Article in NY Times about Loss of Smell in Food Section

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May 18, 2005

Failing the Sniff Test: The Nose, Ruined

By PAUL LUKAS

ROBERT WEINSTOCK doesn't remember the accident.

" It was Oct. 7, 2003, and I was going to get a prescription from my

doctor, " he recalled recently. " It was just two blocks away, but I was

running late, so I took my bicycle. I'd only been biking for about five

seconds when I turned a corner. The next thing I remember is waking up

in the hospital. "

Mr. Weinstock, a 37-year-old illustrator and children's book author

who lives in Greenwich Village, soon learned that he had been hit by a

truck, resulting in a broken arm, hearing loss in one ear, spinal fluid

leakage and a fractured skull. He spent two weeks in the hospital,

where he underwent two spinal taps and skull surgery.

Given the gravity of his injuries, Mr. Weinstock didn't worry too much

about how his food was tasting. " My mother was bringing me soup from

some fancy market, " he said, " and I realized at some point that it all

tasted like chicken fat, schmaltz. I didn't say anything, because I

figured there was just something off with the food. "

But after he left the hospital, he realized the problem was

wide-ranging.

" Coffee smelled a bit rank, anything with garlic tasted horrible - and

I always loved garlic! " he said. " Then I had mint chocolate chip ice

cream, one of my favorite foods, and it tasted really chemical-y. "

Mr. Weinstock was experiencing a loss of smell, or anosmia. Because

smell and taste are so closely related, anosmia patients usually

complain first about food that doesn't taste right. They find

themselves in a world where they can no longer take for granted that

chocolate will taste like chocolate, longtime favorites are suddenly

unpleasant, and the parameters of good and bad flavor, or ripe and

spoiled, become a guessing game. A lifetime's worth of learned

assumptions and preferences are sent back to square one.

" The taste buds can only detect sweet, sour, salty and bitter - the

full symphony of flavor comes from the nose, " said Dr. P.

Kimmelman, a Manhattan anosmia specialist. " But when your brain is hit

really hard, it wiggles like Jell-O, and the little fibers going from

the smell nerve endings up to the brain are stretched taut. Some of

them get torn, injured or bruised. "

Can the damaged fibers regenerate? " To a certain extent, " Dr.

Kimmelman said. " But not necessarily along the same pathways they had

before. It's like a crossed circuit. And there's usually a phantom

sensation, like when a person loses a foot but still feels like his toe

is hurting. The brain is trying to make sense of what little

information it has coming in. "

So some things may be perceived differently than they were before the

injury, and others may not be perceived at all. Dr. Kimmelman said that

most anosmia patients recover only 20 to 30 percent of their sensory

function, and that there is little doctors can do about it.

Anosmia may be caused not only by head trauma but also by upper

respiratory infection, nasal or sinus disease and exposure to toxins.

Some people are born with the condition. People from all these camps

usually find their way to a anosmia message board

(health./group/anosmia) that has emerged as a popular

support group.

Many anosmic people say the biggest challenge is in the kitchen. " I

wasn't a great cook to begin with, but with anosmia you can't tell when

something's burning, " said Lori Mesnik, a computer consultant from

Edison, N.J., who suffered a head injury in December. " One time I

steamed some broccoli, and it wasn't until I cleaned up later that

evening that I realized the water had boiled out and burned the Teflon

from the inside of the pot. "

Another common complaint: dealing with the frequent perception that

compared with other disabilities, anosmia is no big deal.

" Most people treat me like a circus oddity, " said Topper, a

school science coordinator from Oceanside, Calif., who became anosmic

about two years ago, apparently because of allergies. " They do not

realize how much of a life-changing experience it is to lose these

senses. "

Mr. Weinstock initially played down his condition.

" At first my attitude was that I was grateful not to be a vegetable, "

he said. " I thought, 'If this is the worst I have to deal with, that's

fine.' But it did take a lot of the joy out of eating. It was deflating

to bite into something and have it taste bad. " Because eating is such a

social activity, he sometimes felt left out at dinner gatherings.

Restaurant outings became crapshoots at best, pointless extravagances

at worst.

But the problems of this condition go beyond culinary inconvenience.

Anosmic patients may not be able to smell a gas leak or a fire, and

they can unwittingly eat spoiled food. Mr. Weinstock once handed a milk

carton to his girlfriend, Dana s, who poured milk in her coffee

and discovered it had turned sour. Mr. Weinstock, completely oblivious,

had already finished his cereal.

Mr. Weinstock was eventually referred to Dr. Kimmelman, who gave him

the University of Pennsylvania Smell Identification Test, considered

the gold standard for assessing olfactory function (available from

smelltest.com for $26.95; minimum order seven tests). Mr. Weinstock

initially thought he'd done " fairly well " on the test but was

disappointed to hear that his score placed him among the bottom 5

percent of the population. " That's when it began seeming more real, " he

said. " I realized this was going to be a problem. "

Undaunted, Mr. Weinstock slowly began orienting himself to his

reconfigured palate. " Thai, Japanese and fruit were O.K., but almost

anything else tasted off, " he said. " Anything with a sauce or a melding

of flavors tasted muddy and schmaltzy. Processed foods like candy, soda

and toothpaste were very chemical-y, almost astringent. "

Ms. s, a freelance journalist who occasionally writes film

reviews for The New York Times, helped out by setting up blind taste

tests for Mr. Weinstock. She primarily used ice creams and sorbets,

since they all had similar, neutral textures. Slowly but steadily, Mr.

Weinstock showed progress: At first he couldn't tell chocolate ice

cream from vanilla, but later on he successfully distinguished between

the relatively similar coffee and dulce de leche. Both he and Ms.

s remember that as a milestone.

" My theory was that immersion therapy would help - lots of stimulus,

lots of flavors, " Ms. s said. " Besides, the alternative seemed so

grim. At one point I found this anosmia web site where people posted

messages like, 'There's more to food than flavor - there's still

texture and color and temperature!' And that just seemed depressing,

like, 'Ah, here's a red cube, and it's tepid, oh boy!' The taste tests

made me feel like we were working on something, making progress. "

Whatever the impetus, Mr. Weinstock's taste sense appears to have

improved. " I've definitely gotten better at eating things with garlic,

especially cooked garlic, " he said. " In general, there are more things

that taste good. And I'm better at understanding what tastes good and

what doesn't. "

At a Brooklyn cafe recently, he tucked into a lemon buttermilk soufflé

with obvious gusto.

Although he estimates that he's recovered about 70 percent of his

taste capacity, he concedes that this could simply be a matter of

acclimating to his new sensory environs - after all, he initially

thought he did well on the smell identification test, too. Taste, it

turns out, is a difficult thing to pin down.

" It's like asking a kid, 'Do you feel taller today?' " he said. " Any

changes have been happening so gradually that it's hard to tell. I've

had more than a year to forget what it was that I lost. "

One thing he hasn't forgotten: his old favorite, mint chocolate chip

ice cream - or " mint chocolate R.I.P., " as he now calls it. " I kept

trying it, but eventually I gave up, because it became too

dispiriting, " he said. His new favorite foods are blood orange juice

and salad.

" And as sad as it may sound, vanilla may now be my favorite ice cream.

It tastes very vanilla-y. " He paused, and then added: " Or at least how

I remember vanilla tasting. "

Copyright 2005 The New York Times Company

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