Oscar (therapy cat)

Oscar (born 2005) is a therapy cat living in the Steere House Nursing and Rehabilitation Center, Rhode Island, United States. He came to public attention in July 2007 when he was featured in an article by David Dosa, a geriatrician and assistant professor at Brown University, in the New England Journal of Medicine. According to Dosa, Oscar appears able to predict the impending death of terminally ill patients. Explanations for this ability include the lack of movement in such patients, or that the cat can smell ketones, the biochemicals released by dying cells.^[1]

Oscar became the subject of a book by Dosa in 2010, Making Rounds With Oscar: The Extraordinary Gift of an Ordinary Cat.^[2]

Background

Oscar was adopted as a kitten from an animal shelter and grew up in the third-floor end-stage dementia unit at Steere House Nursing and Rehabilitation Center in Providence, Rhode Island. The 41-bed unit treats people with Alzheimer's, Parkinson's disease and other illnesses, most of whom are in the end stage of life and are generally unaware of their surroundings.

Oscar was one of six cats adopted by Steere House, which bills itself as a "pet friendly" facility (a variety of pets visit and reside at the facility)^[3], after the death of Steere House's original therapy pet Henry (named for benefactor Henry J. Steere).

Death prediction

After about six months, the staff noticed that Oscar, just like the doctors and nurses, would make his own rounds. Oscar would sniff and observe patients, then curl up to sleep with certain ones. The patients he would sleep with often died within several hours of his arrival. One of the first cases involved a patient who had a blood clot in her leg that was ice cold at the time. Oscar wrapped his body around her leg and stayed until the woman died.^[4] In another instance, the doctor had made a determination of impending death based on the patient's condition, while Oscar simply walked away, causing the doctor to believe that Oscar's streak (12 at the time) had ended. However, it would be later discovered that the doctor's prognosis was simply 10 hours too early: Oscar later visited the patient, who died two hours later.^[5]

Oscar's accuracy (which stood at more than 25 consecutive reported instances when the NEJM article was written) led the staff to institute a new and unusual protocol: once he is discovered sleeping with a patient, staff will call family members to notify them of the patient's (expected) impending death.^[5]

Most of the time the patient's family has no issue with Oscar being present at the time of death; on those occasions when he is removed from the room at the family's request, he is known to pace back and forth in front of the door and meow in protest. When present, Oscar will stay by the patient until they die, then after death will quietly leave the room.

Oscar is described by Dr. David Dosa as "not a cat that’s friendly to [living] people."^[6] One example of this was described in his NEJM article. When an elderly woman with a walker passed him by during his rounds, Oscar "[let] out a gentle hiss, a rattlesnake-like warning that [said] 'leave me alone.'"^[5]

As of January 2010, Oscar had accurately predicted approximately 50 patients' deaths.^[2]

Possible explanations

It is not certain if Oscar's behavior is scientifically significant. Nor is there certainty whether his behavior results from inborn abilities or is the result of learned behavior from him living nearly his entire life in an end-stage medical facility where death is quite common and expected.

Dr. Joan Teno, a professor of community health at Warren Alpert Medical School of Brown University in Providence who cares for Steere House residents and sees Oscar on a regular basis, said: "It's not that the cat is consistently there first. But the cat always does manage to make an appearance, and it always seems to be in the last two hours."^[7]

Dr. Dosa (also affiliated with Alpert Medical School), who describes the phenomenon in an essay in the July 26 issue of the NEJM, says that "(Oscar) doesn't make too many mistakes. He seems to understand when patients are about to die," speculating that "the cat might be picking up on specific odors surrounding death." Dr. Teno supports this view: "I think there are certain chemicals released when someone is dying, and he is smelling and sensing those." ^[4]

Some animal behavior experts say the explanation about Oscar sensing a smell associated with dying is a plausible one. "I suspect he is smelling some chemical released just before dying," says Margie Scherk, a veterinarian in Vancouver, British Columbia and president of the American Association of Feline Practitioners. "Cats can smell a lot of things we can't," she says. "And cats can certainly detect illness." Dr. Jill Goldman, a certified applied animal behaviorist in Laguna Beach, California says that "Cats have a superb sense of smell," adding that keeping a dying patient company may also be learned behavior. "There has been ample opportunity for him to make an association between 'that' smell [and death]".^[4]

The sense of smell may, however, be just one explanation. Dr. Daniel Estep, a certified applied animal behaviorist in Littleton, Colorado suggests that "One of the things that happens with people who are dying is that they are not moving around much. Maybe the cat is picking up on the fact that the person on the bed is very quiet. It may not be smell or sounds, but just the lack of movement."^[4]

Dr. Thomas Graves, a feline expert from the University of Illinois, told the BBC: "Cats often can sense when their owners are sick or when another animal is sick. They can sense when the weather will change, they're famous for being sensitive to premonitions of earthquakes." ^[8]

Pitlik (2009) used Oscar as a metaphor for the infection by carbapenem-resistant Klebsiella pneumoniae. There is no definite evidence of the virulence of KPC, and this bacterial infection is not the cause for the patient's death, but an indication of the poor prognosis.^[9]

In popular culture

• A fictionalized character bearing Oscar's name and likeness is used as the "host" of "The Oscar the Cat Show" on Sirius Satellite Radio's Raw Dog uncensored comedy channel.
• A cat with similar prediction abilities to Oscar appears in the "Here Kitty" episode of House, in which his abilities are attributed to a preference for the warming blankets placed on patients dying of wasting diseases and for the natural warmth of patients dying of fevers.
• A similar nursing home cat appeared in the comic strip "Crankshaft" in 2009.
• A cat with similar prediction abilities appears in the indie short "Saying Goodbye".
• A feature film is in development based on Dr. Dosa's book.^[10]

See also

• Fred the Undercover Kitty

Footnotes

1. ^ Leonard, Tom. Cat predicts 50 deaths in RI nursing home , The Daily Telegraph, February 1, 2010.
2. ^ ^{a b} Henry, Ray (2010-1-31). "Just-Released Book Profiles Feline Angel of Death". AolNews (Associated Press). http://www.aolnews.com/story/book-profiles-furry-angel-of-death-oscar/882605. Retrieved 2010-03-14. ^{[dead link]}
3. ^ "Pet therapy". Steere House website. http://www.steerehouse.org/Activities/pets. Retrieved 2009-03-20. 
4. ^ ^{a b c d} "Cat's "Sixth Sense" Predicting Death?". CBS News. 2007-07-25. http://www.cbsnews.com/stories/2007/07/25/health/webmd/main3097899.shtml. Retrieved 2009-03-20. 
5. ^ ^{a b c} Dosa, DM (2007). "A day in the life of Oscar the cat." (pdf). NEJM 357 (4): 328–9. doi:10.1056/NEJMp078108. PMID 17652647. http://content.nejm.org/cgi/reprint/357/4/328.pdf. 
6. ^ "Oscar the Cat Predicts Nursing Home Deaths". Associated Press (FOX News). 2007-07-26. http://www.foxnews.com/story/0,2933,290840,00.html. Retrieved 2009-03-20. 
7. ^ Cat senses impending death The Register, July 26, 2007.
8. ^ US cat 'predicts patient deaths' BBC News, July 26, 2007.
9. ^ Pitlik, Silvio Daniel (2009-05). "Oscar the cat, carbapenem-resistant Klebsiella pneumoniae, and attributable mortality". Infection Control and Hospital Epidemiology: the Official Journal of the Society of Hospital Epidemiologists of America 30 (5): 500–501. doi:10.1086/596733. ISSN 1559-6834. PMID 19344272. http://www.ncbi.nlm.nih.gov/pubmed/19344272. Retrieved 2009-08-17. 
10. ^ "Feline Oscar heads to bigscreen". Variety.com. http://www.variety.com/article/VR1118023122. Retrieved 2011-07-07. 

References

• When death comes calling, so does Oscar the cat CNN.com, July 25, 2007.^{[dead link]}
• Oscar the cat predicts patients' deaths AP via Yahoo News, July 25, 2007.^{[dead link]}

External links

• Cat Is Harbinger Of Death (video) Item in the CBS News, July 26, 2007.
• Oscar The 'Amazing Cat' (video) Interview with Dr. David Dosa, CBS News, July 26, 2007.
• Oscar the Cat Picture in The New England Journal of Medicine.