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Skeptimedia is a commentary on mass media treatment of issues concerning science, the paranormal, and the supernatural.

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Psychic cat or clever doctor?

1 Feb 2010. In July 2007, the media went gaga over a paper published in The New England Journal of Medicine (NEJM) by David M. Dosa, M.D., M.P.H. Dosa claimed that a cat named Oscar possessed death-predicting ability. Never mind that the cat lives in a nursing home for the nearly dead and that his ability was identified by his lying down on the beds of patients who died soon afterward. Dosa made a case that the cat was predicting death.

Here are a few of the headlines I culled for my newsletter at the time:

Oscar, cat with the purr of death

A Feline With Foresight

Oscar the cat is dead-on accurate

Oscar, the Compassionate Cat

Oscar the Cat Predicts Patients' Deaths

Dr. Dosa and Oscar are back in the news because Dosa now has an inspirational book out about Oscar: Making rounds with Oscar: the extraordinary gift of an ordinary cat. It seems that Oscar has the ability to turn a skeptical scientist into a storyteller who's lost his skepticism and doesn't seem to be much of a scientist. That may seem harsh, but let me explain.

Dosa is a geriatrician at a Rhode Island Hospital and an assistant professor of medicine at the Warren Alpert Medical School of Brown University. In the NEJM article, Dosa claims that Oscar, a cat who lives on the third floor of a Rhode Island nursing home, seems to predict when a patient is about to die. He makes his prediction by curling up next to the patient and leaving after the patient dies. He had done this 25 times over the two years before the article was published. Now, Dosa says, Oscar has done this 50 times. The numbers are nice and round, but don't expect to see a list naming the dead. Even though Dosa portrays himself as a scientist, we are not provided detailed data on how many times a day the cat curls up where and for how long, how many patients die within x minutes of the cat's leaving and how many live for days or weeks, etc. Only the data that confirms the hypothesis seems to be of interest to this scientist.

Anyway, in the NEJM article, Dosa admitted that the cat sometimes curls up to a patient who doesn't die and leaves while the patient is still alive. He gives an example of Oscar curling up next to a patient who isn't on death's door and none of the staff panic, but when Oscar curled up next to a patient on death's door, the nurse called the family and the priest in so they could be there when the patient died. Dr. Dosa does not mention how many times the cat has curled up next to a patient not at death's door and left when the patient was still alive. He does mention in an interview that Oscar sometimes "makes mistakes."

Dosa thinks that Oscar shows relief that a patient is not dying, makes rounds, surveys and examines patients, and pauses "to consider the situation."  Dosa apparently has made no attempt to identify any unusual differences in medicine, blankets, treatment, and the like of near-death patients that might attract the cat. Despite the belief of Dosa and the staff in the medical skills and attentiveness of the cat they've hung a plaque in his honor "for his compassionate hospice care" Dosa doesn't take too seriously the idea that maybe the cat is picking up cues from him and the staff. The cat might be as clever as Clever Hans, after all, and Dosa or the nurses might be exhibiting a type of Clever Linda phenomenon.

In his original article, Dosa was careful to use suggestive language that would likely mislead many in the media who love to print feel-good stories about pets or children. There he wrote: "After all, no one dies on the third floor unless Oscar pays a visit and stays awhile." That is not the same thing as saying that everyone Oscar visits dies shortly thereafter, but it is close enough to mislead a few journalists. Publishers Weekly writes about the author and his new book: "Dosa, a geriatrician with a strong aversion to cats, tells the endearing story of Oscar the cat, the aloof resident at a nursing home who only spends time with people who are about to die" (italics added). One customer review on Amazon claims "when he detects that someone is near dying, he takes up residence on their bed and usually stays until the funeral director comes to collect the body." Another writes: "Oscar has the same gifts as most animals: an understanding of two different dimensions and life unfolding in each one of them. There is no death. But he serves to guide the spirit to the other side with dignity and compassion." Wow. Oscar is almost as compassionate as James Van Praagh and Jon Edward in helping people deal with death. By the next generation of storytellers, I imagine Oscar will be described as teaching surgical techniques to janitors.

My local paper, The Sacramento Bee, published an Associated Press story about Dosa's cat. The headline reads: Book profiles furry angel of death: Oscar the cat. The story notes that if kept outside the room of a dying patient, Oscar will scratch at doors and walls, trying to get in. No mention is made of whether Oscar claws at closed doors of rooms where patients aren't at death's door. Most of the "evidence" for Oscar's abilities seems to be little more than anthropomorphizing by people who count the hits (selective thinking and memory) and don't seem too interested in observing any misses: a classic case of confirmation bias and shoddy science. In the AP story, Dosa is portrayed as speculating that Oscar imitates the nurses who raised him or smells odors given off by dying cells, perhaps like some dogs who scientists say can detect cancer using their sense of scent. I've watched a video of dogs detecting cancer by scent and came away thinking that the dogs were picking up cues from those testing them. Dosa may be right about the cat picking up his cues from the nurses who raised him, but who would want to read a book about that? If you want to sell your story, better to promote the "the loving angel of death" or "the extraordinary cat who can predict death."

On the bright side, the book is 240 pages long. It can't be only about the cat. Dr. Dosa may have some useful information for those with loved ones suffering from dementia who are near death and fated to spend their last days in an institution. It may not be science, but it may provide comfort and solace to certain readers.

update: 13 May 2010. Dosa and his cat story are featured in Something Unknown is Doing We Don't Know What, which I reviewed. A cat with the death-predicting skill is featured on an episode of House, the television program, where Dr. House explains the cat's behavior as due to a love of warm places. Wikipedia authors found a "certified applied animal behaviorist" to suggest that Oscar is responding to the patients' lack of movement. Why not jump in the empty beds, then? Or on one of the many other things that aren't moving. A "feline expert" from a university 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." Right, but this cat allegedly prefers the dying to the merely sick. Anyway, everybody knows that snakes are much better than cats at predicting the weather and earthquakes. And snakes don't have as much dander.

One reader suggested the following: "Perhaps the cat can smell the signs of death in the body. A lot of predators can zero in on the weakest/near-death animals in a herd. Maybe the cat is having an evolutionary response to the sick and dying in the hopes of getting an easy meal. I do not think he would actually try to eat a patient, but maybe some ancient cat gene has been turned on and he doesn't know how to react." Maybe Dr. Dosa should have called his book Oscar's Last Supper.

Before I'd look for an explanation for Oscar's behavior, I'd require a more formal method of observation than just relying on the memories of Dr. Dosa and his staff. Maybe what needs explaining is not how Oscar knows when people are dying but why these people think in such magical terms without doing a proper scientific investigation. What kind of people buy the book or can't wait until the film comes out? I have to admit that I find the behavior of humans regarding Oscar much more interesting than Oscar's alleged abilities. How many people would believe Dr. Dosa and his staff if they claimed Oscar hasn't eaten or drunk anything in ten years?

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