I thought he was just a cat.
When Oscar came to live on the third floor of the Steere House Nursing and Rehabilitation Center in Providence, R.I., I barely paid him any notice. He looked like an ordinary black-and-white tabby cat. Besides, I generally have a lot to do when I come to work. I’m a geriatrician and the third floor serves as the last home for some of my sickest patients who are coping with advanced dementia.
Many of these patients have lost the ability to walk, take care of their own most basic needs and even communicate. They’ve long forgotten what they did for a living or where they were when Neil Armstrong walked on the moon. Dementia is a devastating disease, and I’ve seen it at its worst. Yet, despite this, I couldn’t imagine doing anything else with my life.
People wonder why I could ever want to work in a place where people suffer so many losses before succumbing to illness.
“Isn’t it depressing?” a lawyer friend once asked me.
“Hardly,” I countered. “I get the opportunity to work with patients who have lived the most fascinating lives.”
“But they can’t even talk with you,” came the reply.
“Sometimes they don’t need to,” I told him, thinking back to a cold winter day a few years back when Oscar the cat paid a visit to Mrs. T., a Steere House patient with advanced dementia.
I had been in a rush that day, overscheduled and stressed out. I had an important meeting across town at Brown University and admittedly was annoyed when Mary, the charge nurse, paged me to inform me that my patient was deteriorating.
“Maybe you should come over and see her,” Mary requested. “She looks uncomfortable and I may need a few additional medications to help with her breathing.”
Arriving on the third floor, I made my way to Mrs. T.’s room, where she lay attached to an IV line, sleeping fitfully, her breathing staccato and shallow.
“How’s she doing?” I asked Mary, who was already in the room.
“Not well, David. I don’t suppose it will be long now.” She pointed to the foot of the bed. “I suppose that’s why your friend is here.”
Oscar was curled up tightly next to Mrs. T.’s left leg. He lifted his head briefly and stared at me before returning it to a space between his front paws. Oscar had deemed my presence inconsequential—he was already on the case.
“How long has he been here?”
“Oscar wandered in about 30 minutes ago. I suppose that’s the main reason I called you in to see her.”
I chuckled, prompting a disapproving stare from Mary. She and I had been down this path before. Mary was already a believer, but I still didn’t quite believe that a cat could accurately predict when a patient on the third floor was about to die.
“Have you called her family?” I asked, changing the subject.
Mary turned away from the IV and looked at me with a hint of sadness. “David, there is no one to call. Her husband died a few years back, and they never had any children. Her next of kin is a brother who hasn’t been by in months.”
I nodded and sat down in the armchair next to Mrs. T.’s bed. Mary finished her job and turned to leave the room.
“Are you coming?” she asked. “I could use a few prescriptions.”
“I’ll be there in just a minute.”
Mary nodded and left me to my vigil. The three of us—Mrs. T., Oscar and I—sat in silence for a few moments. I studied Mrs. T., then found myself looking at a Tiffany’s frame on her bedside table. The photograph was of a young couple: a handsome man dressed smartly in a Navy uniform with his hand draped around the shoulders of his young sweetheart. There was radiance in her eyes that spoke of a lifetime’s worth of opportunities. They were very much in love. Suddenly Mrs. T. stirred, prompting a bothered look from the cat at the foot of the bed. After a brief moment, Oscar settled back into his curled-up position.
I got up and said my final goodbyes to Mrs. T. On my way out, I wrote a few orders for Mary, then jumped in my car for the ride across town to Brown.
The phone call came while I was still driving.
“Mrs. T. has just died.”
I felt the familiar sensation of icy fingers coursing down my spine. Though I confront death frequently in my field, I am always humbled by it.
When Mrs. T. had first arrived on the unit, her words were already muddled from her disease, but there was still a spark of life behind her brown eyes. One day as I arrived on the unit, she had met me at the front door with a smile stretching from ear to ear. She grabbed my hand and directed me to walk with her down the hallway. When we got to the large picture window at the end of the hall, she pointed outside. The sun was setting and the light was brilliant. She looked at me again and smiled. We both stood there admiring the setting sun, without a care in the world.
As I drove, my thoughts left Mrs. T. and I found myself once again thinking of Oscar. Thankfully, he had been with my patient at the end. She hadn’t died alone.
But how had he known? Was it a smell that only an animal could perceive? Was he just trying to be a member of the team?
I shrugged and smiled to myself.
As the writer Collette once said, “There are no ordinary cats.”
Since he was a kitten, Oscar the cat has sat in vigil with dozens of patients on the third floor of Steere House. His ability to “predict” when dementia patients are about to die was the subject of an essay Dr. Dosa wrote for the New England Journal of Medicine. Dr. Dosa’s book, Making Rounds with Oscar: The Extraordinary Gift of an Ordinary Cat, was published in February 2010.