Remembering Smell (2 page)

The odor was sickly sweet, and I admitted to myself why it was more than a mild annoyance. It didn't smell like hog dung, dead fish, sour milk, sulfur, smoke, or musk as much as it smelled like death. Rotting flesh. Roadkill.
Carrion
is the polite term. It smelled the way
Amorphophallus titanum
(a.k.a. the corpse flower) smells when it opens. The enormous red bloom has an odor so similar to bad meat that carrion beetles stampede to pollinate it, and humans with sensitive noses can't handle the stench. When
A. titanum
bloomed for the first time at a conservatory in St. Paul, the event was given lots of media play. The conservatory even had a webcam installed so the public could track the flower's progress. People thronged to catch a sniff. The stench was even worse than they'd expected; it really
did
smell like rotting flesh. That deceptively beautiful flower got people in the door all right, but not many of them stayed long.

The stench was bad the next day and worse the day after that. Could it be a drug interaction? I'd recently switched from a beta-blocker to a different pill to control my blood pressure. Maybe this new drug didn't mix with all the other stuff I was taking—Synthroid for a thyroid condition, multivitamins, calcium and Fosamax for thinning bones. It was quite a cocktail. For the first time, I told Cam that I was scared. He offered to phone his friend Dan, a physician.

Dan tried not to sound skeptical when Cam gave him this report of nose trouble. Smells. Weird smells. "No, Dan, I can't smell anything—it's just Bon." Dan said his wife smelled weird things occasionally too—"when she has her sinus infections, pretty awful stuff apparently."

"That makes sense."

So the smells were just the lingering effects of that head cold I'd had three weeks ago and only vaguely remembered? I'd been trying to write, and my nose had kept dripping on the keyboard.

Dan prescribed an antibiotic and recommended I use a steamer to open up my sinuses. The steamer cleared my head all right, but it didn't take care of the smell. If anything, the disgusting, dead-animal sweetness intensified. Bent over the device with my nose locked onto its rubber collar, I gave in to an eerie detachment. My glasses fogged up, and my mind with them.

Cam was starting to get the picture. My sinuses weren't causing this.

"What does it smell like now?" he asked.

"Imagine every disgusting thing you can think of tossed into a blender and pureed," I finally said for lack of any other comparison that I hadn't already banged to death. "Now take off the lid and stick your nose in it."

The steamer's rubber collar made my voice nasal and distant. Cam said I sounded like I was talking through a garden hose. My husband has a penchant for dreaming up offbeat analogies. Hoping to cheer me up, he said he couldn't stop thinking about those long-nosed monkeys in Borneo that looked like they had tubes attached to their faces.

"Everything still stinks then, just as bad as before?"

"Do you honestly want to know?" I asked.

"Of course I want to know."

"Worse."

As the weeks passed and the smell didn't, Cam wondered what was
really
bothering me. Was it the fast-approaching holiday season? Menopause? Our marriage? Is that why I thought he smelled?

My internist too kept mining my personal life for answers. How were the girls? Was my mother still sick? When I insisted that my new blood pressure medication was causing the smell, she reluctantly switched me to a different one. She also prescribed a mild tranquilizer for my nerves. I was astonished by its cool efficiency. An invisible hand gently put my brain back in order. Anxiety was erased as completely as a set of equations off a chalkboard. I could get used to this. Hooked.

Unfortunately, the drug failed to jump-start negotiations for a lasting truce between me and "this smell thing"—which was how my doctor now referred to my condition. After I spent a few hours in la-la land (with no respite from the smell), the racing heart and roiling gut—symptoms that had become as constant as the odor itself—returned.

I wanted to keep popping those amazing little yellow pills but kept running into my inner hall monitor on the way to the medicine cabinet. Nurse Ratched on patrol.
Tranquilizers are for genuine crises,
she'd scold.
A messy divorce, or a death, or a job layoff when you have enough credit-card debt to drive you into
bankruptcy. You don't take tranquilizers when all you're suffering from is some nameless odor that no one can smell but you.

What I needed to do, I told myself, was a bit of mental tap-dancing—convince myself that the smell wasn't all that strange or scary, that it would go away, and that even if it didn't go away, I could live with it. I could tune it out as I would any other minor irritation, like low back pain, a runny nose, the pain and itch of hemorrhoids. If only living with a constant stench were a minor irritation or the sort of routine complaint you could whine about to a girlfriend whose hemorrhoids were as bad as yours.

Besides, I'd already tried "giving in" to the smell. Did I have to keep trying to give in? Yes,
try harder.

I developed another theory: I was allergic to my wristwatch. I called my doctor to ask her if I should switch from an aluminum to a cloth watchband. She said she'd been meaning to get back to me. I had something called burning mouth syndrome. "It may be psychiatric in origin. Your mouth just goes nuts for no reason. Everything tastes bad. Like really, really hot."

She referred me to an ear, nose, and throat specialist. "He'll be able to rule out anything else." She added, "Then I'd suggest you see a psychiatrist."

M
Y OLDER DAUGHTER,
Alex, came along with me to the ENT doctor, whom henceforth I will refer to as Dr. Cushing. Alex lived in New York City and had asked for a few days off from her job to help me get ready for the holidays. That was her stated reason, anyway. I knew the real one: she didn't like what she was hearing from Cam.

I'd read in one of those health articles that fill the Sunday newspaper supplement that distorted smells can be an early indicator of schizophrenia. One theory to explain the connection is that schizophrenia appears to be associated with abnormalities in the hippocampus; this organ in the brain plays a major role in bringing together environmental signals and helping to form a coherent view of the world, and it's also an essential part of the olfactory system. Cam knew I was no more likely than he was to be diagnosed with schizophrenia. He also knew I'd nonetheless diagnose myself as schizophrenic if this smell didn't go away.

A short roundish man with glasses and thinning black hair greeted me and my daughter with a brisk handshake each. His manner was hurried, but he seemed nice enough: "What brings the two of you here today?" Dr. Cushing asked.

I'd rehearsed my spiel; I didn't want to leave out a single detail that might turn into a vital clue. I told him about the drive home from Madison, the various causes I'd assigned to the odor along the way: coffee, truck exhaust, my own car. I wanted him to know exactly what the smell was like and how it came in waves with various but all equally awful notes competing for dominance. I could tell he wasn't paying much attention. Why the listless response?

Anyone with my problem would know immediately what I was talking about. My verbal renderings of the smell grew more and more overwrought as it became clear—at least in my mind, which probably was not the best gauge—that this man did
not
know what I was talking about. Was he a gardener? I asked. Yes, he was. Did he grow snakeroot? No? I suggested that he might know this popular late-blooming perennial by one of its other common names, bugbane or black cohosh, or by its Latin name, which used to be
Cimicifuga racemosa
but was recently changed to
Actaea racemosa.
Either way, it stank to high heaven when in flower. Had he ever noticed?

"Sorry, I haven't," he said.

Why no questions? Shouldn't he be asking for more symptoms? I mentioned burning mouth syndrome and my aluminum watchband. He only chuckled. I told him my husband still thought it was a sinus infection. I'd had a cold a few weeks ago. I'd been using a steamer.

"Did you take anything for it?" the doctor asked.

"Just the amoxicillin. I suppose it's possible that I've built up an immunity." (How delightful to finally be conversing.) "My kids lived on that stuff. One ear infection after the other."

"I mean when the cold was coming on," he interjected. "Any over-the-counter medications?"

"I don't take cold medications," I said. Then I remembered I had taken something. A nasal spray. "Some homeopathic thing my husband bought. If anything, it made it worse."

"Zicam?"

"That was it."

"How much of it?"

Dr. Cushing was wide awake now and looking me right in the eye. How could I have omitted this important fact? Because until now it had seemed so ‹‹important. And so dumb. I wasn't into homeopathic remedies. A neurologist friend in California had recommended this one to Cam. Everyone out there was using the stuff. "Maybe it works, maybe it doesn't, who knows?" Cam had said. "Anyway, give it a try if you think you're getting sick. What have you got to lose?"

"How much of it went up your nose?" Dr. Cushing repeated.

I tried to recall. I went back to the beginning—that conversation with Cam. We'd been driving to the airport. He was off to New York for a trade show and was feeling cranky and tired. A bad cold had persuaded him to pick up the Zicam—for next time, he said. I'd noticed my throat felt scratchy as we pulled up to the sidewalk check-in counter.

"Damn, you
have
given me your cold," I said.

Sorry.

"You can't get your own cold back," I joked, kissing him on the lips.

The next day I felt clobbered and useless. By the time I went to bed, the chills, headache, and raging sore throat were like a chorus of nagging crones telling me it was now or never if I wanted to slow this thing down. After an hour or so of pointless tossing from side to side, I got up and debated trying the Zicam.

Cam was right. What did I have to lose?

At first, in the dim light and without my glasses, I couldn't find the small white bottle with the orange label, so when I finally did a wave of relief swept over me and I wondered why I'd hesitated. I tilted my head back—the more the better, I figured—and sniffed hard from the pointed rubber tip, the index finger of my left hand covering my left nostril to maximize the force of my inhale. I squeezed again, even harder this time, with my head tilted farther back. A glob of gel swooshed up my nose, cold at first but then within seconds burning into my membranes. I went to work on the other nostril.

My sinuses were suddenly on fire, and so were the tissues far back in my throat where the gel had apparently started to drip.
So this is how cattle feel under a branding iron,
I thought as tears filled my eyes. One made it over the edge and rolled down my cheek. But even though my nose felt like someone was burning a match up there while pouring a steady trickle of battery acid down my throat, and I had to take a Tylenol No. 3 to get to sleep, I didn't panic. So I'd have a sore nose for a while.

"I've stopped recommending Zicam to my patients," Dr. Cushing said when I fins shed my story. "The nasal spray has been causing some problems. Problems like yours."

His personal opinion was that the active ingredient in Zicam Cold Remedy nasal gel spray, zinc gluconate, was toxic to smell receptor neurons, but no studies had proved this conclusively because cold infections too can harm the nasal receptors. Colds and head injuries are the leading causes of smell dysfunction, Dr. Cushing said. "Head injuries are the more serious of the two. They can permanently destroy the olfactory receptor sheet. It doesn't take much of a blow to the head to sever the nerves completely."

"I'm afraid you lost me back at
receptor neurons,
" I said.

"The receptor sheet is where smelling begins. The technical term is
olfactory epithelium,
but I think
receptor sheet
gives you a better visual picture of how smell works."

He went on to explain that smell is called a chemical sense because it's triggered by substances with distinct molecular structures. The olfactory epithelium (or receptor sheet) is where proteins called receptors receive odorants—volatile airborne molecules—bind with them, and then send electrical signals up the nerve axons for interpretation by the brain's limbic system and olfactory cortex. Dr. Cushing explained that a glitch at any stage of processing could cause (a) no smell, (b) weird smells, (c) a serious brain disorder, or (d) all of the above.

It's a cliché to compare the brain to a computer, he went on, but the similarities are remarkable—except that computers don't have neurotransmitters and hormones in synapses controlling their digital impulses or DNA speaking in complex codes. Also, and critically important, computers are man-made, while the human brain is alive and still evolving and therefore, almost by definition, not entirely known or knowable.

I began to fiddle with my purse. Glitches? Serious brain disorders? Where was this headed? My eyes met my daughter's. Alex replied with a weak smile that said
You got me.

"You were talking about head injuries," I reminded the doctor. "What about colds? Did you say a cold could damage your receptor sheet?"

Dr. Cushing nodded. "Certainly."

So why did he think Zicam and not the cold was the culprit in my case? I asked.

"I just ... my gut tells me, based on how the gel affected you, the pain you describe, that Zicam is the cause."

Dr. Cushing decided it was time to trot out some statistics. An estimated half a million people annually see doctors about olfactory problems. Two percent of the population below sixty-five is essentially smell-blind. A quarter of these people were born without smell. Smell diminishes precipitously in old age; half of all eighty-year-olds report reduced smell.

He eventually got to some numbers I cared about. Ten percent of people who lose the sense of smell after a head injury get it back, but for those patients whose loss of smell stems from colds, the odds improve fairly dramatically—about 30 percent get it back.