Transcript

The Story of Oscar the Cat

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David M. Dosa, M.D.
Assistant Professor of Medicine, Brown University
Friday, July 27, 2007; 2:30 PM

David M. Dosa, M.D. and assistant professor of medicine at Brown University, will be online Friday, July 27, at 2:30 p.m. ET to discuss the story of Oscar, a cat with the ability to predict when residents of a nursing home are about to die.

Read the Article A Day in the Life of Oscar the Cat ( The New England Journal of Medicine, July 26)

A transcript follows.

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Dr. David M. Dosa: Hello everyone, I'll try to answer as many questions as I can.

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Little Rock, Ark.: Is Oscar extremely unique, or are you aware of other domesticated animals exhibiting this ability to predict death?

Dr. David M. Dosa: Interestingly, since this story broke, I have received dozens of emails from others around the world with similar stories of animals predicting everything from birth to death. Of note, a priest from Canada told me about a similar story as did a nursing home from New York. Does that make Oscar unique? I think he is a truely remarkable animal.

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Newton, Mass.: How old was Oscar when people first noticed his ability? Can/does he do his end-of-life interaction with people whom he has not previously met, or are previous day-to-day visits required for him to know what is going on?

Thanks for sharing this with everyone.

Dr. David M. Dosa: Oscar was about 6 months old when we first started to notice his amazing ability. At 12 months, he received a commendation from a local hospice agency here in Rhode Island regarding his end of life care. Since then, we have all been paying attention.

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Harrisburg, Pa.: We have dogs that can sniff out tumors. Is there probably something the cat can physically sense about impending death that we can't tell with our senses?

Dr. David M. Dosa: My sense is that the cat responds to a pheramone or smell that we simply, as humans cannot recognize. Of course others have ascribed Oscar's unique abilities to everything from behavioral mimmicing to higher powers. I'll leave it for the experts to figure out

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Centreville, Va.: Great, now I'm afraid of doctors AND cats. Seriously though, has anybody had the opportunity to examine possible causes for this? I assume the cat could be picking up on a variety of clues that people can't or are missing. The possibilities seem endless and difficult to measure.

Dr. David M. Dosa: Afraid of doctors and cats! That's too much to be afraid of in one's life. We are everywhere. In all seriousness, doctors are simply trying to do the best they can for you (or at least most of us, anyway).

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Washington, D.C.: Something seems to be wrong with your methodology. Ever think seeing that cat might make them die? It's cause and effect all right, see cat, freak out and die.

Dr. David M. Dosa: You know, I really want to be clear that this is a terminal dementia unit and most people are not aware of the effects of end-stage dementia. In most cases, these patients have lost the ability to ambulate, communicate, and even eat in some cases. One of my goals with writing this piece was to try to let people know about this type of environment. Oscar is not "killing patients" and the patients on the unit, unfortunately, have lost the ability to understand the higher meaning behind his presence at the bedside.

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Charlotte, N.C.: Dr. Dosa,

I have read with great interest Oscar's story. My wife and I had a similar incident with our cat years ago. Boggles (the cat)had a habit of sleeping on my wife's pillow at night. Out of nowwhere, he stopped, and for days, he would not even come close to her, even when she fed him.

It was about a week later when we found out that she was pregnat with our first child. We have thought that her scent changed so much that it put him off.

Is it possible that when a human is in the last hours, their body puts out a scent or some sort of chemical change that Oscar picks up?

Thanks!

Dr. David M. Dosa: Absolutely, I have heard from several biochemists about certain chemicals that are emmitted from dieing organisms. I really do believe it is a sense of smell---and we simply can't smell it.

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Cape Town, South Africa: Has Oscar ever made a sound or cried when he can't get into a room?

Dr. David M. Dosa: Generally, he paces backwards and forwards in front of the closed door.

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Warwick, R.I.: How did Oscar come to live at the home? Did he experience any kind of abuse or near-death experience before you adopted him?

Dr. David M. Dosa: Oscar, I believe, was part of a litter from a stray cat that one of the staff members brought into the facility. This particularl facility owns six cats--Oscar being only one of them (albeit the only internationally famous cat)

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Philadelphia, Pa.: How does Oscar interact with other staff members as opposed to the patients?

Dr. David M. Dosa: Generally Oscar is not particularly friendly with staff--unless you bribe him with food. The last time I tried to pet him, he snapped at me. I hope that means I'll be around for a while.

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Montgomery Village, Md.: Does Oscar ever spend any significant amount of time curled up with somebody who isn't about to die?

Dr. David M. Dosa: Not generally, no--He keeps to himself and avoids staff/ more robust residents on the unit

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Arlington, Va.: No question, just a comment. Cats aren't stupid, and can pick up cues that humans miss. We need more cats like Oscar, living in hospices and assisted living centers, giving residents just a little bit of extra comfort towards the end of their lives. Do you have any clues on his pedigree, cuz I think he looks like a partial Norwegian Forest Cat or Turkish Van.

Dr. David M. Dosa: I hate to say this but I really don't know what type of cat he is. I've heard him refered to as a tabby cat--but I must attest to not being very familiar with cat breeds.

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Salt Lake City, Utah: The article said that Oscar has presided over the deaths of more than 25 people. Is that a small or large percentage of the people who have died during the time period that Oscar has been there? In other words, does he recognize most of the deaths that take place, or just a small percentage? (Still an amazing feat even if it's just a small percent!)

Dr. David M. Dosa: Oscar has been at each and every death that occurs in the facility in one capacity or another---there are a few occasions where family have not wanted him in the room. In those cases, he is never far away.

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Leno: Jay Leno: "They say a cat in a nursing home in Providence, Rhode island, can predict patients' deaths. They say the cat will walk through, and curl up next to a patient, and within four hours, that patient dies. And the cat has been correct in 25 cases so far. Anyone stop to think maybe these patients are allergic to cats?"

Jay Leno: "Anyway -- today, the cat curled up next to the John McCain campaign."

Dr. David M. Dosa: Certainly I've watched this and listened to the media coverage. Its ammusing (and probably right in the case of John McCain's campaign).In all seriousness, the idea of all of these residents being allergic to cats is preposterous and really biologically implausable. In most geriatrics cases, the immune system simply can't react with the type of vigor needed to cause death to occur.

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Southfield, Mich.: The part that is interesting to me is how Oscar reacts to whatever it is he is sensing, not the what of it. The fact that it makes him want to be with the person and cuddle and stay with them.

Dr. David M. Dosa: I think you really nailed the message here--Oscar is a compasionate cat for people who might otherwise die alone. Look---these residents often outlive immediate family members and might otherwise die alone.

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Hmmm,: I have one cat who is much more affectionate when I'm ill, and one that is much LESS affectionate when I'm ill. I always thought they were responding to something I was doing, but after reading about Oscar I'm wondering if there's something else.

And poor Oscar. Does he have many human friends? I don't know I'd want him to hang out with me for a long period of time. I'd worry!

Dr. David M. Dosa: Oscar is beloved by the staff--so yes he has friends. Sure we joke about it like everyone else but the reality is he really is okay all by himself-he doesn't particularly like company

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Washington, D.C.: This is so fascinating -- thanks for your moving piece in the NEJM. It seems probable that there IS some sort of scent, etc., that signals imminent death; however, what do you think makes Oscar or other animals attracted to this? It seemed in the article that he wasn't particularly interested in cuddling up next to patients unless they were about to pass away.

Dr. David M. Dosa: Some people note that the body releases a sweet smell when dieing occurs. I've heard some staff call it that. Maybe that is it---maybe it is behavioral---certainly Oscar is in an environment where he gets experience predicting death.

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Washington, D.C.: If Oscar is so unfriendly and snappy at people, why is he allowed around this facility? What would happen if people were allergic to cats, or if Oscar were the cause of an infection to be transmitted from feline to patient?

In short, how does a medical institution justify having an animal present?

Dr. David M. Dosa: Animals become important parts of units like this----there is ample evidence to suggest that animals help keep things normal for residents who relocate to a NH. They also decrease the levels of depression. Remember, many people are pet people before they move into a NH. In terms of those that do not like animals, there are a number of exceptional NHs in each and every state that don't allow pets and no one is forced into staying in an environment where they don't want to.

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Fairfax, Va.: Does Oscar lick or touch the dying person, other than to just sit beside them? Does he stroke or purr or anything?

Dr. David M. Dosa: He will purr and nuzzle.

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Arlington, Va.: What a wonderful story Oscar has to tell! I'm curious about Oscar's logistics -- does he live at the hospital? He eats and goes to the bathroom in the hospital?

I'm so surprised that an animal is allowed within a hospital environment.

Dr. David M. Dosa: This is a nursing home---not a hospital. The regulations are different. Yes Oscar eats and goes to the bathroom on the unit----just like other animals that live inside, he uses a litter box which is changed daily by staff.

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Waltham, Mass.: As a cat lover and daughter of a woman living in a LTC facility for 8 years, I advise less time spent on monitoring the cat's activities and more time spent caring for our aging loved ones. Rely on medical care. We need better care in nursing homes.

Dr. David M. Dosa: Certainly, I understand your message and you are right that care in nursing homes should improve. My main research interests are actually on improving the quality of care in nursing home institutions and my feelings are shared by others at this institution----I think the professionals at this NH pride themselves on delivering exceptional medical care. We all know that we practiced high quality care before Oscar and will after he is gone.

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Arlington, Va.: What a sweet story. I really enjoyed reading about Oscar. Animals provide so much comfort to sick and dying patients -- and giving staff the extra time to alert family members is really invaluable. Thanks for the article!

Dr. David M. Dosa: Thank you for the lovely email---I have heard from so many people who seem to understand the message that I am trying to deliver. Certainly the "cat of death"--Grim reaper stuff is way over the top--the media uses it to sell newspapers and get people to turn on their tvs.

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Parsippany, N.J.: Have there been requests from families or other facilities to have Oscar bought out to them, to see if his senses work outside your facility. If he has been to other places, how has he behaved?

It's just an amazing yet eerie and powerful story ...

Thanks.

Dr. David M. Dosa: Oscar rarely leaves the facility---today being an exception when he visited the vet.

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Cape Town, South Africa: Does Oscar interact with the other cats?

Dr. David M. Dosa: There is one other cat on the unit---and occasionally a dog or two brought in by staff---He responds to all of the, as one might expect. Tollerance but "stay away"

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Boston, Mass.: Hi Dr. Dosa. Needless to say your essay had my friends and me in tears. What a gift Oscar is to your patients, particularly those who are alone. As a life-long cat owner I have long been convinced that they have a leg up on us in many ways, but this seems really extraordinary. Have you heard/read anything that makes you think this is a common ability among cats (maybe it's a question of degree?) If so, what a great solution for the patients and all the cats who need homes! Thanks!

Dr. David M. Dosa: Unfortunately--I think there are more strays out there than nursing home residents and while a nursing home might be able to maintain one or two--cats are expensive. In fact, the NH often struggles to pay for all of the food/kitty litter etc. We hold bakesales and the staff contribute.

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Davidsonville, Md.: I'm a cat owner and a veterinarian, and Oscar's story is fascinating -- both surprising and not surprising, because I think people discount the senses and emotions of animals for fear of being accused of anthropomorphism.

I would welcome the presence of a purring cat in my final hours, and I'm sure the members of my pet-loving family would as well. My parents are aging, and if the time comes when I must find respite care for them, I'll look for a facility with a cat!

Dr. David M. Dosa: As one patient recently told me---and I truely believe this for myself---I'd rather die with Oscar curled up next to me than alone in a hospital with tubes running in and out

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Washington, D.C.: Were you at all anxious about writing about this given the skepticism present? It's a great testiment to the uniqueness of all living spirits.

Dr. David M. Dosa: Skeptism is welcome---at least people are talking and maybe this can raise awareness for end of life care and the utility of pets in nursing home environments

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Syracuse, N.Y.: How is Oscar dealing with his new-found celebrity? Is he getting some fish tonight, rather than kibble?

Dr. David M. Dosa: No--Just kibble---He hasn't let celebrity get to his head just yet. Although the morning shows all wanted to wisk him off to New York. I think he is holding out for Oprah though!

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McLean, Va.: Have you all been hounded by the press? Will you be letting any more press cameras in the facility? I heard the staffers there weren't giving any more interviews, this true?

Dr. David M. Dosa: You have to understand that many people live in this nursing home and call it home. Imagine coming home to an international media circus outside your house. I think the facility and its fine administrator should be commmended for how it has handled all of this publicity. It really is a model for others to follow in this respect.Remember HIPPA rules apply to everyone of us and it gets much more complicated when you are in an environment where patients can't consent for themselves. Understand that the NH is doing the best they can

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Alexandria, Va.: Is there somewhere we can send a donation to help support Oscar (and any other cats) at the nursing home? Thanks!

Dr. David M. Dosa: I would try the nursing home's website. The address is listed---I am sure they would appreciate it. The nursing home is Steere House Nursing and Rehabilitation Center. Remember other nursing homes need the help too if they have animals so also contact your local nursing home.

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Southern Maryland: It has been known for a long time that dogs and cats can predict earthquakes. It's really a great human interest story about Oscar and only hope my cat is still around to cuddle next to me when I'm dying!

FWIW, my sister and her husband swam with dolphins in Florida. The naturalists working there said the dolphins get freaked out with pregnant women in the water. They can hear the heartbeat of the fetus but only see one person in the water with them.

Dr. David M. Dosa: Animals across the board are amazing--I think we dismiss their skills too often----I had a dog growing up and the dog knew we were going on vacation days in advance. They are amazing at taking and analyzing non-verbal cues.

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Rockville, Md.: Hi,

I've heard of nursing homes having animal visitors but not as many with residential cats. I think it's a win-win situation for the animal and the residents.

Do you think more homes may be encouraged to adopt a homeless cat to wander around? Of course, not every cat may be like Oscar.

Thank you,

Rockville

Dr. David M. Dosa: Not every cat should be like Oscar----Animals are wonderful for residents at nursing homes.

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Washington, D.C.: Has anyone considered the possibility that the reason this cat is always there is because it's stealing the patients' souls?

Dr. David M. Dosa: Harkens back to the ancient Egyptians who I believe used to mention this (or so I am told). I really doubt it.

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Gaithersburg, Md.: Cat story -- when my aunt was dying of cancer she spent her last months in bed at my cousin's, with her cat curled up on the foot of the bed. After she died I adopted the cat. When I developed premature labor and was put on bed rest the cat kept me company, but stopped grooming herself. The day I came home from the hospital with the baby and was up and around again, the cat started taking care of herself again. I always figured she associated being in bed all the time with a person she cared about leaving.

Dr. David M. Dosa: I've heard dozens of stories like this one----It really helps illustrate how amazing animals can be.

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Washington, D.C.: Who, specifically, does Oscar belong to, the nursing home people as a group or to one single individual?

Dr. David M. Dosa: The nursing home

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McLean, Va.: Have any veterinary schools expressed interest in researching Oscar's ability?

Dr. David M. Dosa: Not as of yet--I'm sure that we will hear from them soon

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Houston, Tex.: Dr. Dosa,

Are you a cat person or have you come late to an appreciation of Oscar and his kind?

Dr. David M. Dosa: I've come late to an appreciation of Oscar----I think his caring for those at the end of life is truely remarkable. Again he allows for those that die alone to have companionship at the time of death and allows us to notify those that have family so that they may have them present

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washingtonpost.com: This concludes our discussion with Dr. Dosa. Thank you for joining us.

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