Authors: Molly Birnbaum
But without smell, the world around me seemed suddenly strange and stagnant. It was as if I was watching myself in a movie, present but not wholly, interested but not engaged.
When my mother came to visit me in those weeks after surgery, she took me for rides in my wheelchair outside. She wore sweaters and jeans and tucked a fleece blanket carefully around my legs. I thought of how her hair usually smelled of rosemary and mint and how she used a drop of lilac perfume on the nape of her neck for special occasions. I had picked out that perfume for her after smelling more than a dozen scents—lemon, rose, clove, a muddled more—at a specialty shop near the Santa Maria Novella church in Florence when I was studying abroad in Italy.
My mother’s feet crunched on piles of browned leaves and pine needles. These were perfect fall days that begged for the scent of earth and grass. But without the scent of rain or moss or bark mulch, my world seemed blank. I was reminded of days I had horrible head colds, stuffed up and unable to breathe, and was struck by the dullness of my landscape, which had suddenly been cast in two dimensions. This time, though, the air flowed freely through my nostrils and I sunk deeper in my seat with every passing minute. Autumn passed in a dim brown chill. What was once vibrant and colorful faded into shades of gray.
I didn’t know how to explain it to my mother or my father, who both looked at me with eyes wrinkled in concern.
How do you describe the scent of nothing?
I wondered. It was strong; it was blank. It was completely overwhelming.
One afternoon while my father was at work my mother and her boyfriend, Charley, took me to a nearby farmers’ market. They pushed me along in my wheelchair and we bought a pumpkin and some late-season tomatoes. Small kids shrieking and running among the piles of gourds stopped and stared at me, too thin and too young in that big metal chair. I felt uncomfortable but tried not to mind the attention. I knew that my knee and pelvis would heal. I knew I would eventually be able to walk. It was the apple cider bubbling away in a pot on a table that upset me. I could see it: a metal crock, a thick trail of steam wafting from within. I could imagine its sweet fermented aroma—like Christmas in Germany, like fruit baking in the sun, like cinnamon sticks and clove buds—like a word on the tip of my tongue. But I sniffed and there was nothing. It may as well have been a pot of water, bubbling away as it waited for a box of pasta to be dumped within. It may as well have been empty. That’s what finally brought tears to my eyes. My world was no longer as I remembered.
How will I cook?
I asked myself over and over again. Silently. Never out loud. I wasn’t yet ready for that.
After two wheelchair-bound weeks, my pelvis had healed enough for me to put weight on my right leg and I was able to hobble by myself from bed to couch on crutches. My skull fracture had mended enough for me to focus my eyes and read. I began to write e-mails to my friends and family across the country, thanking them for the bounty of colorful but scentless flowers that had filled my room for the past two months. I was happy to leave behind my state of complete dependence. But I still was not ready to articulate my fear. I wouldn’t take a single step into the kitchen.
I returned to my mother’s house in Brookline because it was close to the physical therapist’s office, where I began to spend painful mornings bending my knee back and forth. I had to break through the scar tissue that had piled up, slick with disuse. I could feel it tearing, rocking my body with its red-hot burn, as the therapist pressed back against my shin. I couldn’t stop the tears, but I told her to keep going. It hurt, but it helped. This was recovery I could feel.
Back in my mother’s house the once familiar rooms felt foreign and strange. I hardly remembered the days before knee surgery, when Alex sat by my side as I slept. Returning to the home where I had spent hours rolling fresh pasta dough to feed my family, my fingers caked in flour and egg as butter and onions melted in a pan to my side, was painful in its blankness. Sometimes I had to remind myself where I was. When I first reached my bedroom after climbing the steep staircase on crutches, it looked the same. It was the same square space. My cookbooks were still on the shelves. The desk was still painted white. But something important was missing—
was it the crooked window shade or the new lamp?
I stood in the doorway and inhaled deeply. It smelled thin, white, and utterly unfamiliar.
My younger brother, Ben, came home to visit from his college in upstate New York for a weekend. He is tall and funny, and I had fuzzy memories of him sitting on the couch near my bed in the days after the accident. One evening we drove back to our father’s house for dinner, speeding up the highway to New Hampshire as the sun began to set.
“Do you smell that?” he asked, crinkling his face with a look of disgust.
“No,” I said, annoyed. “Obviously.”
“Oh, God, it’s horrible. Foul. Like there’s a sewage plant leaking . . .”
We were in suburban Massachusetts. I didn’t think there was a sewage plant nearby. But I began to feel uncomfortable. Obviously I was missing something big. I began to think:
What if I was alone and I couldn’t detect a horrible odor?
Instead of sewage, what if it was the smoke of a fire?
A gas leak from the stove?
By the time we got to my father’s house I was terrified that I would be poisoned by rotten food. I would burn to death in my home, unable to detect the scent of smoke in the next room over until it was too late. “If only she could have smelled it coming,” they would say at my funeral.
We got out of the car and I limped with my crutches to the door. Once inside I asked my father if there were any sewage plants between Brookline and Nashua. “Would something pumping odor like that into the atmosphere be a health risk?” And then I looked at my brother, who had plopped himself down on the couch. He was laughing.
“There wasn’t any sewage plant, you goon,” he said. “I just had really bad gas. I farted. I wanted to see if you really can’t smell.” I saw my father begin to chuckle. I gave a weak smile. As the sound of their voices bounced around the room I thought,
what a strange sound.
It had been so long since I had last heard laughter.
EVERY MORNING IN THOSE MONTHS,
my mother would bring me a steaming mug of tea as I sat in my bed, which still dominated the living room downstairs. Sometimes the tea was laced with milk and sugar and sometimes it was served plain. Occasionally she would ask me if I could tell what kind it was, knowing that the taste of bergamot and chai, jasmine and chamomile are indistinguishable without their strong and varied scents. She would ask casually, accompanied with a careful smile as if to say it didn’t matter. And I would inhale, willing myself to register something, anything. But there was nothing—just the wetness of steam and the sharp heat of the mug.
“English Breakfast? Peppermint?” I had no idea.
Food, which only weeks before had been my consuming passion, had been reduced to a tasteless texture. I dreaded eating. I didn’t want to open my mouth. The necessity of smell slapped me across the face with every bite. It forced me to feel what was gone. I didn’t yet want to face what I had lost. But I had to eat.
Without scent, the taste buds are capable of detecting only salty, sweet, bitter, and sour. Umami, which was first identified by Kikunae Ikeda in Japan in 1908 and is associated with a handful of amino acids, especially L-glutamate, is considered by many to be the fifth taste. It is commonly described as a savory taste and is found in many protein-rich foods: from mushrooms to meat, tomatoes to cheese and monosodium glutamate, or MSG. In 2009, a study done by the Monell Chemical Senses Center in fact confirmed that there is a taste receptor genetically coded in humans to aid in the detection of glutamate. But as I quickly learned, every other element of the flavor of food put in the mouth is experienced by smell.
I could taste the sweet of sugar in a Popsicle, the salt on a potato chip, the acid sour of a squirt of lemon juice in a cup of water. I would inhale and exhale, just as Maws had taught me. There was, after all, neurological reasoning: scent is perceived from both the intake of air through the nose, called
orthonasal
olfaction, and in the slow release traveling through the back of the mouth, known as
retronasal
. Both are important, each bringing the perception of scent to the olfactory receptors through different pathways. All were blank for me.
Ice cream was a thick and cold slush. Lattes were hot, sometimes even gelatinous liquid. I ate yogurt for its smooth chill and bread soaked in Tabasco sauce because I could feel the spiciness. Mealtimes were nonevents: when my mother cooked dinner, I could hear the sizzle and the clang from the next room over, but the scent of sautéing garlic and roasting meat fell upon a lifeless string of olfactory tunnels and nerves. And when I ate, a bite of steak may as well have been a chunk of cardboard warmed over.
Only a couple of months earlier I had spent long nights in a professional kitchen, awash in the scents of orange peel and clacking chicken bones. I had breathed in the heady aroma of salt- and oil-encrusted sardines, willowy braised leeks, poached eggs on garlic-skewered toast. A simple mushroom had inspired layers of flavor in my mouth. My clothes had reeked of butter. My hands were caked in the odors of thyme and stock. I had run back and forth from the walk-in refrigerator to the kitchen on strong working legs, holding bitter bouquets of arugula and tubs bearing butchered legs of lamb, pink flesh glistening and mottled with blood.
But now I wouldn’t go near the kitchen. I wouldn’t touch the stove. Even as I became increasingly mobile, nimble on crutches or hopping around on one leg, I hardly ever stepped foot into the room. I couldn’t yet admit my terror.
ANOSMIA HAS A NUMBER
of causes. Blockages can form like nasal polyps, small growths of inflamed tissue lining the inner nose, eliminating the pathway for aromas to the brain. Seasonal allergies can stop scent molecules in their tracks; an illness can strike, damaging the receptor cells of the nose. Or, like with me, there can be an impact, a head trauma, and suddenly the cocoa-crusted scent of your favorite chocolate shop may as well be the musty stench of a high school locker room.
Anosmia can be sudden, stolen by a knock of the head. It can happen slowly, after years of damage caused by a virus or in the aftereffects of surgery. Congenital asnomics are born without a sense of smell. In the weeks after the accident, when I sat at my father’s computer desk with my bandaged leg propped up to the side and Googled “loss of smell,” I couldn’t imagine that the congenitals feel their loss as acutely. Had they ever experienced the scent of fresh-cut grass on a spring morning?
Richard Doty, head of the Taste and Smell clinic at the University of Pennsylvania Hospital, and colleagues conducted a study on the effects of taste and smell disorders, including anosmia, on 750 patients seen over six years. The researchers reported that those without smell had trouble cooking and eating and struggled with mood changes and feelings of safety. Depression, Doty said, was common. I wasn’t surprised.
I wasn’t surprised either to read a study done by Daniel V. Santos and colleagues on 445 patients who were treated at a clinic in Virginia. Santos found that for those with impairment of the nose—whether anosmia or hyposmia—there is a higher risk of experiencing hazardous events day to day. He doesn’t mean broken bones or slips and falls. Santos asked about specific hazards, ones that have to do exclusively with smell. Thirty-seven percent of smell-impaired participants, he found, had experienced a dangerous scent-related event, twice the rate of a fully-functioning control group. Thomas Hummel and Steven Nordin sum it up in the introduction to their 2003 paper, “Quality of Life in Olfactory Dysfunction,” for the Sense of Smell Institute. “When the sense of smell is lost,” they write, “it is not just that it becomes a difficult task to differentiate between cardboard and a hamburger, but also a sense is lost which alerts us to dangers from fire or rotten food.”
I could relate. Already I knew that fear. I examined every piece of food that I put into my mouth. That quart of milk: fresh or sour? That bag of spinach: new or old? I had only the visual to guide me. Without smell, I could not taste more than the salty, sweet, bitter, sour, and umami of the tongue. I hadn’t realized what a role scent played in my mouth until it was gone. I hadn’t realized the full extent of my loss until it was there, hanging over each bite of dinner, each sip of tea.
While at the Monell Chemical Senses Center I met Marcia Pelchat. She is a sensory psychologist who studies the science of flavor and food preference and often demonstrates the relationship between taste and smell with a jelly bean. Close your eyes and pick a jelly bean out of a bowl. Do it blindly, so you won’t know the flavor before you put it on your tongue. Pinch your nose shut, so you can only breathe out of your mouth, pop the bean in, and begin to chew. What can you taste? Can you tell what kind of jelly bean you’re eating? Most report nothing but a bland sweet. Now, let go of your nose and breathe through your nostrils again. Now there’s something.
That’s
how smell makes a difference in flavor. Pelchat conducted this experiment with Ruth Reichl, editor of the now-defunct
Gourmet
magazine, and Daniel Boulud, a well-lauded French chef in New York City, during an interview on WNYC radio in 2005. Her subjects wore clips over their noses as they put the unidentified flavors of jelly bean in their mouths. They chewed silently until, suddenly, they were instructed to remove the clips.
“Oh my God, amazing,” said Reichl in a low, distinctive voice. “It went from absolutely nothing to—the minute it came off, it was pure, devastatingly strong banana.”
“Think of fruit,” Pelchat said to me. By taste alone, fruit is sweet and sour, she explained, with the exception of bananas, which are solely sweet. “But we can distinguish lots and lots of different fruit
flavors
. We can distinguish the difference between peach and mango, apple and grape. Even more: we can distinguish between beef and lamb, the difference between a corn tortilla and a wheat tortilla. There are textural differences. But this is mostly smell.”