Making Rounds with Oscar: The Extraordinary Gift of an Ordinary Cat - By David Dosa Page 0,71
I didn’t smell it if they were going to live.”
There is a plausible biological explanation for that “sweet smell of death.” As cells die, carbohydrates are degraded into many different oxygenated compounds, including various types of ketones—chemical mixtures known for their fragrant aroma. Ketones are also found in abundance during episodes of untreated juvenile diabetes and doctors are taught early on in medical school to sniff the breaths of diabetics to determine if their sugar levels are high. Could it be that Oscar simply smells an elevated level of a chemical compound released prior to death? It is certainly clear that animals have a refined sense of smell that goes well beyond that of the ordinary human.
A 2006 study, published in a leading cancer journal, suggested that dogs could be trained to identify microscopic quantities of certain biochemicals excreted by cancer cells on the breaths of lung and breast cancer patients. Similar studies over the years have also identified melanoma-sniffing dogs and earthquake-predicting fish. Is it outlandish to suggest that Oscar, a cat residing on a floor where patients with end-stage dementia routinely die, has merely learned how to pick up on a specific smell emitted in the final hours of a patient’s lifespan?
Perhaps, but I like to think of Oscar as more than a ketone early-warning system. Ever since I was a child, listening intently as my grandfather read bedtime stories from Rudyard Kipling’s Just So Stories, I have imbued animals with human characteristics and frailties. It could simply be that we see ourselves in them—the best of ourselves, sometimes.
On a floor where the staff has gone to great lengths to make the dying experience tolerable for the residents and their families, I’d like to think Oscar embodies empathy and companionship. He is a critical cog in a well-oiled and dedicated health care team. As the physician, it is my job to prescribe the appropriate medications and provide guidance to the family; it is the nurse’s job to provide the appropriate care; it is the minister’s job to provide the necessary spiritual counselling for the patient and their family; and it is Oscar’s job to provide the critical companionship during the final hours. He is clearly part of the team and as much a comfort to the families as he is to the patient, though in some cases he is the only family the patient has left.
I don’t really pretend to know the nature of Oscar’s special gift—I am not an animal behaviorist nor have I rigorously studied the why and how of his behavior. Whether he is motivated by a refined sense of smell, a special empathy, or something entirely different—your guess is as good as mine. But I believe we can all learn from his example.
Though my interviews with decedents’ families were meant to provide me with more insight into what Oscar does, I found myself learning a great deal more about the diseases that had destroyed my patients’ lives than I did about the cat. For all the mystery surrounding Oscar, there was little mystery about the devastating consequences of dementia.
Today, there are over five million people in the United States with Alzheimer’s disease and hundreds of thousands more with other less common forms of dementia. Without new treatments, estimates suggest that this number is likely to skyrocket as our population continues to age. But the tragedy of dementia is not measured merely by the number of patients directly affected. For every patient with dementia, there are many more caregivers whose lives will never be the same.
Recently, my wife and I joined their ranks when her mother was diagnosed with dementia. Like countless others in this country and around the world, we are entering an uncertain phase in our lives, one that will involve caring for a parent with dementia. We add this new responsibility to the myriad others of parent, professional, and spouse. Where will the extra energy come from?, we wonder. How can we find the capacity to care for yet another dependent—an adult, no less? Even though I work closely with caregivers who tackle the same issues, and have always respected their fortitude and optimism, it is always different when it happens to you and your own family. Suddenly it’s personal.
After another exasperating phone call with her mother’s doctors, who had nothing new to suggest in regard to her failing memory, my wife turned to me for support. “Surely from all of those interviews you gleaned some words of wisdom that might help