I lost my sense of smell just before Christmas, following a severe viral chest infection. I realised how completely it had gone when I mistakenly cleaned my teeth with shaving cream, having picked up the wrong tube. Flavours, like smells, were a thing of the past.
The importance of smell
Post-viral anosmia, or loss of the sense of smell, is fairly common, especially since the Covid epidemic. Yet for some reason I believed it could never happen to me. The sense of smell has been particularly important in my life, for at least two reasons. I thought, illogically, that I would be spared.
Firstly, apart from medicine, my other lifelong passion and hobby has been perfumery. Around my desk as I write are dozens of perfume ingredients. Scattered through my house is a vast collection of vintage colognes and aftershaves, liquid memories each reminding me of some period in my life when I first acquired them. All redundant now. Carefully preserved in two dedicated refrigerators is my library of rare aromatic specialities, some dating back 60 years or more. A closed book to me now.
Secondly, as a doctor and member of Warwick University’s Olfaction Research Group in the 1980’s and 90’s, I pioneered the therapeutic use of fragrance with my patients. A highlight of those years was a guest appearance on the BBC’s Tomorrow’s World, where colleagues from our research group had treated me to a breath of sea air, evoking childhood holidays. My anxiety about appearing live on TV simply melted away.
The sense of memory
Moods and memories are evoked unfailingly by odours, yet smell is notoriously undervalued. It is “the fallen angel of the senses”, to quote the inspirational author Helen Keller. Asked whether they would prefer to lose their sense of smell or their mobile phones, a group of youngsters opted without hesitation to keep their mobile phones. Psychologists like Freud held that man had risen to his present heights by standing upright, freed from the compulsion to sniff round lamp posts like a dog. As senses go, smell enjoys low status.
Like many things in life, our olfactory sense is only appreciated when it is lost. Food tastes bland and life loses its savour, like a technicolour film fading to black and white. Mental health consequences can be significant, yet patients often find they receive little sympathy from others.
Training may help
Currently, a promising non-invasive therapy is “olfactory training”. This involves sniffing essential oils in a purposeful manner. Sceptics might, on the surface of it, consider such an intervention to be an unlikely proposition. After all, no-one would dream of encouraging people whose vision is impaired by cataracts to concentrate harder on what they are seeing. What they need is a lens transplant.
But the sense of smell is different. Here, the brain reaches down through the bony cribriform plate in the roof of the nose, to sense the environment directly. There is no organ corresponding to the eye or the ear to get in the way. It is this intimacy of contact, at the molecular level, that gives smell its power. Our eyes and ears may sometimes deceive us, but if something smells right, it is right.
When evaluating a new perfume, I had sometimes noticed that I could hardly smell it at first, but if I persevered my nose would “tune in”. So that makes me cautiously optimistic for this therapy, if and when my smelling ability starts to return.
The science
For anyone interested in the science, the neuronal mechanisms underlying smell are well illustrated at the Hello Brain exhibition at the Francis Crick Institute in central London. I visited with a group of fellow volunteers from Fifth Sense, a charity set up to help anosmia sufferers. Dr Andreas Schaefer, head of the Neurotechnology Laboratory, gave us a fascinating insight into the cutting-edge research there.
However, despite advances in our understanding, the precise way in which viruses damage the sense of smell remains unclear. For now, it is often a case of learning to live with the disorder. There is always hope of spontaneous improvement, which can occur after months or even years.
That said, as a medic, I am always interested in new and emerging treatments and taking part in trials, for that is the way we will make progress.
Any benefits?
Are there any benefits of smell loss? Well obviously, one does not have to endure obnoxious environmental odours such as traffic fumes and the like. On the other hand, this is a mixed blessing, for one may be unaware of a gas leak, or inadvertently consume food that has gone off.
Talking of food, I had wondered if it would be easier to lose a pound or two, now that I am no longer tempted by aromas from the kitchen. If anything, the opposite is the case. As others have found, one tends to consume more, in a vain attempt to obtain some satisfaction.
That ties in too, with a previous observation of mine, that working with gourmand perfumes can provide similar enjoyment to restaurants, without the calories. I look forward to renewing that pleasure, once I start to recover.
Meantime, so far as food is concerned, there’s no doubt that my anosmia is saving me time and money. When shopping for food, I just buy the cheapest, for it all tastes much the same.
Lastly, here’s the biggest benefit in my own case: I have lost all desire to smoke. My pipe and cigars remain untouched. Knowing the facts about smoking and health, that might just have saved my life.
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