As far as we can determine, Oscar is the only therapy cat who has ever been featured in the prestigious New England Journal of Medicine. And for good reason: Oscar, who makes his round's at Rhode Island's Steer House Nursing and Rehabilitation Center, can sniff out death. Month after month, this feline of death has ignored patient after patient, only to curl up on the bed of a patient destined to die within hours. Clearly, this is no occult visitation: By smell or sight or something even more subtle, this special cat can detect what trained physicians can not. Dr. David Dosa's Making the Rounds with Oscar follows the soft-paw tracks of a cat with a sixth sense. Now in paperback and NOOK Edition.
Making Rounds with Oscar: The Extraordinary Gift of an Ordinary Catby David Dosa
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A remarkable cat. A life-changing story.Making Rounds with Oscar: The Extraordinary Gift of an Ordinary Cat is the story of a doctor who, at first, doesn't always listen; of the patients he serves; of their caregivers; and, most importantly, of a cat who teaches by example, embracing moments of life that so many of us shy away from.
"Oscar has much to teach us about empathy and courage. I couldn't put it down." --Sara Gruen, author of Water for Elephants
"This book is a must-read. Truly, this is a story that needs to be told." --Fresh Fiction
"You'll be moved." --People
"This touching and engaging book is a must-read for more than just cat lovers; anyone who enjoys a well-written and compelling story will find much to admire in its unlikely hero." --Publishers Weekly
"[The] book, both touching and humorous, isn't just about Oscar. It's about listening and letting go." --USA Today
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Making Rounds WITH OSCARThe Extraordinary Gift of an Ordinary Cat
By David Dosa
HYPERIONCopyright © 2010 David Dosa
All right reserved.
Chapter One"Animals are such agreeable friends-they ash no quuestions, they pass no criticisms."
IF YOU LOVE YOUR JOB, ON THE BEST DAYS YOUR WORK-place can seem beautiful, no matter how it might look to the rest of the world. An oilman looks at a flat, dusty plain and sees the potential for untapped fuel. A firefighter sees a burning building and runs into it, adrenaline surging, eager to be of use. A trucker's love affair is with the open road, the time alone with his thoughts-the journey and the destination.
I'm a geriatrician and I work on the third floor of the Steere House Nursing and Rehabilitation Center in downtown Providence. People tell me they would find my job depressing, but I'm always a little puzzled by that. Looking at my patients and their families, I have a remarkable view not just of lives well lived, but of deep commitment and love. I wouldn't trade that for the world. Sure, sometimes I'm caring for people at their worst, but I'm also blessed to be with them at their best.
My parents, both doctors, thought I was crazy for going into geriatrics. The family business has always been pediatrics-my mother and uncle are pediatricians, as was my grandfather. I think there was always this sense that I was choosing the wrong end of the life continuum to stake out my career. "Aren't children so much cuter?" my mother would say.
I thought of going into pediatrics. I love children and babies, and have two little ones of my own. The difference for me has always been the stories. Children are a blank canvas, portraits waiting to be drawn. When we look at them, their lives just beginning, we feel a sense of renewal and an expanse of infinite possibility.
My older patients, on the other hand, are like rich paintings and boy, do they have stories to tell. On my best days I can look at them and see all the way back to their childhood. I think of their parents (long gone now), the places they've been, the things they've seen. To me it's like looking through the other end of a telescope, back to the beginning.
That's why Steere House looks beautiful to me-that and the fact that it's a pretty nice place, as nursing homes go. The large, atrium-like windows flood each floor with light on sunny days, and on most days there's music coming from the piano in the lobby. And then there's Oscar.... I'd like to say I was the first one to notice his peculiar abilities-but I wasn't. Thankfully there were others who were more astute.
THE UNIT had been empty that summer morning back in 2006, except for a pair of eyes that glared at me from atop the nurse's desk. Like a warden cautiously evaluating a visitor to her facility, the questioning eyes sized me up to determine if I'd pose a risk.
"Hello, Maya. How are you?"
The pretty white cat made no move to greet me; she was consumed by the act of licking her front paws.
"Where is everyone, Maya?"
Aside from the cat, the third floor was strangely quiet. The hardwood-tiled corridors were vacant; the only signs of life were a few randomly placed walkers parked next to patients' doors. Empty now, these four-sided walkers seemed strange and unwieldy, like an imaginative child's Tinkertoy creation abandoned after play. At the far end of the east corridor, the morning light shone through the large picture windows, illuminating a broad swatch of the hallway.
I was looking for Mary Miranda, the day shift nurse. Mary is the source of all knowledge on the unit, a central intelligence agent who knows not just the story of every patient, but of Steere House itself. Though she's not technically in charge, there's little doubt among the physicians and staff as to who actually runs the floor. Mary is the maternal figure for each resident and she is fiercely protective of her children. Nothing happens on the unit without her knowing about it. Even her supervisors have been known to defer to her.
The doors to the residents' rooms are generally closed this early in the morning, and room 322, where Mary was performing AM care on her patient, was no exception.
I knocked on the door and heard a muffled voice telling me to hold on. As I waited in the hallway, I studied the corkboard display of family pictures attached to the wall outside Brenda Smith's room.
Mrs. Smith's full name, GERTRUDE BRENDA SMITH, and her date of birth, JANUARY 21, 1918, were stenciled in block letters on a rectangular piece of paper at the top of the corkboard. Each letter had been cut from construction paper and meticulously decorated with beads and other trinkets, the loving effort of some grandchild no doubt. Underneath the artwork there was a black-and-white photograph of a beautiful young woman in her early twenties. She wore dark lipstick that contrasted with her pale face, and she was fashionably dressed in a 1940s summer outfit. She was walking arm-in-arm with a handsome man in a Navy uniform. A parasol hung on her other arm. I imagined them in a park on a warm summer's afternoon shortly after the war. I studied their faces. They were happy, and clearly in love.
Beneath that picture was a second photograph of the same couple years later with two young children. This one was in color, the faded stock of an earlier day. His hair had receded some and hers now revealed a few streaks of gray. This picture contained a promise of a different sort. They weren't just young lovers now; they were proud parents, thinking of a future larger than their own.
The last picture in the collection was of Mrs. Smith in her later years, meticulously dressed, her silver hair neatly pulled back below a tastefully chosen hat. Her husband was gone, but she was surrounded by several generations. A banner hung in the background proclaimed HAPPY 80TH BIRTHDAY, GRANDMA. Eight years had passed since then.
I knocked again and made my way inside where Mary was tending to her patient. Gone was the vibrant, well-dressed grandma of the birthday picture. In her place was a smaller replica of the woman that was. Until I worked with patients in the late stages of Alzheimer's the expression "a shadow of her former self" was just a cliché. This is what I saw with Mrs. Smith and so many of the other residents here. But behind that shadow I still saw the substance, even if she seemed no longer to see me.
"Do you need me?" Mary asked, a little annoyed by the intrusion.
"Yes," I replied. "I need to know who has to be seen today."
"Let me finish up here and I'll meet you at the front desk."
As I turned to leave, Mary stood up from her stooped position at the bedside, arching her back against the strain.
"On second thought, David, I'm going to be busy here for a little bit. Why don't you go take a look at Saul's leg? It's red and angry looking. I think he has that skin infection again."
"Fair enough. I'll go see him."
I left the room and headed off in search of Saul Strahan, an eighty-year-old man who has lived on the unit for many years. I found him dressed in his usual garb-a Boston Red Sox sweatshirt and baseball cap-in his usual place, a La-Z-Boy recliner in front of the TV. The television was tuned to a morning talk show.
"What's on TV?" I asked, not expecting a reply.
I sat down beside him and glanced at the television. A young actress was telling the show's host how annoyed she was by the paparazzi that followed her everywhere.
"Everyone's got problems, right, Saul?"
I looked at him more closely. In addition to his progressive Alzheimer's, Saul had been the victim of a nasty stroke that had robbed him of his language four years ago. His eyes stared back at me with life, though, and I could sense that he was trying to speak. I placed my hand on his shoulder and told him that I was there to examine his leg.
As Mary had said, Saul's legs were both swollen with edema, a result of his twenty-year battle with congestive heart failure. Yet his right leg seemed angrier and decidedly warm to the touch. Mary's concerns seemed justified.
"Saul, my friend, I'm sorry but it looks like you're going back on antibiotics." I made a mental note to call his daughter.
I returned to the nurse's station where Maya remained hard at work cleaning her fur. Startled by my return, she leaped off the countertop, but not before giving me one of her this this place isn't big enough for both us looks.
I finished my note and sat at the desk waiting for Mary to return. A nurse for most of her life, Mary started as a nurse's assistant when she was in high school in the seventies and in nursing school discovered she loved working with old people. Not only is she one of the most dedicated nurses I know, she has some sort of intuition for the profession. She always seems to know who actually needs the most attention.
"Hello, sorry to keep you waiting." Mary's pleasant voice kept me from feeling too bad about my dependence. If she had been annoyed before it was all forgotten now.
"David, do you have a few minutes? I want to show you something down in room 310."
As we walked down the hall, Mary told me a little about Lilia Davis. "She's one of your colleague's patients. She's about eighty now, and has been here on the unit for eighteen months. About three months ago, she started losing a bunch of weight. Then one morning, she started to bleed from below. We sent her to the hospital and they diagnosed her with colon cancer that had spread everywhere. Given her severe dementia, her family decided not to treat it; they sent her back on hospice services."
A reasonable approach, I thought to myself.
We found Mrs. Davis lying on her back, her eyes closed and her breathing shallow. A morphine pump was connected to her left arm via an IV. On the other side of the room was an empty cot, the sheets displaced off to the side. Someone had been sleeping here not long ago.
"Mrs. Davis's daughter," Mary said before I could ask. "I sent her home for a few hours to shower and change her clothes. I think she'd been here for thirty-six hours straight."
"So, what did you want to show me?" I asked.
Mary pointed to the base of the bed. "Take a look."
As I approached, the head of a black-and-white tabby cat rose up off the sheets. Moving caused the bell on his collar to jingle slightly. The cat's cars perked up and he glanced at me with questioning eyes. I ignored him and moved toward the patient. The cat put his head back down on his front paws and purred softly while nestled against Mrs. Davis's right leg. I looked over at her face and noted that she was clearly comfortable.
"She looks okay," I said. "Do you need an order for medication or something?"
"Not the patient, David. She's fine. It's the cat."
"The cat? You brought me in here to see a cat?"
"This is Oscar," she said, as if introducing me to someone at a dinner party.
"Okay," I said. I was starting to share Maya's bad mood. "He's a cat hanging out with a patient."
"Well, that's just it. Oscar doesn't really like to hang out with people. I mean, how many times have you actually seen him up here? Usually he's hiding somewhere."
It was true: I'd only seen Oscar a handful of times, even though he had lived on the unit for about a year by then. Sometimes I would see him by the front desk, where his food and water bowls were, or curled up asleep underneath the remains of a tattered old blanket. Oscar did not have a reputation as a sociable cat.
"He's probably just warming up to us a little," I said. "Though I don't profess to be an expert in cats, my experience says they do whatever it is they want to do. He's probably sitting here because he found someone who won't bother him."
"I know this is weird, David, but the thing is, Oscar never really spends any time with the patients. He usually just goes off and hides, mostly in my office. Lately, though, a couple of us here have noticed that he's spending more time with certain residents."
I shrugged. "And why is that weird?" Looking at Oscar curled up beside Mrs. Davis, I was reminded of the cats they buried with the ancient Egyptians. This scene was certainly peaceful enough.
"The thing is," Mary said slowly, "Oscar only spends time with patients who are about to die."
Now I'd heard everything.
"So you're telling me Mrs. Davis is going to die today?" I looked over at her and immediately regretted what I had said. Her breathing was clearly labored and I felt guilty for my breach in decorum. I realized that Mrs. Davis indeed might die today-a fact that had more to do with her dementia and rapidly progressing cancer than the presence of a cat on her bed.
Mary smiled but I could sense her embarrassment. I felt bad for scoffing at her.
"I suppose it's possible that a cat might know when someone's going to die. Remember that article recently about the cancer-sniffing dogs? And there are those Japanese fish that sense earthquakes before they happen. And what about Lassie? He always knew when Timmy fell down the well."
Mary was not amused. "You know, Oscar wandered into another patient's room right before she died yesterday."
The look on my face must have said it all because Mary stopped trying to convince me. For a moment we both looked in silence at the scene in front of us. The cat, curled up next to Mrs. Davis's leg, was quietly purring.
"Don't get me wrong, Mary," I said, breaking the spell. "I love the concept of an animal sitting with me as I die. It's really quite sweet. I had a dog growing up and he was always by my side."
I walked over by the bed and reached down to pet Oscar. With lightning reflexes he slapped my hand with his front paw. I pulled back, searching for evidence of blood.
"I told you he's not that friendly," Mary said with a smile.
"Friendly! He damn near tried to maul me!" I replied with an air of unnecessary drama.
"Oh, he's okay. Oscar really is affectionate when he wants to be. He just tries to protect his patients."
"Mary, he's a cat-cats don't do anything unless there's something in it for them. He's probably just looking for some empty real estate and a warm blanket to sit on."
I studied my hand some more, looking for the nonexistent scratch.
"God, you're a baby. He barely even touched you."
"The truth is, Mary, I really don't like cats. And from the evidence I can honestly say that I don't think he much likes me either."
Mary laughed. "Cats don't hate you, they just know if you're afraid or not. If you are, they respond accordingly."
"Don't laugh," I said, "but I had a bad experience with a cat while I was a kid and it left me a little traumatized."
For a moment I contemplated telling her the story of my grandmother's cat, but the look of mock sympathy on Mary's face convinced me that it would be better to keep the past in the past.
"Some cats are just ornery," she said breaking the silence. "Some people too, I suppose. But you can't forsake every cat because of one bad experience. Besides, you know we wouldn't have a cat here if there was even the slightest chance it would hurt anybody. Even a doctor!"
"Very funny." I looked back at Oscar and Mrs. Davis. "You know, maybe he likes patients who are dying because they don't give him any trouble."
"I don't know, David. I really think there's something more to it."
"So does that mean that Mrs. Davis is going to die today?"
"I guess we'll see."
* * *
I LEFT THE HOSPITAL and drove across town to my outpatient clinic. Unconsciously I found myself thinking of the cat at my grandmother's cottage. His name was Puma, and appropriately so. In my mind, he was a thirty-pound behemoth of a cat-as any fisherman will tell you, size tends to get larger over time-and for years he terrorized me every time I entered "his house." As I thought of his eyes burning with hatred toward me, I told myself that my fear of cats was not irrational.
Mid-reverie my cell phone rang. It was Mary.
"Mrs. Davis died a few minutes after you left."
It had been less than an hour since I was standing in her room watching her breathe. Even after years of seeing it happen, I still feel a sense of humility at being so close to a death.
"Look, Mary. Don't make too much of that cat business. She was going to die soon anyway. She has two horrible diagnoses."
Excerpted from Making Rounds WITH OSCAR by David Dosa Copyright © 2010 by David Dosa. Excerpted by permission.
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Meet the Author
Dr. David Dosa is a geriatrician at Rhode Island Hospital and an assistant professor of medicine at the Warrern Alpert Medical School of Brown University, both in Providence.
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I was fortunate enough to read an early copy of this book. This is a beautiful book that meant a great deal to me on a number of levels. Currently, I have a mother with Alzheimer's and this book really allowed me to think about this disease from a different perspective. Though the book tells Oscar's remarkable story, I found myself even more drawn to the stories of the caregivers. "Be present" is a reminder in the book on dealing with loved ones with Alzheimer's. At times, it is difficult for me to grasp the concept that I may be one those individuals with this disease. I think about my mom and grandmother both women who were diagnosed at a young age. I think about the future and my children...be present and live in the moment as Oscar reminds us to do everyday. I hope you will find this book as meaningful and inspiring as I have.
I heard about Oscar the cat on the nightly news, so when I saw the title of the book, I just had to read it. It was everything that I expected and more. Dr Dosa was a skeptic at first and after many interactions with Oscar and his presence at the time of a patient's death he could no longer ignore that somethings cannot be explained. Dr. Dosa does bring scientific theory into why this cat chooses to spend time with the patients at the end of their lifes, but the reader will draw their own conclusions. I have recommended this book to many friends.
Making Rounds with Oscar was an easy read, very informative and inspirational. It is excellent for audiances young and old, who know someone with alzheimers or not. I personally have not had a friend or family member with alzheimers but through Dr Dosa's account of Oscar I feel enlightened about the disease. I strongly suggest making this book apart of your reperture and will read it over and over for years to come. Congratulations David!
I read a brief review of this book and the title caught my eye because I'm a cat lover. The subject matter interested me, too, because our family is experiencing other members' memory loss of varying degrees and for different reasons. I feel the book was written very well, and as I read, I could tell Dr. Dosa was changing his opinion of Oscar. It was written with respect for the patients and their families, but also with a sense of humor. I will read it again.
this book is wonderful. It is well written and touches everyone.
This is a beautiful, sensitive, insightful and practical book about the emotions and intricacies of responding to the dementia of a loved one. Although the intuition of Oscar the cat is the apparent focal point of the story, it turns out that through the cat we may well learn what it means to be truly human in the face of the frightening prospect of Alzheimer's.
This book is simply amazing!!! It was so well written and you feel like you are right by the side of each patient while you read the book!!!
I found Oscar (the book) at a friend's house who is caring for his elderly mother - she's in a nursing home - and though I am not a cat lover I found the story of this doctor at the nursing home who discovers a cat that comforts the terminally ill patients so moving. This is a terrific book - I recommend it to everyone.
If you picked up this book because you are a cat lover and were excited to learn more about this fasciniting cat, you will be sorely disappointed. This book is more accurately a memoir of a doctor specializing in geriatrics who shares with us his case notes on his elderly patients. At the end of each chapter it feels like he tacks on a token "Oh yeah, and when the patient died Oscar was there and that was quite interesting". That's it. He spends very little of the book pondering the mystery of this cat phenomena. If you have had some life experience with an Alzheimers patient, you will probably find this book quite touching. But if you wanted a good read about a cat, go read Dewey the Library Cat.
After only a couple of pages I was hooked. As a nurse and a cat lover, I could appreciate the story on more than one level. However, the author does not bombard the reader with difficult technical language. Doctor Dosa also weaves a bit of his own personal philosophy into the story. The reader will walk away both encouraged and challenged. Oscar models a behavior that any human could adopt. At the end of life, people need a non-judgmental presence to ease them to the next world.
Having been in the medical profession for many years I was fascinated by Oscar's intuitiveness to those that were in need of his comfort as they were dying even if they weren't aware of his presence. Animals do have an ability that we a humans don't possess. They know when they are needed and Oscar shows that not only for the patient but the family members of the dying patient also.
You Must Read This Book My Mother suffered from alzheimers and was confined to an extended care facility. Months before passing my Mother did not know me. I would ask her if she knew me and she would laugh saying, "I know you, you", not acknowledging that I was her only child. When she passed I was alone with her, holding her hand and assuring her that everything was going to be okay. I believe she heard me and understood I was her only child and that I was there holding her hand. I believe sharing this end of life experience with Oscar would have helped ease my sorrow."
Wonderful insight on the animal/human bond that goes largely unspoken. I learned a lot about the human mind as well as animal senses that we know little about. Very touching and enlightening reading. I have already recommended this book to others.....cat lovers or not.
My mother has dimentia. I thought I knew a lot about it, but Dr. Dosa gave me so much more information. What Oscar does is amazing. I recommend this book to anyone with friends and relatives who have dimentia or Alzheimers. I'm giving copies to my sisters and sons.
I found this book to be very helpful in understanding the process of dementia my father was going thru the last six months before he passed away. We had no idea we were dealing with dementia in him until after 3 months of rehab when a psychiatric evaluation was finally done because he was not improving from an ankle injury. He would forget how to do the rehab exercises and would tell us everyday that they were not working with him, even when we would sit with him at rehab. The doctor in the book, writes about what is really happening inside a persons mind when they are going from "mild dementia" to alzheimer. We lost our father before he reached the point of not recognizing us. But his, what we thought stubborn attitude at the time, was really his dementia. We would get angry at him because we did not know any differently. This book helped me/us understand what was happening. I would recommend it to everyone who may need to deal with or understand what is happening in a person during this time or to comfort someone they know dealing with someone like this. The doctor writes it very well and Oscar is an added bonus and diversion of the seriousness about this topic. Our Dad had an "Oscar" at his nursing home (actually named Taffy). We are very grateful to Taffy for seeing our Dad thru his journey. This book came out right after our Father passed and I know we would have done a few things differently.
This is the story of Oscar. He lives with other cats at a nursing home. He is extraordinary. He goes to rooms of residents who are about to pass away. He sits on their bed until they pass. He gives them comfort and love with asking nothing in return. He gives comfort to the loved ones also. He is a cat but knows what his special job is. I really liked this story. Oscar gives you a lot to think about. He is a pet but gives love. He just wants to be with that person who is dying. He just seems to know who needs him and when. I give this book 5 stars. I think we need to cherish our pets. They are here to love us and give us company. They only want us to love them back. Protect them and care for them. I love my kittie, Callie. She has her moments when she drives me crazy then she does something to make me laugh. I love her.
This little book is a fast read and one I will never forget. It gives us an inside view of nursing homes and coping with Alzheimer's on the part of nurses, doctors, patients and patient families. And with all our technology and advances in medicine it is the simple things that give most pleasure and comfort. I heartily agree with the author -- "at the end of my days, I prefer the cat over the ICU."
Like the author, I am more of a dog person than a cat person. As I read this book about the author's experiences with this unique cat, I found a new appreciation for these mysterious felines. Dr Dosa was at first skeptical of a tale of a cat who seemed to know when Dr Dosa's patients in the nursing home where about to die. Oscar, the cat, would regularly show up in the patient's room and keep them company during their final hours. Being a man of science, Dr Dosa, with a good amount of skepticism, began to research the many cases of Oscar's vigils. The stories of grieving families who found solace and relief in this extraordinary cat, made a true believer of the doctor and this reader.
I had been curious about this book ever since I'd seen it written about in newspapers and one of my professional laboratory journals. When I saw that Oscar was being written about in a book I just had to have it. I believe the author presented his research about what made Oscar go to people in their last hours effectively. There was never a definitive conclusion made about why Oscar did what he did but several possibilities were presented. I enjoyed this book immensely and have recommended it to several of my friends.
This seems to be one very special friend that doesn't need to be told, he just does what he wa a meant to do. The end.
This cat has such ESP about the people in the nursing home where he lives....it is amazing. The families of the patients in the nursing home seem to appreciate the "gift" this cat has and the friendliness and "compassion" this cat showed them. Yes, animals can be very compassionate and, if you have lived with cats and dogs in your lives, you know how compassionate they can be when you are ill or have sadness in your life. This cat made even a doctor who was not fond of cats "a believer" in Oscar's "powers".
I read this book with a heavy heart as my mother suffers from Alzheimer. She is being cared for by a very wonderful staff in Sun City, AZ. There are no cats where she resides but if there was they would be with her as she's had cats all her life. As I watch my cats June and Freida sleeping I think fondly of Oscar and the precious job he has,
I enjoyed reading this touching story. It gives you some insight as to what animals can do to help relieve heartache as well as provide undying love through the way the are always around when you need them most.