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Three months after Hemingway was released from Mayo Clinic, back in Ketchum, in April 1961, one morning in the kitchen Mary "found Hemingway holding a shotgun". She called Saviers who sedated him and admitted him to the Sun Valley hospital; from there he was returned to the Mayo Clinic for more electro shock treatments. He was released in late June, and arrived home in Ketchum on June 30. Two days later, in the early morning hours of July 2, 1961, Hemingway "quite deliberately" shot himself with his favorite shotgun. He had unlocked the basement storeroom where his guns were kept, gone upstairs to the front entrance foyer of their Ketchum home, and according to Mellow, with the "double-barreled shotgun that he had used so often it might have been a friend", he shot himself. Mary called the Sun Valley Hospital, and a doctor quickly arrived at the house. Despite his finding that Hemingway "had died of a self-inflicted wound to the head", the initial story told to the press was that the death had been "accidental".

During his final years, Hemingway's behavior had been similar to his father's before he killed himself; his father may have had the genetic disease hemochromatosis, in which the inability to metabolize iron culminates in mental and physical deterioration. Medical records made available in 1991 confirm that Hemingway had been diagnosed with hemochromatosis in early 1961. His sister Ursula and his brother Leicester also killed themselves. Added to Hemingway's physical ailments was the fact that he had been a heavy drinker for most of his life.

Family and friends flew to Ketchum for the funeral, officiated by the local Catholic priest who believed Hemingway's death accidental. Of the funeral (during which an altar boy fainted at the head of the casket), Hemingway's brother Leicester wrote: "It seemed to me Ernest would have approved of it all." He is buried at Ketchum Cemetery.

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