Taste: Surprising Stories and Science About Why Food Tastes Good (55 page)

It makes intuitive sense that smoking hinders smelling. Cigarette smokers will generally score lower on smell tests than nonsmokers of the same age. The loss increases with the number of cigarettes smoked. Heavy smokers have more pronounced smell losses on average.

Quitting smoking can and will reverse smell loss that was caused by smoking. You’d trade the smell of burning tobacco for an increased ability to smell bread baking in the oven, the fresh, green aroma of extra virgin olive oil, and the volatiles in a subtle pinot noir. You’ll immediately experience much more sensory stimulation from nose-and mouth-smelling after you stop smoking.

Snorting recreational drugs such as cocaine can also cause a loss of smell if it damages the olfactory tissues as did Zicam, an over-the-counter product, also applied directly to the nose. Years ago, a friend turned me on to the Zicam brand of nasal swabs, which supposedly prevented or lessened the symptoms of the common cold. I used them about a half dozen times without side effects before I decided they didn’t work. Others weren’t so fortunate. After 130 people reported loss of smell from Zicam, the U.S. Food and Drug Administration advised consumers to stop using these products. The FDA website warned:

Loss of sense of smell is a serious risk for people who use these products for relief from cold symptoms. We are concerned that consumers may unknowingly use a product that could cause serious harm, and therefore we are advising them not to use these products for any reason.

People who have experienced a loss of sense of smell or other problems after use of the affected Zicam products should contact their health care professional. The loss of sense of smell can adversely affect a person’s quality of life.

Carlo Middione knows this painfully well.

“Head trauma is a relatively common cause of smell dysfunction,” says PhD Richard Doty, coauthor of
The Neurology of Olfaction.
But it’s not necessary to crack a bone in the skull, even though Carlo’s case indicates that this might make it easier for you to win a lawsuit. A simple bonk on the head or the force of whiplash—where there may not even be contact with another surface—is enough to knock out smell. Just as Carlo experienced, a severe head trauma can start with swelling, which can result in the permanent, or sometimes temporary, loss of smell. Until the swelling subsides, in as little as a few days to as long as a few months, a doctor can’t diagnose the extent of the loss. A knowledgeable doctor will let some time elapse before they conduct smell or taste testing.

When patients do get around to being tested, it’s really important that the testing is done properly. None of Carlo’s doctors ever administered the UPSIT (University of Pennsylvania Smell Identification Test), the standard test for smell, to Carlo. Instead, one of the doctors tested Carlo with stuff she had around the office. Because some doctors know little about the sense of smell, I wondered if this so-called test was helpful or harmful to Carlo’s case. What many people don’t realize is that almost all aromas have a tactile component to them. If an untrained examiner tested Carlo with one of these substances (such as vinegar, mint, or cinnamon), Carlo might have been able to feel the aroma. If this was indeed the case, he might have reported, correctly, that he detected
something
, since his trigeminal nerve was fine, even if his olfactory nerve was as totaled as his car.

If you suspect that you or someone you know has smell loss, it’s important to visit a smell and taste center or clinic. You want experts administering a proper test using the proper methodology, regardless of whether they use the UPSIT, the Brief Smell Identification Test, Sniffin’ Sticks, or an olfactometer.
And if you can’t get that person to a doctor, you can do a test at home. You can buy a smell test from
www.tastewhatyouremissing.com
.

Complete taste loss is exceedingly rare. There is only one way to duplicate a loss of the sense of taste. It requires anesthesia and a willing, open-minded dentist. In the interest of science, Dr. Laurie Novinsky injected me first with one carpule of carbocaine, followed shortly thereafter by one carpule of lidocaine. I wanted her to anesthetize my entire mouth but she cautioned strongly against this.

“You’ll panic,” she said. “You’ll feel like you can’t swallow, like you can’t breathe. Some people choke and vomit from the sensation.” I remembered Bartoshuk telling me about getting sick once while doing this experiment, so I believed my dentist.

We agreed she’d knock out only about two-thirds of my mouth. When the numbness set in, I went to an empty office, clamped my nose, and opened a bag of food I had brought with me. The first thing I noticed when I tasted the samples was how much of the mouth contains taste cells—if I wasn’t careful about keeping the food in the two-thirds that was numb, I could detect sweet and salt on the inside of my cheek, which is much more sensitive to tastes than I ever could have imagined.

When I took a spoonful of unsalted butter and mashed it around my numb tongue and cheek, I got zero taste. No sour, no salt, no bitter, no sweet. Only the slick mouthfeel. Even when I moved the butter to the part of my mouth that still had a bit of taste remaining I tasted nothing. I released my nose and the “sweetness” of the butter unfurled itself slowly, like a pat melting down a stack of hotcakes. It was a revelation: The sweetness of unsalted butter isn’t a sweet taste: it’s a sweet-smelling aroma. And of course there are other subtle notes, too, which give butter its unmatched flavor: dairy, cheesy, funky,
buttery.
This completely changed the way I think about butter, which I now consider a contributor of fat and aroma but not taste. I’m not sure I ever would have discovered this without a numb tongue.

A hunk of bread gave me a new appreciation of texture. Although my saliva level was fine, I was repulsed by the process of getting the bread wet enough to swallow, because, while I chewed and chewed, I experienced zero tastes. It was
less pleasant than no taste: it was like chewing a mouthful of sand until it came together into a wet mass of gluey paste. I realized why Cameron Fredman—the attorney born without a sense of smell or taste—and Ben Cohen of Ben & Jerry’s are so fixated on food texture. When it’s all you’ve got, texture takes on a life of its own. Finally, I got something on the sober left side of my mouth: an unpleasantness that was sharp and irritating like vinegar. When I let go of my clamped nose, the sour taste made sense together with the fermented aroma of sourdough bread.

Dr. Novinsky was right: it was really hard to swallow without first being able to taste food. It was surreal, almost like eating while asleep. I wanted to talk with someone with true taste loss, but it is so rare that there are only a handful of documented cases. Beverly Cowart, who ran the Taste and Smell Clinic at Monell, told me about one case she’d worked on.

“People with true taste loss have more trouble eating than those with smell loss.” she told me. “For people with smell loss, food isn’t pleasant anymore. But with taste loss, what always struck me was that people would describe it as having trouble swallowing.”

She told me of a patient who lost his sense of taste and just couldn’t bring himself to eat. It was as if he couldn’t convince himself that food was safe. With his “decider” sense broken, he began to lose a lot of weight. Then he became malnourished. I asked Cowart what happened to him after that.

“He died,” she said.

When someone comes to Linda Bartoshuk’s clinic complaining of a loss of smell, she counsels him to try remembering aromas, because certain people have an uncanny ability to “visualize” aromas and experience them almost as intensely as if they were smelling it for real. One practitioner of the technique is movie critic Roger Ebert.

For years Ebert has written movie reviews for the
Chicago Sun Times.
He also shared the television screen with the late critic Gene Siskel in their weekly show,
At The Movies
, and later with Richard Roeper, clashing often with both. There is no denying that Ebert is a deep thinker, as has become especially apparent now that he can no longer talk, having lost the lower half of his face to cancer. Ebert’s voice is silenced, but his pen now conveys his eloquence.

Along with his lower jaw and the ability to speak, Ebert has lost the ability to eat. As a result, he does not even put food in his mouth, but receives nutrition through a feeding tube (also called a g-tube). Yet on his website Ebert writes beautifully about his new relationship to food:

I went through a period of obsession about food and drink. I came up with the crazy idea of getting some Coke through my g-tube. My doctors said, sure, a little, why not? For once the sugar and a little sodium wouldn’t hurt.

I dreamed. I was reading Cormac McCarthy’s
Suttree
, and there’s a passage where the hero, lazing on his river boat on a hot summer day, pulls up a string from the water with a bottle of orange soda attached to it and drinks. I tasted that pop so clearly I can taste it today. Later he’s served a beer in a frosted mug. I don’t drink beer, but the frosted mug evoked for me a long-buried memory of my father and I driving in his old Plymouth to the A&W Root Beer stand (gravel driveways, carhop service, window trays) and his voice saying “and a five-cent beer for the boy.” The smoke from his Lucky Strike in the car. The heavy summer heat.

For nights I would wake up already focused on that small but heavy glass mug with the ice sliding from it, and the first sip of root beer. I took that sip over and over. The ice slid down across my fingers again and again. But never again.

One day in the hospital my brother-in-law Johnny Hammel and his wife, Eunice, came to visit. They are two of my favorite people. They’re Jehovah’s Witnesses, and know I’m not. I mention that because they interpreted my story in terms of their faith. I described my fantasies about root beer. I could smell it, taste it, feel it. I desired it. I said I’d remembered so clearly that day with my father for the first time in sixty years.

“You never thought about it before?” Johnny asked.

“Not once.”

“Could be, when the Lord took away your ability to drink, he gave you back that memory.”

Whether my higher power was the Lord or Cormac McCarthy, those were the words I needed to hear. And from that time I began to replace what I had lost with what I remembered . . .

Richard Doty’s advice about how we can protect ourselves from loss of taste and loss of smell is only somewhat tongue-in-cheek: “Don’t go outside. Stay away from small children and pets,” he said, and launched into the litany of threats from kids and pets. “Viruses. Bacteria . . .”

Doty believes that our species has evolved to live robustly only to about thirty. Just because we have the technology to keep ourselves healthy a lot longer doesn’t prevent many bodily systems from failing much earlier than we’d like. Like Rutgers’s Paul Breslin, Doty describes the regeneration of taste and smell cells using a car simile. The human body is “like a car that was designed to go only so many miles. At some point you have to start replacing all the parts.”

Unfortunately, we don’t yet have any way to replace a lost or dysfunctional sense of taste or smell. We’ve made great advances with joint and bone replacements. We can transplant internal organs. And we can install a new retina to help someone see again. Yet we have not figured out how to replace the “parts” of our vital smell and taste systems.