Here is the full text of the article in the New England Journal of Medicine that started all this hub-bub. I had expected to find an analytical treatment of the subject, and was astounded to see that it's written as a narrative -- even more of a human-interest treatment than the news articles give it! I didn't know that the NEJM published anything except descriptions of medical studies and patient histories.

In the NEJM article, the author (Dr. David M. Dosa) says dramatically, "No one dies on the third floor unless Oscar pays a visit and stays awhile." Yet in the BBC article to which GUEST Sapper linked (above), Dosa says, "He doesn't make many mistakes" [my emphasis]... so Dosa admits that Oscar has made a few errors. I wish there were an article with a more quantitative description of when, and under what circumstances, Oscar is right or wrong.

In the NEJM, Dosa says Oscar entered one room (where the patient's daughter was keeping a vigil), jumped onto the bed, jumped off again and left. Then he entered a room where the patient was alone -- this is where he curled up and stayed until the patient died. Was he simply choosing a room without a visitor in it? When the patient's family arrived for the death watch, did Oscar stay there out of sheer stubbornness and refusal to be moved once he'd chosen his spot? Did he leave after the death because he knew the nurses' routine of removing the body and the bedclothes was about to ensue? Having observed cats' habits all my life, it wouldn't surprise me if all of that were the case. Cats are highly motivated to seek their own comfort. It has not been my experience that they set out upon any course of action to comfort humans (although they're quick to learn that, if they want attention, a sad human is likely to give plenty of it to them).

There are a couple of things that disturb me about the descriptions of this nursing facility. In the NEJM article, Dosa describes a resident: "Moderately disheveled after eating her lunch, half of which she now wears on her shirt, Mrs. P. is taking one of her many aimless strolls to nowhere." I realize that it may be challenging for the staff to get their patient to wear an adult bib at meals or change stained clothing or sit still long enough for a midday hair-combing, but still Dosa doesn't give the best impression of the conditions there! Also disturbing to me is the description of Oscar's behavior when he is removed from the bed and room of a dying patient at the request of the patient's family: according to the article I linked above, a doctor there says, "He kind of rubs aggressively against the door, paces back and forth, yowls in protest." Why would the staff allow the cat to linger there, wailing and disturbing the patient's loved ones (not to mention the patients in adjoining rooms)? To me, it's unconscionable that they would let the cat do that rather than shut it in a room where its vocalizing would not be intrusive.

But the most disturbing thing to me is that the staff would wait for a signal from a cat before calling a dying patient's family to come in for their final visit. Is the staff so inexperienced or inept that they can't tell when a terminally ill patient has only a short time left to live? Is this what health care in America is coming to????