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The Kitty of Doom

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This sort of thing makes one wonder if the personification of Death should in fact be a cat, although, oddly enough, not a black cat:

Oscar the rescue cat is not simply a welcome feline companion at the Steere nursing home in Providence, Rhode Island. According to a new report in a medical journal he has a remarkable, though morbid talent – predicting when patients will die.

When the two-year-old grey and white cat curls up next to an elderly resident, staff now realise, this means they are likely to die in the next few hours.

Such is Oscar’s apparent accuracy – 25 consecutive cases so far – that nurses at the US home now warn family members to rush to a patient’s beside as soon as the cat takes up residence there.

“He doesn’t make too many mistakes. He seems to understand when patients are about to die,” said David Dosa, an expert in geriatric care who described the phenomenon in the New England Journal of Medicine.

To me this just looks like a load of confirmation bias. Probably what happened is that the cat happened to curl up near a patient who just happened to die within a couple of hours. After that, the staff were on the lookout and now they notice it. It’s the same reason that, even though there is no evidence that craziness, injuries, or crime are any more frequent during nights of full moons, there is the persistent myth among emergency room staffs, police, EMS drivers, etc., that they’re busier during full moons.

In fact, look at this excerpt from the story, pulled straight out of the New England Journal of Medicine:

Oscar decides to head down the west wing first, along the way sidestepping Mr. S., who is slumped over on a couch in the hallway. With lips slightly pursed, he snores peacefully — perhaps blissfully unaware of where he is now living. Oscar continues down the hallway until he reaches its end and Room 310. The door is closed, so Oscar sits and waits. He has important business here.

Twenty-five minutes later, the door finally opens, and out walks a nurse’s aide carrying dirty linens. “Hello, Oscar,” she says. “Are you going inside?” Oscar lets her pass, then makes his way into the room, where there are two people. Lying in a corner bed and facing the wall, Mrs. T. is asleep in a fetal position. Her body is thin and wasted from the breast cancer that has been eating away at her organs. She is mildly jaundiced and has not spoken in several days. Sitting next to her is her daughter, who glances up from her novel to warmly greet the visitor. “Hello, Oscar. How are you today?”

Oscar takes no notice of the woman and leaps up onto the bed. He surveys Mrs. T. She is clearly in the terminal phase of illness, and her breathing is labored. Oscar’s examination is interrupted by a nurse, who walks in to ask the daughter whether Mrs. T. is uncomfortable and needs more morphine. The daughter shakes her head, and the nurse retreats. Oscar returns to his work. He sniffs the air, gives Mrs. T. one final look, then jumps off the bed and quickly leaves the room. Not today.

Making his way back up the hallway, Oscar arrives at Room 313. The door is open, and he proceeds inside. Mrs. K. is resting peacefully in her bed, her breathing steady but shallow. She is surrounded by photographs of her grandchildren and one from her wedding day. Despite these keepsakes, she is alone. Oscar jumps onto her bed and again sniffs the air. He pauses to consider the situation, and then turns around twice before curling up beside Mrs. K.

One hour passes. Oscar waits. A nurse walks into the room to check on her patient. She pauses to note Oscar’s presence. Concerned, she hurriedly leaves the room and returns to her desk. She grabs Mrs. K.’s chart off the medical-records rack and begins to make phone calls.

Within a half hour the family starts to arrive. Chairs are brought into the room, where the relatives begin their vigil. The priest is called to deliver last rites. And still, Oscar has not budged, instead purring and gently nuzzling Mrs. K. A young grandson asks his mother, “What is the cat doing here?” The mother, fighting back tears, tells him, “He is here to help Grandma get to heaven.” Thirty minutes later, Mrs. K. takes her last earthly breath. With this, Oscar sits up, looks around, then departs the room so quietly that the grieving family barely notices.

As I said, this looks like nothing more than confirmation bias. Of course, it is possible that the cat somehow senses something common to people who are within hours of death, but to determine whether this is indeed the case, at the very minimum, as Phil Plait points out, this is what we would need to know:

Nicholas Dodman, who directs an animal behavioral clinic at the Tufts University Cummings School of Veterinary Medicine and has read Dosa’s article, said the only way to know is to carefully document how Oscar divides his time between the living and dying.

And that is a question that has not been looked at systematically. It probably never will be, given that no one seems particularly interested in knowing whether Oscar is really detecting impending death or something related to impending death (such as more attention to the patient or simply, as Dodman put it in his comments, more warm blankets placed on dying patients), or whether this is just a classic case of confirmation bias.

Of course, what’s really disturbing is how such a foolishly credulous bit of “human interest” was published in the New England Journal of Medicine in the first place. This sort of stuff belongs in the Weekly World News, not in the NEJM.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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