I’m old enough to remember when scientific medical journals insisted their articles be scientific.

So now the “Cute” study of the day is a pussycat who can predict who is going to die in a nursing home.

And that is just what it is: Cute.

No tables on what percentage the cat got right.

But there is one “scientific” clue to what might be behind the cat’s “psychic” ability to diagnose death: odor.

Maybe because I trained in the days before ICU’s and spent much of my life in areas where medical practice lacked sophisticated machines to help us diagnose things, I still know that taking time to talk to people and observe and examine them is important in diagnosing what is wrong with them.

One of the great teachers in the history of American medicine, William Osler, reminded us that medicine is learned at the bedside. In my day, we no longer tasted urine to check for diabetes, but still were taught the now “useless” test of checking the colour of a person’s sputum, the paleness of the mucus membranes, and the way they walk into the room.

So a patient who comes in with an asthma attack is noted to be pale…and turns out to have cancer of the bowel causing anemia. The man coming in for a cold has “dirty neck syndrome” (acanthosis nigricans), a marker for prediabetes. You check his sugar and it is 300. Or a young girl getting a routine immunization is found to have abdominal distention: another pregnant teenager afraid to tell her mom, but in one case the mass actually turned out to be a 25 lb ovarian cyst.

And those who are at the bedside know well the “odor of death: the sweetish smell of acidosis of one who no longer is able to eat, the foul odor of a body whose tissues are shutting down and whose kidney is failing (uremia), and often the odor of infection as the person can no longer cough up his or her secretions.

Could a cat notice such odors? Of course. And when I’m upset, my cats and dogs sense I need comfort, because empathy doest not require a high IQ, merely empathy.

Which brings us to the real question of the article: Why is it that only the cat could sense impending death?
Usually I have worked with “old time” nurses who would call me and say: You’d better check Mrs. So and so”. And I’d arrive, and find they had a heart attack, or  pneumonia and were dying. It was partly instinct, but it was also partly experience, the ability to see the difference in how a person is normally and who has changed for the worse, and the “little clues” of pale skin (low blood pressure), sweating (shock) and odor (acidosis, melana, uremia).

So why is it only a cat has time to sense what any experienced nurse would have done in the past? Is the nursing home understaffed? Or is the nurse only there to supervise,  delegating the messy “Hands on” business of nursing to poorly trained nursing assistants, so the more experienced nurses can do the more important job of documenting what was done so the nusing home can get paid?

Which brings to mind another quote from KublerRoss, a pioneer of death and dying who forsaw this emphasis on the science of medicine over the art of care:“We have to ask ourselves whether medicine is to remain a humanitarian and respected profession or a new but depersonalized science in the service of prolonging life rather than diminishing human suffering”

I laud the medicine whose science cures the sick, but we need to remember that cure is not always the goal, but part of our work is to comfort and the personal touch.
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Nancy Reyes is a retired physician living in the rural Philippines. Her website is Finest Kind Clinic and Fishmarket, and she writes medical essays to Hey Doc Xanga Blog. 

 

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