Taste: Surprising Stories and Science About Why Food Tastes Good (54 page)

Ma brought our own preserved rabbit braised in wine, vinegar, olives, capers, and onions, and lots of our own homemade bread, apples, oranges, tons of dried fruits, such as figs, raisins, and prunes, lots of nuts, especially almonds, hazelnuts, and walnuts in the shell and enough cookies, such as
stronzi di pollo
(in our vernacular, chicken turds but really sesame cookies),
cuccidata
, dried fig–filled cookies and
savoiardi
, a kind of ladyfinger, to feed an army.

Marco had chosen little Carlo to follow in his footsteps. This meant Carlo would be a cook. He had no choice in the matter. When Marco opened a restaurant
in Glendale, little Carlo was expected to be there in the kitchen, peeling potatoes as soon as he was old enough to hold a knife. He apprenticed at his father’s side for eleven years and also cooked at home with his mother, Josefina, who was perhaps the most instinctual cook in the family, knowing how to fix a dish with a pinch of this, a dash of that. All the while she lamented that her little Carlo would not become a priest.

During World War II, the Middione family ate much better than most of their neighbors in Southern California. They made pork sausage, cooked wild pigeon
in agrodolce
—a mixture of figs, olives, and garlic—and foraged greens from the parks, using the father’s skills from the Old World.

In his twenties, Carlo visited San Francisco with a friend and fell in love with the city and the woman he would marry. In 1981 Carlo and his wife, Lisa, opened a shop in San Francisco’s Pacific Heights neighborhood, offering sophisticated San Franciscans the pleasures of the tables of Italy; what Carlo’s father had served every night at dinner. Today it is hard to imagine Italian food as exotic, but in the early eighties most Californians knew very little about authentic Italian. Carlo was the chef who changed this. The Middiones called their shop Vivande, which Carlo translates as “dishes that are prepared, ready to be eaten.” From their deli counter they cooked and sold Italian specialties such as rotisserie chickens, house-made pastas, and Sicilian-style seafood. Vivande had the largest selection of extra virgin olive oils and balsamic vinegars in the United States at the time. They sold white truffles and imported aged Italian cheese.

They attribute much of their success to a liberal policy of over-the-counter sampling, which they
had
to do with certain as-yet unknown Italian foods such as white truffles, prosciutto, and bottarga—the dried, salted, and cured fish egg sacs. Carlo used bottarga to season pasta or shave over bread with olive oil and cracked pepper.

“When I put that on the menu, I couldn’t believe the response. People went nuts for it. You think,
They are going to throw this at me.
But they didn’t,” Carlo told me. “The atmosphere was one of great adventure.”

Carlo relished his role as the San Francisco ambassador of Italian cuisine and wrote his first cookbook,
Pasta! Cooking It, Loving It,
in 1982. He taught cooking classes at the California Culinary Academy, eventually starting its first Italian curriculum, which became so popular that the school decided to make it a requirement of the degree program.

Consumers continually begged the Middiones to hire waiters and serve their food hot, but they resisted, fearful of becoming just another restaurant as opposed
to the “Italian provisioning” niche they had carved out for Vivande. But as specialty retailers—and eventually grocery stores—added imported olive oils, cheeses, and vinegars to their inventory, Vivande necessarily evolved into a restaurant to stay relevant. The Middiones converted some of their retail space into a full-service dining room and began serving their classic Italian food at twelve cloth-covered tables.

“We gave in,” says Carlo’s wife, Lisa.

For the next few decades they ran Vivande together. Lisa ran the business. Carlo made the restaurant an outgrowth of his personality and passion. He was not only the face of Vivande but the nose and tongue as well. He tasted every single Italian wine before it was given approval to grace the shelves or wine list. He cooked and tasted almost every dish that came out of the kitchen. His sheer passion for Italian food kept him energized and cooking at the restaurant well into his seventies. He finished his sixth cookbook,
Pasta
, in early 2007, completing his canon with an updated take on his first cookbook subject.

Meanwhile, the world of food and cooking changed around them. In the United States, Italian food has become so mainstream that it is barely considered ethnic. Extra virgin olive oil is now available at Walmart; balsamic vinegar at convenience stores. Public television is no longer the only channel broadcasting cooking shows, which have hit prime time on the major commercial networks.

Today Carlo Middione, at age seventy-five, could be considered somewhat of a grandfather to today’s crop of celebrity chefs, but he is horrified by some of what he sees in his line of work. He’s saddened by the lack of refinement and lack of respect young people show in his profession today. “Cooking is not show biz,” he says. “At least it isn’t to me. I am a purist. This is a craft, you know.”

In May 2007, everything changed for Carlo Middione. He was driving along Valencia Street in San Francisco in his tiny Toyota Corolla on his way to the restaurant and was struck from behind by a full-size Toyota Tundra pickup truck. Carlo ended up in the hospital, missing his front teeth, with a shattered sternum, fractured vertebrae, broken ribs, and a concussion.

When he came to and opened his eyes, he was disoriented and in severe pain. The doctors had given him potent painkillers, to which he attributed his dulled senses of taste and smell. For the first time in his life, Carlo Middione didn’t have much of an appetite.

As he healed, he slowly stopped taking the painkillers. His appetite came back, but his ability to smell didn’t return. He thought something was wrong, but he couldn’t quite put his finger on it. One day he noticed that he had mindlessly
switched from wine to scotch, seeking a more intense flavor because he wasn’t getting enjoyment from wine any longer. Yet he couldn’t even taste the smoke in the scotch.

Doctors told him the impact of the car crash had probably severed his olfactory nerve. When his head bounced between the steering wheel and headrest, his smell connections were either cut or misaligned. He began to smell things that weren’t present, especially putrid, offensive smells, such as decaying meat or dog poop. These phantom smells, or phantosmias, are thought to result when the olfactory receptors attempt to regenerate, and in the process, flail around trying to make any connections that they can, oftentimes perceiving aromas that aren’t there. Unfortunately for Carlo and other sufferers of phantosmias, these are never pleasant smells.

Disorders of Smell and Taste

From Christopher H. Hawkes,
Smell and Taste Complaints
, 2002.

Carlo also started to experience dysosmia, a distorted perception of some smells. For example, the first time Carlo came to my house, I asked him what he smelled in the wine we were drinking. He stopped, swirled, sniffed, and tasted the pinot noir from the wineglass in front of him. He pronounced that he smelled fresh laundry. Pillowcases. I can assure you this was a distortion: I stopped serving pillowcasey wine in the nineties.

Eventually his sense of smell settled down into a level of function he can only term fleeting, at best. The doctors told him that the medical community has not yet found a way to cure traumatic loss of smell. He may never smell properly again. When he received this news, he said, “I wanted to cry.”

Most of what people think of as taste loss is actually
smell loss.
The reason for this is that there is more redundant nerve capacity for taste than there is for smell. Taste is communicated by three nerves: the trigeminal, the chorda tympani, and the glossopharyngeal.

“You just damage one taste nerve, you’re never going to notice,” says Linda Bartoshuk of the Center for Smell and Taste at the University of Florida. Smell, on the other hand, is communicated over only two nerves: the olfactory nerve and the trigeminal. And the trigeminal nerve is really more of a supporting player, communicating only the irritation of aromas that burn, such as vinegar and ammonia. That leaves the olfactory nerve as the single true line of communication for smell. You need to sever only it, alone, to experience a profound loss of function.

Carlo had only his trigeminal nerve to
feel
the scent of foods, which is not at all the same as smelling them. Doctors told him there was nothing they could do to repair his sense of smell.

In an attempt to give Carlo some hope, I sent him a research paper by Dr. Thomas Hummel of Dresden, Germany, who has reported success in patients who practice odor training repeatedly. Hummel had patients smell scented pens called Sniffin’ Sticks over and over to try to associate whatever sensory input they were getting with an aroma, however vague. I urged Carlo to try the method himself. The fact that none of Carlo’s physicians even knew of this study shows you how far removed most primary care doctors are from the science of taste and smell.

Carlo fought to keep Vivande going without his sense of smell, but the economic downturn, softening of their business, and increased costs to compensate
for Carlo’s inability to be the restaurant’s sole arbiter of taste hit the Middiones hard. In early 2010, they closed Vivande after twenty-nine years in business.

When you lose your sense of smell, there isn’t much you can do to compensate for it. If you lose your sight, you can learn to read braille. If you lose your hearing, you can wear a hearing aid or learn to read lips or sign language. But if you lose your sense of smell, there’s no proxy for getting sensory input from aroma molecules. In fact, many of Carlo’s doctors told him to start wearing a signaling device around his neck that would be able to detect gas leaks. Without his sense of smell to keep him safe, Carlo was at risk.

His occupation was abruptly cut short. He filed a lawsuit, but the jury didn’t award Carlo money that would have shown that they believed either that he lost his sense of smell or that it was diminished by the accident. This result was hugely disappointing to the Middiones.

Two hundred thousand people seek treatment for loss of smell each year, but this figure probably represents only a portion of people who experience smell loss. Most people don’t recognize it or don’t seek treatment.

If you lose your sense of smell, you lose 20 percent of your five senses. If senses were a basketball team, this would be like losing one of the starting lineup. If senses were a rock band, it would be like losing a guitarist.

If Carlo had been blinded in the accident, he would have had a greater chance at a jury award, as his attorney, Sean O’Rourke, says. “It would have been something more tangible that the jury could see. If he had suffered a broken leg or, God forbid, if he had suffered a skull fracture that we could show on an MRI or an X-ray, that could have made a difference, too.” But with smell loss, there is no smoking gun.

During Carlo Middione’s lawsuit, the defense played heavily upon his age, which was a reasonable legal strategy that worked. Half of people between the ages of sixty-five and eighty exhibit olfactory loss.

Various pharmaceuticals can also hamper smell and taste. Drugs prescribed
for conditions such as high blood pressure and depression can affect olfaction. One study suggested that the incidence of drug-induced taste disorders was as high as 11 percent among those taking prescription drugs. A decreased ability to smell can make you increase your sodium intake, oversalting food in search of the flavor intensity you remember from the past. You may also seek out more sweet foods, trying to satisfy your sensory needs with taste as a substitute for smell. The problem is that too much sodium and sugar can wreak havoc on health. Lost or compromised smell and taste systems are a silent health epidemic.