Remembering Smell (11 page)

I opened my eyes. The smells, such as they were, vanished. What would my home be like now? Not just this chair, but my garden? My kitchen? This room stripped of its layers of fragrance was a barren cell. It would no longer delight my eye, its physical beauty having been formed by the smell of it. I might as well live in one of those new condos that Cam suggested we take a look at now that the kids were gone, with their white Sheetrock walls and plastic carpeting and sanitized air. No dust, no dirt, no crumbs allowed. No pets or children. No memories.

What did this room smell like now that the bad odor was gone? How do you describe what isn't there? Especially something that is off-limits even to memory, trapped forever in some shuttered chamber deep in the brain? The brain can store pictures and events, and melodies, and even smells, especially smells—but like Sleeping Beauty, who can only be awakened by a certain kiss from a special prince, smell and all its attendant emotional connections lie dormant until triggered by smell itself. This requires a working nose. Without my sense of smell, my great-grandfather's wing chair would gradually become a stranger. Its visual presence would mock the richness of what it had once been to me. It would be like the photograph of a loved one who has died. Wouldn't you rather, until the pain has dulled a bit, put the picture away?

B
ECKY PHILLIPS SAID
it took months for her to stop dreading meals: the shock of recognition "with each and every bite," as she put it, that steak was no longer steak but something profoundly and repugnantly altered. In other words, while anosmia might come as a relief from phantosmia's twenty-four/seven assault of putrid smells, it would not restore my pleasure in eating.

When you can't smell, the simpler and more familiar the food, the more traumatic its transformation. Buttered toast, the ultimate comfort food, is no longer familiar. You've been conditioned through long years of exposure to expect toast's symphony of delightful sensations, beginning with the sweet aroma, then the liquid saltiness on the tongue, and finally the crisp yet chewy feel between the teeth. There is no way to describe the revulsion that attaches itself to the poor excuse for the food that every fiber of your being is begging for. To compare the taste of scentless toast to cardboard is to admit defeat.

I'd been smell-free for a month when Dr. Cushing took me off the amitriptyline. I assumed the stench would return. My husband assumed the opposite. To him, the end of phantosmia signaled recovery. He was convinced that my sense of smell was on the mend—until the night I tried to cook dinner for a dozen guests. Lasagna seemed like a no-brainer. How could I screw that up?

Cam never said the flavors were off. He didn't have to. The evidence was on all those confused faces around the dinner table, and on those half-full plates, and in the second pan that I always had ready for second and third helpings. It's hard to cook well when you can't smell, almost as hard as it is to eat when you have no appetite. The extra pan went back in the fridge untouched.

No one asked for seconds, even after I'd helped myself to thirds.

That was the weirdest part. I couldn't stop eating.

"I know, it doesn't make sense, does it?" Becky Phillips said after telling me she had put herself on a diet. "You'd think anosmia would be a great diet plan. But now when I'm eating I lose track of what I'm doing. I don't ever feel full. It's as if I don't know that I
am
full. And of course I never feel satisfied. So I just keep on eating, expecting to feel like I've had enough, but that signal never comes. I used to think that feeling full came from having a full stomach. Like 'I'm so full I'm going to burst.' But apparently it's something else."

By late February I'd gained back all the weight I'd lost, and then some. This should have been a sign of recovery, if not of my sense of smell then at least of my joie de vivre. It wasn't. I had not adjusted to anosmia. Acceptance of anosmia can't be taught in a self-help book. I'd tried that too. Lots of books deal with how to cope with loss, but my loss felt ludicrous compared with the ones in those books. My rational self still scoffed at my emotional self for thinking that being unable to smell was in any way comparable to losing a loved one.

I was traumatized and alone with my imponderable pain. I was still trying to ration those little yellow pills that seemed essential to getting me through the day.

Dr. Cushing hadn't prepared me for any of this—except for the weight gain. Twenty-five pounds is about average, he'd said. For the first time ever, I felt real empathy for overweight people. They'd always baffled me before. I'd thought,
If you don't want to be fat, stop eating.
It's not that simple. Overweight people complain that they struggle with demons. They crave certain foods. They can't stay away from sweets. They eat compulsively and can't help it. They try too hard to lose weight, which leads to yo-yo dieting, which leads to hormone imbalances, which create more of those addictive feelings about certain (usually sweet) foods.

It's those metabolic disturbances scientists want to know more about. Why do people feel compelled to keep eating even though they're full? Why do they compare the urge to eat to an addiction? What triggers appetite and satiety? These issues occupy the minds of biologists testing satiety responses in lab rats, and they also concern the physicians treating a growing number of patients whose problems, ranging from diabetes to sterility, have an underlying connection to hormones and appetite. These professionals have all reached the conclusion that the sense of smell plays a key role in regulating food intake. The primary sense doesn't just prompt the salivary glands to prepare the digestive system to make fuel from food. It also announces when the tank is full.

During his tenure as chief of the Food and Drug Administration, David A. Kessler, a pediatrician, accused the tobacco industry of studying certain human psychological vulnerabilities and deliberately designing products that made cigarettes irresistible to addictive personality types. Kessler thinks food companies and restaurant franchises do the same thing, creating what he calls hyperpalatable foods rich in a carefully balanced blend of sugar, fat, and salt—ingredients that just happen to be linked to the current epidemic of diabetes and obesity, as well as to cancer and heart disease. Texture and taste are paramount in such foods—think chocolate chip cookies—but certain microwavable instant meals also waft mouthwatering aromas into the kitchen. Kessler thinks processed-food manufacturers, probably without understanding the neuroscience behind their products, intentionally manipulate the brain's ability to create mental images of desirable things and then get stuck on them, especially in times of stress. To combat the nation's weight problem, he promotes a sweeping "perceptual shift." Nutritional education, he believes, has the power to turn the public away from unhealthy foods by literally turning their stomachs at the thought of them. The same phenomenon causes a once-avid steak eater who switched to vegetarianism after a heart attack to find the mere mention of a well-marbled rib eye repulsive. It happens with smoking too; after all, you don't have to be a neuroscientist to feel turned off by something you know could kill you.

Some biologists think Americans' lousy eating habits wreak havoc not only on the body but also on the olfactory system—specifically, that sense's role in triggering hormones that regulate appetite and metabolism.

Most Americans don't cook anymore. Not really. No olfactory signal of "doneness" emanates from the microwave oven as an instant meal is being heated. The normal sequence of hunger and satiety is interrupted when anticipation triggered by smell is removed.

No wonder so few families take the time to sit down at the dinner table and savor a meal. They haven't received those alluring multisensory prompts. We're like a nation of anosmics when it comes to family dinner rituals. Meals have been stripped of the essential anticipation: the gathering of appetites around the table as the food is served; the traditional sniffs over the steaming stew pot; the soup spoon sliding beneath the surface; a pause to savor the smell a final time before the mouth opens around the spoon and the soup is allowed to spill over the tongue. The irony is that even as we've developed an ever-higher food IQ as a society (we have access to and have developed a taste for many more foods than earlier generations), unless we're having guests for dinner or dining out, we gulp, nosh, and shlurp without much pleasure. Enjoyment and nutrition are both diminished, and obesity statistics climb.

Hormones tell us not only when to start eating but also when to stop. The limbic system includes the hypothalamus, an almond-shaped organ located below the thalamus and just above the pituitary gland; it regulates the nervous and endocrine systems. The hypothalamus is a busy place. It synthesizes neurohormones that stimulate or inhibit the secretion of pituitary hormones, which in turn control body temperature, thirst, fatigue, anger, and certain sleep cycles, as well as hunger. In people with working noses, the sensing neurons in the olfactory receptors and taste buds stimulate the hypothalamus to welcome an order of fries as well as tire of them, even though a few remain on the plate.

Adaptation (also called habituation) is why you can't smell the garlic on your own breath. It's what makes mice, and probably people, stop smelling an odor after a few minutes. But how do these mysterious mechanisms—satiety, adaptation—actually work? Investigators at Johns Hopkins University think a protein molecule in the receptor neuron causes a particular channel in the neuron's membrane to open and close, helping the brain discriminate among different incoming odors. An odorant triggers a series of molecular "gates" on the cell surface to admit certain charged ions. Differences in charge between the cell's interior and exterior allow electrical signals to travel the axon highway from the tissues lining the nose to every corner of the brain. Researchers speculate that the brain uses this same mechanism to aid in balance, fertility, and digestion.

About thirty minutes after ghrelin, the so-called hunger hormone, turns on the salivary glands, leptin and obestatin kick in to curb appetite. Destruction of one part of the hypothalamus can cause massive overeating, while destruction of another region causes the opposite to occur: appetite is erased. Recent research suggests that satiety occurs in two stages: first, the palatability of the food on your plate is selectively reduced (probably starting with the broccoli), and then food odors fade. Smell researcher Alan Hirsch tried to test this theory a few years back. His informal studies showed that sweetening food shortened the amount of time between hunger and satiety. He went so far as to market a sweetening agent, which he called Sprinkle Thin.

Venture capital is pouring into start-ups that are trying to come up with sure-fire weight-loss solutions that harness the body's own systems. Most research involves manipulating electrical currents that go to the brain (stimulating the satiety response in the hypothalamus) or the gut.

All too late for me. As I mindlessly munched on sugar cookies and taco chips, I felt like a robot programmed to feed itself indefinitely, experiencing neither pleasure nor pain. The robot would go on eating until its batteries died, unsatisfied to the end.

My husband insisted that I was overthinking my weight gain. It was hardly surprising that I couldn't stop eating: I was depressed. He always ate too much when he was depressed. Everything would return to normal once I got used to this.

Maybe so, but regardless of whether the hunger was psychological or physiological, it felt like a leaky faucet that would continue to drip until someone replaced the washer.

I
N FEBRUARY, A FOODIE
friend of mine named Peter told me that Grant Achatz, cofounder and head chef at Alinea, the Chicago restaurant considered by many experts to be one of the best in America, had been diagnosed with tongue cancer. Peter used to live in Chicago and knew someone on the staff who'd been keeping him up to date on the boss's health. Peter, Cam, and I had dined at Alinea together just six months before I lost my sense of smell. He hadn't called to bum me out, Peter said, but to invite us for dinner at his house the following weekend. Did I want that potato, butter, cream, cauliflower, and truffle thing we'd had at Alinea that Peter was dying to make, or would I prefer something less caloric?

I thanked Peter for asking and reminded him of my own situation; I said I could go either way on the dinner, and whatever he wanted to cook was fine. "Oh, sorry, of course," he replied. "I'll do the truffle thing. You can tell me if you like the texture."

Then it was back to Grant Achatz. "How unfortunate he didn't lose his sense of smell instead," Peter said, "like you did."

Better to lose smell than taste? Are you crazy?

Finally I said, referring to the cancer, "I sure wouldn't trade places with him."

I was lying. And not just because I'd come to value smell (in its absence) more than taste (what was taste without smell?), but because, for all the anxiety I'd had over the C-word just a few months ago, I was now battling something for which there was no treatment and that no one I knew, including Peter, had ever heard of.

In the latter half of the nineteenth century, a Frenchman named Auguste Escoffier was pushing the culinary envelope. He shifted the focus of the culinary arts from sight to smell.

The peasants of the time ate relatively well. They had no choice but to boil their tough meats (and to extend them) in a hearty and nutritious broth flavored with bone marrow, fat, and fresh vegetables. But eye candy—stunning, sweet-tasting but odorless confections served cold to preserve their beauty—was the culinary ideal in the royal court at Versailles. Antonin Carême, who cooked for Napoleon, was a superb visual artist. The only taste of much importance in his extravagantly ornate dishes was the sweetness extracted from rare and exotic fruits.

Escoffier radically altered the recipe for dining pleasure. Aromatic soups and stocks inspired his dishes; slabs of bone scented with herbs and spices and vegetables were simmered for hours, even days. Reduction with a dash of red wine turned simple stocks into enticingly fragrant sauces, which were served piping hot.