.
In the last year or so of Virginia’s life, one thing their friends and family remember clearly is how unmoored she was if her husband wasn’t with her. “She’d say ‘Where’s Aurlo? Where’s Aurlo?’” says Donna Leggett, activities director at the Hearthstone and a longtime friend of the couple. “Sometimes if he couldn’t be there, we’d talk about him and then she’d feel better. There really wasn’t very much time she was awake that he wasn’t there.”
Just as it seemed impossible for Virginia and Aurlo to think of being apart, no one else could imagine it either. Kathleen remembers her daughter Shanley telling her in early June, “My wish is that they die the same day.”
'He always looked out for her'
Don and Margaret Irwin, who were married in 1951, became fast friends with Aurlo and Virginia Bonney when they moved to the Hearthstone. The four made a point of eating together each day in the dining room.
“Their relationship was remarkably close,” Don remembers. “He always looked out for her and they worked well together.”
While the Irwins say they understand how Aurlo and Virginia might not have wanted to live without the other, that’s not the case for them, they say. “We’ve got lots of interests,” says Margaret. “If I go, he’ll keep himself busy with all of his interests.”
That independence may be a key difference in whether a widow or widower thrives after their partner has died, says James Ellor, director of the Center for Gerontological Studies at Baylor University’s School of Social Work.
He says longtime couples tend to fall into one of several groups: Those who’ve been together decades but may not really have deep emotional roots with each other; those who are close but are still able to find purpose without the other, although they grieve deeply; and lastly, couples who feel they can’t find hope without the other.
The last group is where you see one mate dying soon after the other, he says.
“Viktor Frankl called this the will to meaning,” Ellor notes, referring to the psychiatrist and Holocaust survivor. “Human beings, according to Frankl, need to find meaning in their life. When they can absolutely find no meaning there, they are capable of giving up and dying regardless of their medical status.”
Ellor, who knew Frankl, said the doctor recounted that when he was a prisoner in Auschwitz he sometimes witnessed another prisoner finding out that everyone they loved had been killed. “At that point you can count on them dying,” Ellor said. “They would simply sit down in a corner and not move.”
Conversely, one of the greatest hopes may be the dream of never being separated from your love by that gaping divide of death.
‘I think he was lost’
On June 11, Tara Coffland went to visit her grandparents and found Virginia in a deep sleep and breathing irregularly.
As the day wore on, it became clear Virginia was dying. Her children and grandchildren gathered around her bed and told stories as Aurlo listened and laughed. They pushed the couple’s beds together so that Aurlo could hold his wife’s hand one last time, rub her arm and whisper his love to her.
As the day wore down, Virginia’s breathing continued to slow and then, at last, stopped. Not sure if Aurlo was aware that she was gone, their daughter-in-law Kathleen told him, “Aurlo, Virginia just died.”
“He started crying and I told him they were a great example to all of us,” she remembers. “It was amazing to see that kind of love.”
In the days after Virginia died, Aurlo declined quickly, seeming more confused and withdrawn.
“He didn’t look like he wanted to be here,” says Leggett, the activities director at the Hearthstone. “I didn’t see any joy, humor, a desire to even eat. I think he was lost.”
During Virginia’s memorial service, Kathleen sat next to him as he sobbed and wiped the tears that flowed down his cheeks.
Two days later, as he sat in his bed in the room he and Virginia had shared, Aurlo slipped away.
Losing both parents so close together was devastating, says Bill. But he couldn’t imagine it any other way.
"Their loved ones are grieved by their deaths," their family wrote in the couple's obituary a week later, "but no one would have wanted them apart from each other, in this life or the next."
Freelance writer Debbie Cafazzo contributed to this article.
© 2013 msnbc.com Reprints