Authors: Molly Birnbaum
I sighed.
Richard Doty, the head of the UPenn Taste and Smell Center and author of
The Great Pheromone Myth,
wrote a paper, published in 2007 by the American Neurological Association, about a study conducted on the predictors of prognosis. In it he discusses the results gleaned from 542 patients whose olfactory ability he first tested in his clinic, and then again, sometime between 3 months and 24 years later. He found that a third to a half of the patients tested regained at least
some
of their ability to smell. The rate of return depended on age. It depended on the time between the initial test and the initial loss. It depended on the amount of smell the patient still had when he or she walked in the door. The younger, the less time, and the more smell retrieved at the time of the test, he found, the better. I thought as I read:
Well, I’m young, within a two-year window of the accident, and could already smell chocolate and rosemary when I was tested at the clinic in Connecticut.
That’s good.
But there’s another factor too. Cowart has found in her clinic that the cause of the original damage also plays a role in prognosis. “At least in this clinic,” she told me, where she has seen thousands of patients with damaged olfactory systems, “it’s clear that people with viral damage are more likely to regain their smell than those with head damage.” With a virus, she told me, there is less risk for damage beyond the severed neurons. I shuddered to think of the other possible effects of the smash of my skull against that windshield. Like almost every day since the accident, I felt lucky. I wondered how lucky I could be.
“Is it ever possible to fully recover?”
Again, a pause.
“People do seem to continue to get better,” she said. “But whether they ever actually get back to normal is questionable.”
I WALKED OUT
of the front door to my Midtown office building one evening in November. It was going to be a late night at the magazine, and I needed coffee. I set off down the block toward my usual caffeine haunt. But, then, suddenly, I stopped. There was a smell. Another one. A strong one. But this one was different—sticky, cold, almost crass. It reminded me of something vague but familiar, like the name of a friend I hadn’t seen in years. I looked around, unsure. And then I saw it.
Trash. Ripe containers full of trash. There was a pile of garbage bags busting at their seams lying on the sidewalk nearby. I stared. They smelled bad. I mean,
bad
. Like rotting fish, like stagnant water on a hot summer day, like the slimy mouthful of an old mushroom you forgot to check. This was the first fully comprehensible “bad” smell I had perceived in more than a year. It was glorious. I took a deep breath and reveled in it.
As I again encountered foul odors, I became reacquainted with disgust. The subway was a bastion of scent, always promising a rich, cloying ride. Discomfort ran off the backs of passengers in smells that stuck to my face and my hair. I often had trouble recognizing these new smells. The words didn’t return alongside them. It was sometimes difficult to identify anything. I mixed many things up, and I doubted myself constantly.
I met my mother for a long weekend on Martha’s Vineyard. There, we drove down a thin gravel road with the windows open. I leaned my face out to nuzzle that touch of warm air.
“What’s that smell?” I asked, suddenly struck by something buttery, something sweet. “Is it some kind of baked good?”
My mother looked at me.
“No, Molly,” she said, bemused. “That’s a skunk.”
This confused me. I wondered what was happening beneath the surface of my skin. For coffee to smell like coffee after the neurons signaling its molecules have died and regrown, one would assume that the new neurons are attaching to the same spot on the olfactory bulb, so that they can send the same signals to the brain. How do they know where to go?
I once asked Stuart Firestein, the Columbia University neurobiology professor and leading olfaction scientist, about this over a tumbler of whiskey at a bar near Union Square. “There are lots of questions,” he said, throwing his arm up in the air. “Does regeneration recapitulate development? Or is it different? Is regeneration the same process as development?”
“We do know that the replacement is very long term, very stable,” he added. “But we don’t know how.”
How would smells remain the same? I wondered. How would the scent of cotton candy take you back to the state fairs of your youth if it were different with age? “Presumably the neurons regenerate and reattach to the same places in the brain.” Firestein shrugged. “There are many mysteries.”
DAVID AND I
broke up on the same apartment stoop where we first kissed.
After the sound of his footsteps faded down the street, I walked up the stairs to my apartment, collapsed on my bed, and fell asleep wearing all of my clothes. It wasn’t until I woke up the next morning, the sun streaming through the curtain on the window near my head and the ambient sounds of my roommates making coffee down the hall, that the cold waves of panic began.
Chapter 5
Cinnamon Gum and Sulfur
IN WHICH I GET COOKING
I MADE TOMATO SOUP ONE NIGHT,
months later. I wore sweatpants and an old T-shirt, my hair in a knot on the top of my head. I had turned off my cell phone and powered down my computer. I stood over a large metal pot that bubbled on the burner, steam fogging my glasses, stirring with a wooden spoon. This soup, which I had been meaning to make for weeks, was a thick concoction of canned tomatoes and chickpeas, rosemary and garlic, chicken stock and a pinch of sugar, salt, and pepper. It was a simple soup, a nourishing one. I had forgotten how much I loved the rhythmic lull of cutting board and knife, the burble and pop of dinner simmering on the stove.
This was the first Saturday night I had stayed home alone in many weeks and the first meal I had cooked for myself in even longer. After David left, that spiked sense of panic had receded, leaving the depression to bloom. I was filled with a foreign exhaustion. A deep, dark lethargy. I slept long and hard, glacial nights without dreams. In the mornings, I had to force myself to move. This slow, creeping depression no doubt came in part because I was lonely. But mainly it came because I was scared. I was terrified of what I didn’t know, of what else I had lost alongside my sense of smell. The professional kitchen, yes. David, of course. But connection, flavor, love? Only a year and a half before, at the Craigie Street Bistrot, I had known who I was, what I wanted, where I would go. I had been so sure of my passion. I had found my vocation. I was living my life. Now, without a map, I felt empty and confused. I began forcing myself to go out at night, to see friends, to act and interact. I distracted myself with films and restaurants. I wouldn’t let myself think about the implications of my failed romance, the possibility of losing more. I wouldn’t let myself think about my sense of smell. If I did, I would have to admit that the rate of olfactory return had slowed to a dribble. I hadn’t smelled anything new in weeks, maybe months, and the scents already back had dimmed, pale in comparison to their raucous days of entry. I had no idea why.
On this night, however, I felt soothed by the mechanics of stirring and chopping, listening to the crackle of garlic in the pan, its warmth emanating softly on my face. There was something healing about the act of eating alone, of cooking just for myself. I concentrated on the stove and the sink, washing vegetables and wielding the slow crank of the can opener. I tried to concentrate on the smell of the fresh sprigs of rosemary and the knobby rounds of garlic, which I had chopped on the counter to the background lilt of Bach, but their scents seemed muted, pale. The soup finished a light, easy shade of red. I pureed it in batches to break down the beans and turn its texture to smooth. I ate it out of a chipped white bowl at the kitchen table alongside a hunk of the sourdough bread I had picked up in the farmers’ market that morning. I read a well-worn copy of a Wallace Stegner novel and sipped a glass of dry white wine—a Sancerre—which seemed to grow more aromatic and flavorful as the evening went on. I felt, for a moment, like I wasn’t really alone.
I WROTE A LETTER
to neurologist Oliver Sacks while sitting at a Park Slope café one humid afternoon in July. I had just read one of his pieces in the
New Yorker,
about a man who became hauntingly obsessed with piano music after lightning struck his face, and had called my mother to tell her about it. I was enthralled with Sacks’s ability to show the mystery of the human body through its malfunctions.
“Why don’t you write to him?” she asked.
“Who?” I said. “Oliver Sacks?”
“Yes.”
“Why would I do that?”
“He might understand you.”
I had been moved by Sacks’s writing since high school, when I first picked up
The Man Who Mistook His Wife for a Hat,
his elegant collection of case histories about patients with conditions that ranged from autism to the inability to form new memories. It had never really occurred to me that the neurologist-author was more than a character in his books, a bumbling but astute celebrity scientist with a thick white beard. Could he explain what was happening in my body the way he described the inability of Jimmie to form new memories in “The Lost Mariner” or the Tourette’s syndrome of Ray in “Witty Ticcy Ray”?
But perhaps he could. Sacks had, after all, written about Stephen D., a young medical student who could smell abnormally well for a few days while hyped up on drugs, like a hound dog sniffing everything in its path. (Sacks later revealed that the story, “The Dog Beneath the Skin,” was autobiographical.) “It was a world overwhelmingly concrete, of particulars,” he wrote of that time. “A world overwhelming in immediacy, in immediate significance.”
When my mother and I hung up the phone, I stared absently out the window for a moment. I
did
want to understand what was happening to me. The holes in my olfactory knowledge gaped like craters, and I had long been afraid to find out more.
Why not?
“Dear Dr. Sacks,” I wrote.
I stopped.
What did I want to ask? Questions twisted around in my mind, unformed and unacknowledged. I fully understood the importance of smell, but knew none of the specifics. I knew what scent provided through the lens of my loss, through each aroma that painstakingly crawled back into my nose. I knew that if damaged, the sense of smell could come back. That it could return in mysterious ways, ebbing and flowing with my emotions, turning around with words, flipping with color or sound. But I had been avoiding deeper scientific understanding for close to two years. I found in the numb months that I lived in an odorless, textureless world that I just didn’t want to know. I found in the exciting, colorful months of return that I didn’t care how or why.
Just keep coming,
I thought. But when recovery proved to be less swift, less concrete than I had imagined, a more primal curiosity emerged. What was this mystery happening beneath my skin?
I could now smell the milk-white steam of my coffee and the floral haze of perfume emanating from the woman who sat to my right. But my sense was far from fully restored. I couldn’t detect the intricacies of Syrian oregano or lemon thyme, the herbs that were once so relevant to my daily life. The potency of their aromas had faded to vague, vaporous ghosts of memory. They were ones no longer racked with pain, but I could feel the absence nonetheless. Each time I stepped into the kitchen it hung like an apostrophe over the stove. I could feel it in the buzz of my desire to cook, to no longer feel alone. I didn’t miss David, but I did miss
something
. What was it? My wonder woke me up early, tapping me again and again with the inescapable hand of anxiety as I waited for understanding.
Why don’t you find out?
It whispered.
Do you really want to know?
I did.
I wanted to know why I could smell again when doctors had told me I would not. I wanted to know why the good smells came back first and why they all had muted when I felt so down. Why couldn’t I recognize, or remember, or put into words what had once sprung thoughtless from my tongue. I wanted to know how my nose worked, and why it meant so much. If I understood, then I could move on. And if anyone could explain it to me, it would be Sacks, who was once deemed “the poet laureate of contemporary medicine” by the
New York Times.
Dear Dr. Sacks. . .
I began to type.
“In the last few years,” I wrote, “I have been witness to a confusing neuronal phenomenon of my own—one that has been simultaneously frustrating and fascinating, depressing and hopeful . . .”
When I arrived home later that afternoon, I printed out the page, folded it into crisp thirds, and slid it into an envelope. Using the contact information on Sacks’s website, I addressed it, stamped it, and walked down the block to the big blue bin outside the post office. I dropped it in.
MEANWHILE, I CONTINUED
to keep pace with the ferocious speed of New York City. I wouldn’t let myself rest, jumping between home, work, and friends. I moved quickly, restlessly. I rarely gave myself time to breathe.
But then again one Saturday morning, my kitchen filled with the scent of fresh-brewed coffee, I looked at the oven, the door of which I rarely cracked. I remembered the calm I once felt when cutting butter, sifting flour, and kneading dough. I remembered the slow rhythm to the mixer’s whirl, the clank of heat from the stove. And I thought:
I will bake
.
I began again with bread.
I hauled out my electric mixer, a bright red one given to me by my mother before the accident but hardly used since. The kitchen flooded with morning light as the yeast bubbled softly in a bowl of warm water. I added careful cups of flour against the background hum of roommates showering, doors opening and whispering shut. I let my mind wander as I kneaded the dough, which morphed from sticky to supple on the counter with each turn of my palm. And as the bread baked, the kitchen filled with a nutty, sweet perfume.