Oscar (born 2005, died 2007) was a
therapy cat in a
Rhode Island hospice who was featured in the
New England Journal of Medicine for his purported ability to predict the impending death of terminally ill patients. Explanations for this ability include Oscar being able to smell chemical changes that accompany death, and the lack of movement in near-terminal patients.
Background
Oscar was adopted as a kitten from an
animal shelter and grew up in the third-floor
dementia unit at Steere House Nursing and Rehabilitation Center in
Providence,
Rhode Island. The unit treats people with
Alzheimer's,
Parkinson's disease and other illnesses, most of whom are in the end stage of their illnesses (where death is imminent) and are generally unaware of their surroundings. Steere House bills itself as a "pet friendly" facility; a variety of pets visit and reside at the facility.
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.
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.
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.
Most of the time the patient's family had no issue with Oscar being present at the time of death; on those occasions when he wass removed from the room at the family's request, he was known to pace back and forth in front of the door and meow in protest. When present, Oscar would stay by the patient until they die.
Oscar was described by Dr. David Dosa as "not a cat that’s friendly to [living] people." 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.'"Possible explanations
No one is 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."
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."
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]".
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 happen 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."
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."
Pitlik (2009) noted that the patients that Oscar slept beside all succumbed to infection by carbapenem-resistant Klebsiella pneumoniae, he suggested that Oscar was able smell the scent of this bacterial infection, he was thus aware that the patients were terminally ill and would not bother him by trying to pet him.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 House episode "Here Kitty".See also
Footnotes
