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Monday, July 30, 2007

A Visit from Oscar Means That the Grim Reaper Cannot Be Far Behind for the Terminally Ill at a Rhode Island Nursing Home

Oscar Sitting on a Bed
"What is the cat doing here?" a young boy asked his mother.
"He is here to help grandma get to heaven," she replied.
-- David M. Dosa, "A Day in the Life of Oscar the Cat."

The scientific community is in a tizzy following last week's publication in The New England Journal of Medicine of an article about a two-year-old gray and white cat named Oscar who is able to more accurately predict when a patient is about to die than attending physicians and nurses.

In an article entitled "A Day in the Life of Oscar the Cat," Dr. David Dosa of Brown University details how Oscar has correctly predicted the deaths of twenty-five terminally ill mental patients at the Safe Haven Advanced Care Unit of the world-renown Steere House Nursing and Rehabilitation Center in Providence, Rhode Island. When patients only have a couple of hours left to live, Oscar enters their room, hops in bed with them, snuggles up, and begins to purr. As soon as the patient dies, he gets up and makes his exit.

Perhaps just as telling, he has never shown much interest in patients who are either merely sick or dying but yet have a few days of life left in them. "This is a cat that knows death. His instincts that a patient is to die are often more acute than the instincts of medical professionals," Dosa told The Boston Globe on July 26th. (See "With a Purr, Death Comes on Little Cat Feet.")

"We've come to recognize him hopping on the bed as one indicator the end is very near," nurse Mary Miranda told The Globe. "Oscar's been consistently right."

"Caregivers are always there trying to make the patient comfortable until the very end," Pamela Toll, also a nurse, told The Globe. "But Oscar's a component of dying...It's kind of weird, but kind of lovely. He's become part of the death ritual, along with lowered lights, aromatherapy, and gentle music."

Oscar Making His Rounds

Oscar's prescience has two obvious benefits. It first of all allows the staff time to notify loved ones so that they can be with the patient at the end. Secondly, Oscar provides companionship for those without family and friends.

As any visitor to a nursing home or reader of Nicholas Sparks' The Notebook knows, these types of facilities can be enormously depressing for all concerned. It is therefore not surprising that Oscar's presence is much appreciated by most family members even though it is debatable just how many of the mentally-deranged patients are even aware of his presence.

"The staff was wonderful. But Oscar brought a special serenity to the room," Jack McCullough of East Providence, whose mother and aunt died at Steere, told The Globe. "What's more peaceful than a purring cat? What sound more beautiful to fill one's ears when leaving this life?"

Barbara L. Diamond would no doubt concur. "If there were to be a universal sound depicting peace, I would surely vote for the purr."

In his journal article, Dr. Dosa relates the poignant story of the death of a Mrs. K. "What is the cat doing here?" a young boy asked his mother after observing Oscar on top of his grandmother's bed. "He is here to help grandma get to heaven," she replied. Half an hour later, the woman died and Oscar quietly hopped down from the bed and unobtrusively left the room.

For his invaluable service to humanity, Oscar has been rewarded with a plaque from a local hospice. It hangs in the third floor corridor that he patrols and reads in part: "For his compassionate hospice care, this plaque is awarded to Oscar the Cat."

Once in a while, however, a family will resent his presence and the staff has to forcibly remove him from the room. On these occasions, Oscar remains outside the door yowling in protest and futilely pawing the woodwork, Clearly, he feels that it is his duty to help the dying cross over to the other side.

Oscar Waiting Outside a Patient's Room

Oscar's uncanny ability to predict the Grim Reaper's arrival has, as it would be expected, generated all sorts of palaver from those within and without the scientific community. The simplest and, consequently, most unscientific explanation is that cats are psychic. As Jules Verne once put it, "I believe cats to be spirits come to earth. A cat, I am sure, could walk on a cloud without coming through."

Another possible explanation is that Oscar's highly-developed sense of smell is capable of detecting subtle metabolic changes in the terminally ill that presage death. In other words, death has a distinct aroma that eludes man but not cats.

Dr. Joan M. Teno, also of Brown, theorizes that Oscar may simply be mimicking the behavior of the staff. "Oscar is a normal cat with an extra-normal sense of death. He is drawn to death," she told The Globe. "Either he wants to give comfort. Or he is just attracted to all the quiet activity that surrounds a patient close to dying." (Her interview with the CBC's As It Happens on July 26, 2007 entitled "Oscar the Cat" can be heard at www.cbc.ca/aih.)

Although he concedes that cats give every bit as much affection as they take, Dr. Nicholas H. Dodman, a veterinarian at Tufts and a frequent contributor to Pet Place, feels that Oscar could be attracted to the warm blankets, dim lights, aromatherapy, and soft music that the staff provides for its dying patients.

Teno's mimicry theory can be disposed of right away because cats are loners. Besides, Oscar is known to go about his work in a businesslike manner.

Oscar in a Contemplative Mood

"This is not a cat that's friendly to people," Dosa told The Guardian on July 26th. (See "The Nursing Home Cat That 'Predicts' Death.") Dodson's explanation likewise can be dismissed for many of the same reasons.

That cats can smell and anticipate death is not surprising. Knowing that the end is near, many of them have been observed wandering off to die alone. Other animals, such as deer, have been known to anticipate the deaths of other animals, such as cats. (See Cat Defender post of January 16, 2007 entitled "Dying of Kidney Failure, Nine-Year-Old Cat Named Sammy Is Shown Compassion by an Unexpected Friend.")

Because of their acute senses, animals are aware of a world of sights, sounds, smells, and other phenomena that totally elude man. Recent research has also demonstrated that some animals possess sophisticated language skills, self-awareness, and that they mourn the deaths of family members and friends.

All of these attributes, once foolishly thought to be the sole prerogatives of man, prove that animals are much more like humans than many people are willing to admit. Moreover, the fact that Oscar and, undoubtedly, other animals are able to predict death demonstrates that in certain important aspects they are actually superior to man. All of which is just one more reason that man should stop killing and abusing all animals.

Founded in 1874, Steere House is home to one-hundred-twenty patients. The floor on which Oscar works houses forty-one patients who are suffering from Alzheimer's, Parkinson's, strokes, and other mental disorders. In addition to Oscar, the facility has five other cats, a rabbit, and an unspecified number of parakeets.

Oscar was adopted in 2005 along with another cat named Mayer (as in Oscar Mayer) in order to replace a cat named Henry who had died earlier. Without any prodding from the staff, he began his death vigils about six months after his arrival.

It would be interesting to know if any of the other cats that have resided at Steere ever exhibited any interest in the deaths of the inmates. Since, however, both The Globe and The New England Journal of Medicine are silent on this vitally important point, it is probably safe to conclude that Oscar's perplexing behavior has not been replicated before at Steere.

Oscar Rests on a Chair

If that is indeed the case, then it must be asked what makes Oscar unique? Or, in other words, what percentage of cats are psychic? There can be no doubt, however, that Oscar's prescience is going to spark extensive research into animal behavior and death.

His extraordinary behavior should not, however, be used as an excuse for ailurophobes to label all cats as being the familiars of the Grim Reaper. This could lead to similar types of abuse as those which accompanied the Roman Catholic Church's grotesque slander of the species as being the familiars of witches.

When he is not giving succor to the dying, Oscar, like all cats, spends a disproportionate amount of his time napping. The linen closet, the desk at the nurses' station, and on top of stacks of medical records are reported to be three of his favorite spots for snoozing.

Although he is dead serious about his work, the nurses and physicians at Steere insist that he can be gregarious and even clownish when he is off duty.

Photos: Dina Rudick of The Boston Globe (Oscar on bed and chair) and Stew Milne of the Associated Press (Oscar in corridor, outside door, and up close).