It's been quite a week for the New England Journal of Medicine. In the current issue, we learn that fat is contagious and that cats can sense when people are about to die.
Or at least one particular cat can tell. He's 2 years old, with patches of gray and white fur, and he lives in a nursing home in Providence, R.I. "Oscar the Cat awakens from his nap, opening a single eye to survey his kingdom," begins the article, by Dr. David M. Dosa of Brown University. "From atop the desk in the doctor's charting area, the cat peers down the two wings of the nursing home's advanced dementia unit. All quiet on the western and eastern fronts."
That sounds a little florid for the nation's leading medical research journal. The story of Oscar the Cat - a feline who cuddles up with patients in the moments just before they meet their makers - isn't a peer-reviewed scientific inquiry, nor is it a clinical report, a case study, or even an editorial. It's creative nonfiction - an uncorroborated anecdote that makes vaguely mystical claims about the cognitive abilities of animals. "A young grandson asks his mother, 'What is the cat doing here?' " writes Dosa. "The mother, fighting back tears, tells him, 'He is here to help Grandma get to heaven.' "
Here's a more modest question: Why is the cat in the New England Journal of Medicine?
Gaining credibility, for one thing. Reporters were happy to attribute the news of Oscar's amazing powers to "a new report in a medical journal" by "an expert in geriatric care." Without his prestigious turn in the NEJM, Oscar might even have become as famous as the dog that dialed 911 or the monkey that joined a SWAT team. But after making his debut in the NEJM, he's a sensation.
Dosa tells us only that "Oscar the Cat has had an uncanny ability to predict when residents are about to die" and that he's "presided over the deaths of more than 25 residents" by nuzzling them during their last few hours of life. Did anyone keep track of the number of times he nuzzles people who don't die?
Since Dosa's essay was published, other researchers have argued that the cat might be using its acute sense of smell to detect a patient's organs shutting down. But you don't need a superhuman nose to suss out death's bouquet. Kidney or liver failure can cause waste products or acids to build up in the bloodstream, and patients with these conditions sometimes have a noxious or sweet aroma on their breath. A nurse can sniff out a dying patient, too.
But the NEJM piece prefers to speculate on Oscar's moral powers. His visits to dying patients are described as "his work" at the nursing home.
In an e-mail, a NEJM representative explained the decision to run Dosa's piece: "From time to time, we publish such personal narratives by physician writers." But this isn't just a personal narrative - it's a piece of magical realism that has been taken for science. If doctors really can use household pets as a diagnostic aid, let's find some genuine research on the subject.
A few years ago, the British Medical Journal followed up on anecdotal reports of cancer-sniffing dogs with a controlled study. Authors tried to show that animals could be trained to smell organic compounds released by bladder cancer cells into urine. The dogs could sometimes ID cancerous pee.
Let's do an experiment like that on Oscar, to find out if he really can smell death. Then we'll check out whether other cats can be trained to do the same. If the work is good enough, it might even end up in a top-tier medical journal. Maybe even the BMJ.