The Daily - The Sunday Read: 'The Forgotten Sense'
Episode Date: January 31, 2021“Smell is a startling superpower,” writes Brooke Jarvis, the author of today’s Sunday Read. “If you weren’t used to it, it would seem like witchcraft.”For hundreds of years, smell has been... disregarded. Most adults in a 2019 survey ranked it as the least important sense; and in a 2011 survey of young people, the majority said that their sense of smell was less valuable to them than their technological devices.The coronavirus has precipitated a global reckoning with the sense. Smell, as many have found in the last year, is no big deal until it’s missing.This story was written by Brooke Jarvis and recorded by Audm. To hear more audio stories from publishers like The New York Times, download Audm for iPhone or Android.
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So, there was this one time that I almost blew up a cabin.
It was 2009, and I was visiting my sister in Chile, and we'd rented a cabin in the mountains
to go hiking.
I thought I was cooking onions.
I was standing there by the stove, and I started coughing a lot, and that's when I noticed
that the onions weren't cooking, and realized that I hadn't actually lit the stove.
I looked around, I found some matches, I was just about to light it,
when my sister came running into the house, screaming at me,
to tell me that she could smell what I couldn't,
which was that I had accidentally filled the whole cabin with propane gas.
My name is Brooke Jarvis, and I'm a contributing writer for the New York Times Magazine.
And for this week, I wrote a story about the coronavirus and smell,
since loss of smell is one of the strangest symptoms of the virus.
I don't have a functioning sense of smell.
I don't ever remember having a sense of smell.
I don't know what it means really to smell something
except by watching the people around me react to smells.
I don't notice when something is fishy.
I don't notice if somebody has farted.
And every person that I've ever lived with has been kind enough
to allow me to ask them over and over again
to smell the armpits of my sweaters to let me know if they need to be washed.
It's something that I'm very used to, and I don't stress about it.
But I have also started taking a propane detector with me sometimes when I travel.
Compared to our other senses that we've understood the basics of them, things like hearing and vision, for decades or centuries even,
smell is something that we're only beginning to understand.
The receptors that allow us to perceive odors weren't discovered
until the 1990s. For years now, I've had a Google alert set for anosmia, which is the scientific
term for not being able to smell. And this spring, that alert, which is usually fairly quiet,
started going off multiple times a day as science began to notice this unusual symptom associated with COVID.
Scientists actually realized very early on that not only was it a symptom,
it was the best indicator that somebody had been exposed to the coronavirus,
even though what we were actually doing was screening people for coughs and high fevers.
But the people who really were talking about smell the most
are the ones who lost it after being infected with the virus.
For those people, it was a shocking discovery
that smell was a much bigger part of their lives
than they had ever realized before.
People said that it was like living their lives in black and white
or living behind a sheet of glass,
and they no longer felt like they could integrate with the world
around them. Now it's been almost a year, and I'm still getting Google alerts about anosmia every
day. I remember talking to one scientist early in the pandemic, and she joked that if she went
to a cocktail party and tried to describe her work, people weren't that interested, or they
didn't really get it. And that nowadays, if she were to go to work, people weren't that interested or they didn't really get it.
And that nowadays,
if she were to go to a cocktail party and explain that she was a smell scientist,
she would be the center of attention
and people would have all kinds of questions for her.
But the joke, of course,
was that we don't have cocktail parties anymore.
So here's my story,
The Forgotten Scents,
read by Gabra Zachman.
Danielle Reed stopped counting after the 156th email arrived in a single afternoon.
It was late March, and her laboratory at the Monell Chemical Senses Center in Philadelphia had abruptly gone into COVID-19 lockdown.
For weeks, there had been little to do.
Reed, who is famous in her field for helping to discover a new family of receptors that
perceive bitter flavors, had spent years studying the way human genetics affect the
way we experience smell and taste.
It was important but niche science that seemingly
had little to do with a dangerous respiratory virus spreading around the globe. And then one
Saturday, she checked her email. Reed watched in amazement as the messages proliferated.
It wasn't how many threads there were, though that was overwhelming, but the way they seemed
to grow like hydras,
sprouting in all directions. Recipients copied other people they thought might be interested in the discussion, who added more people, who added still others, across a huge range of
countries and disciplines. The cascading emails were all responding to the same,
rather obscure news alert meant for ear, nose, and throat doctors based in Britain.
rather obscure news alert meant for ear, nose, and throat doctors based in Britain.
It was titled, Loss of Smell as Marker of COVID-19 Infection.
The week before, Claire Hopkins, the president of the British Rhinological Society and an author of the alert, was seeing patients in her clinic in London when she noticed something odd.
Hopkins, who specializes in nose and sinus diseases, especially nasal polyps,
was accustomed to seeing the occasional patient, usually about one per month,
whose sense of smell disappeared after a viral infection. Most of the time, such losses were
fairly self-explanatory. A stuffy, inflamed nose keeps odorants from reaching the smell receptors
at the top of the airway. Sometimes these receptors are also damaged by inflammation and need time to recover. But patients were now
arriving with no blockage or swelling, no trouble breathing, no notable symptoms,
other than the sudden and mysterious disappearance of their ability to smell. And there were nine of
them. At first, it didn't occur to Hopkins to think about the recently
declared pandemic that was dominating the news. None of the patients had traveled to Italy or
China, so they didn't meet the government's criteria for testing or quarantine. The virus,
she understood, was not yet spreading in Britain. As each new patient told a strange yet similar
story, she began to wonder.
A colleague in Italy, where the virus was known to be spreading,
had mentioned that frontline doctors were losing their senses of smell and taste.
Hopkins assumed that a mild version of COVID-19 was causing a standard post-viral loss of smell.
But shortly after seeing the nine patients,
she attended an online chat for physicians hosted by the American Rhinologic Society.
A French doctor posted that he had recently seen an increase in cases of sudden smell loss without any blockage.
Had anyone else noticed something similar?
Yes, several doctors from the U.S. replied.
They had started to hear rumors from colleagues in Iran and Italy
of odd spikes in patients who had unaccountably
lost their sense of smell. Hopkins decided to keep digging. She found that in China,
an unusual number of ear, nose, and throat specialists, doctors who would have been
sought out by patients troubled by an unexplained loss of smell, had contracted the virus. A report
in South Korea found that of 2,000 people with mild cases of COVID-19,
30% lost their sense of smell. The same week that patients were streaming through Hopkins' office,
there was an article in a German newspaper about a virologist named Hendrik Strieck,
who went door-to-door interviewing some of the country's earliest patients.
He found smell loss in two-thirds.
None of these anecdotes amounted to the sort of rigorous proof that Hopkins,
with her research background, was used to seeking. She also doubted that her theory would attract much public interest, even in the face of a world-changing pandemic.
A career studying smell had taught her that most people simply don't consider the sense
to be particularly interesting or important. It was always hard to get financing to study smell or smell disorders,
and patients who lost their olfaction often told her that their friends and family shrugged the
condition away. It was only smell, after all. Still, Hopkins and Nirmal Kumar, the president
of ENT UK, decided to put out an alert,
hoping it would at least encourage their fellow nose doctors to take extra precautions.
Then that same weekend, Rudy Gobert, the Utah Jazz star whose COVID-19 diagnosis caused the
NBA to abruptly suspend its season just after Gobert mocked the danger by touching all the
microphones at a news conference, announced that he had lost his sense of smell.
Hopkins' alert ricocheted around the world,
picked up by news outlets and shared on social media
by people desperate for information about the workings of the new virus
and any signs that they might already have been exposed.
It also kept landing, over and over,
in the inboxes of Danielle Reed
and hundreds of other scientists
who studied smell in some way. The breadth of their backgrounds was stunning, even to one another.
There were neurobiologists and otorhinolaryngologists, virologists and food scientists.
There were chemists and data specialists, cognitive scientists and nutritionists,
There were chemists and data specialists, cognitive scientists and nutritionists,
geneticists, psychologists, philosophers,
an indication of how complicated the interplay of smell, taste, and human life is.
Like Hopkins, many of them were used to their work being as underappreciated as the senses they studied.
Smell is a startling superpower.
You can walk through someone's front door and instantly know that she recently made popcorn.
Drive down the street and somehow sense that the neighbors are barbecuing.
Intuit, just as a side effect of breathing a bit of air,
that this sweater has been worn but that one hasn't.
That it's going to start raining soon.
That the grass was trimmed a few hours back.
If you weren't used to it, it would seem like witchcraft. But of course you are used to it. You may even take it for granted. Perhaps
you would rank smell, as most adults in a 2019 survey did, as the least important sense, the one
you would be most willing to lose. Perhaps you would even agree with the majority of young people who, in 2011, told McCann World Group, a marketing company, that smell was less valuable
to them than their technological devices. As PC Magazine trumpeted, with a mixture of scorn
and glee, majority of kids would rather lose their sense of smell than lose Facebook.
their sense of smell than lose Facebook. The writers of that headline seemed to see disregard for smell as shocking, a marker of a technology-obsessed and perhaps uniquely shallow
generation. That reaction would have come as a surprise to Immanuel Kant, who wrote in 1798
that smell is both the most ungrateful and the most dispensable of the senses.
is both the most ungrateful and the most dispensable of the senses. Charles Darwin considered smell to be of extremely slight service to humans. Until quite recently,
one smell researcher told me, most general medical textbooks didn't bother to include a chapter on
smell or taste, apparently considering them insignificant afterthoughts to the functioning
of the human body. From Plato and Aristotle,
Plato considered smells half-formed and Aristotle wrote that man smells poorly, to Descartes and
Hegel, one called vision the noblest of the senses, while the other dismissed smell and
taste as too pedestrian and vulgar to be included among the senses in his aesthetics. We have spent
centuries writing off our own sense of smell.
One reason we have discounted smelling is our belief that we're bad at it.
Smell was the province of lesser animals, we told ourselves, of pigs rooting out truffles
and sharks scenting blood, while humans were creatures of reason and intellect,
who managed to stand up and grow huge brains and leave that life far behind and literally below us.
Scientists followed Paul Broca, a 19th-century neuroscientist,
in pointing to the relative smallness of our olfactory bulbs as evidence that our brains had triumphed over them,
and likewise over the need to pay much attention to smell at all.
In the late 1950s, a pioneering ear, nose, and throat specialist,
Victor Negus, summed up the consensus view in a book about the comparative anatomy of the nose.
The human mind is an inadequate agent with which to study olfaction, the specialist wrote,
for the reason that in man the sense of smell is relatively feeble and not of great significance.
For centuries, when scientists
studied smell at all, they tended to focus on isolating particular odorants—they thought they
could find the odor version of primary colors—and creating elaborate organizational systems that
shuffled them into various categories. History is littered with the wrecks of universal
classifications of smell, the smell scientist Avery Gilbert wrote in her book What the Nose Knows. Questions of how humans smell, and how our smelling in turn
interacts with our bodies, our health, and our behavior, were of far less interest. The sense,
after all, was seen as practically vestigial, an often handy, sometimes pleasant, but ultimately unimportant holdover from our distant past.
The notion of smell as vestigial has itself come to seem outmoded.
That's because of a renaissance in smell science.
While we have long understood the basic mechanisms of vision and audition,
it has been less than 30 years since the neural receptors that allow us to perceive and make sense of the smells around us were even identified.
The discoverers, Linda Buck and Richard Axel, were awarded the Nobel Prize in 2004.
The revelation opened the door to a new way of understanding the olfactory system,
as well as to a new, ever-expanding world of research.
A system assumed to be unsophisticated and insignificant
turned out to be quite the opposite. Where vision depends on four kinds of receptors,
rods and three types of cones, smell uses about 400 receptors, which are together estimated to
be able to detect as many as a trillion smells. The complexity of the system is such
that we're still unable to predict how,
or even if,
a given chemical will be perceived
by our olfactory system.
The old quest to map odorants
and their perception
is now understood to be
a wildly complicated undertaking.
Joel Mainland,
a neuroscientist at the Monell Center
who is working on the problem,
told me that while maps of color vision are easily presented in two dimensions,
an eventual olfactory map might require many more.
Recent studies have begun to puncture our conviction that we are too sophisticated to be good at smelling.
Our brains know the difference between exercise sweat and fear sweat,
and between a glass of wine that has recently contained a fruit fly and one that has not. They seem to
compel us to sniff our fingers shortly after we shake other people's hands, searching for
information about them that we're not consciously aware of processing. One inventive study found
that, provided we're willing to crawl around with our faces in the grass, humans are fully capable
of finding a scent trail while blindfolded. Not as well as a dog, granted, but we can follow it.
Another found that we can tell, just from sniffing a t-shirt another person has worn,
whether that person's immune system is similar to our own. If it's different,
we find the person more attractive. But here's what's really impressive.
Our noses can also distinguish between two groups of mice that have different immune systems.
Several years ago, the Rutgers scientist John McGann took a critical look at Broca's 150-year-old dismissal of our olfactory bulbs and found it to be mistaken.
Our bulbs are shaped a little differently.
But when you compare how many neurons they hold
with those of other mammals,
humans are solidly in the middle of the pack.
There are, he pointed out,
even some odors we can smell better
than rodents or canines can.
A much-discussed unit of measurement in smell studies
is the JND, the just noticeable difference,
or the degree to which chemicals
have to differ from one another
in order for us to tell them apart. In November, a new paper in Nature advanced the quest for a map
of olfactory perception by creating a model that can predict what odorants will smell like by
contrasting their chemical makeup with that of other smells. The work relied on volunteers
comparing hundreds of different odors and found them to be almost frustratingly good at it.
The failure to reach an absolute JND provides for yet additional evidence of an exquisite sense of smell in humans, the author said.
To rephrase this result, it is simply very hard to generate two multi-component odorants that humans cannot discriminate.
that humans cannot discriminate.
One of the authors, Noam Sobel,
of the Weizmann Institute of Science in Israel,
also worked on the scent trail study and the one about handshakes,
as well as a study that found
that an automatic sniff reaction,
taking longer breaths when something smells good
and shorter ones when something smells bad,
is a reliable predictor
that someone will eventually wake up from a coma.
In the early days of the pandemic, he was spending his days at testing centers in Tel Aviv,
trying to figure out whether an artificial nose could sniff out the novel coronavirus.
Not a crazy notion, because dogs are learning to do it,
and because at least one human has proved her ability to identify sufferers of Parkinson's disease just by smelling them.
Sobel and his colleagues also started a
website, SmellTracker.org, where people who were worried about COVID could track changes in their
ability to smell a variety of common household items. We think that smell is less important to
us than our other senses only because we're fooling ourselves, Sobel told me. After all,
you wouldn't eat a beautiful cake if it smelled like sewage,
but you would probably try some ugly gloop that smelled like cinnamon.
COVID, he hypothesized, could kick off a sort of global reckoning,
forcing our conscious minds to recognize what our brains have known all along.
People are unaware smell is important until they lose it, he said.
And then they're terrified.
The growing mess of emails that followed Hopkins' alert in March
quickly became so unwieldy that the scientists decided to move to a more formalized group.
Within days, it had 500 members from dozens of countries and a name.
The Global Consortium for Chemosensory Research.
The group eventually stabilized at around 630 members from 64 countries.
We decided to become a global organization, explained Valentina Parma, a psychologist who,
along with Reed and seven others, helped found the GCCR's leadership committee.
We all got together to try to figure out what's going on.
The sheer number of questions was daunting.
How many COVID patients experienced smell loss?
How fully did smell disappear?
Smell loss is known as anosmia, when it's complete,
and hyposmia, when it's partial.
Was COVID-related smell loss truly distinct
from that caused by other viruses?
How many patients would be able to recover their olfaction?
And how long might it take?
Many patients were reporting loss of taste as well as smell, but this too was complicated.
Thanks to a process called oral referral, which causes us to perceive what's happening in the nose as if it's inside the mouth,
smell is integral to our experience of taste.
People often struggle to separate the two, certain that they have lost their sense of taste when the
taste buds, which detect only sweet, salty, bitter, sour, and umami flavors, remain fully functional.
There was also the question of the sensations we experience through neither olfaction nor taste, but via the nerves of our trigeminal system.
The coolness of mint, the spice of peppers, the bubble of carbonation.
Were these also affected?
The three, together, are known as our chemosensory senses,
those we use to detect the presence of chemicals in our environment.
Answering these questions could help solve the most urgent puzzle.
What exactly was happening inside patients to make their sense of smell disappear in such an unusual way?
Could COVID-related smell loss teach us anything new about how the virus worked?
Or about how we did?
As a panicked world closed down around them, members of the GCCR started
meeting online every day, working on a plan to survey people with respiratory illnesses about
their symptoms. There were so many eager researchers from so many countries that the
survey was quickly translated into more than 30 languages. Though the group considered using
several of the more objective olfaction tests developed in recent decades,
they decided, given the urgency of the situation, to use the simplest method,
asking patients to assess their own perceptions.
The survey included, along with rating scales for smell and taste and multiple-choice options about diagnoses and symptoms,
a series of open-ended text boxes where people could write as much as they wanted
about what they could and couldn't smell.
It turned out that they wanted to write a lot.
Many people went on for pages and pages, offering enormous detail and torrents of feeling.
This was freaking people out, says Pamela Dalton, an experimental psychologist at the Manel Center
who studies the interaction between cognition, emotion, and the way we perceive odors, and who also worked on the survey analysis. They wrote things like,
I'm inhaling, and there's nothing there. People frequently described themselves as feeling adrift,
disconnected from a world that felt wrong, uncanny, confusing. Reed noticed that many
respondents, ejected from the system because they reported symptoms that weren't recent enough to be included in the design of the study,
signed back in with falsified dates so they could still participate.
Those answers wouldn't be included in the analysis, but Reed understood why they mattered.
Ultimately, people just want to tell their story, she said.
just want to tell their story, she said. In a matter of weeks, 40,000 people took the survey,
and the members of the GCCR began to search for patterns in the data. They quickly established that people who lost smell and tested positive for the coronavirus weren't encountering the
typical nasal blockage. They often referred to the loss as sudden and creepy, and that they were
also noticing genuine impairments not just to their olfaction,
but in many cases to their taste and trigeminal sensations as well.
This clearly wasn't the typical pathology of smell loss following a virus.
The scientists also noticed that a disconnect was forming between what the data showed and how the wider world responded.
Early on, data from apps for tracking symptoms showed that smell loss was more common than the fever or cough the virus was known for.
It also had the diagnostic advantage of pointing directly to COVID rather than to another respiratory illness.
And yet, schools and restaurants and airports continued to use forehead thermometers to screen for fevers, a symptom that many people with COVID never experienced.
a symptom that many people with COVID never experienced.
Later, GCCR analysis showed that smell loss was, in fact, the most reliable predictor of COVID,
and that this was true even for people assessing their own smell loss,
which research has shown is something people tend to be quite bad at.
Reed and other researchers also found that objective smell tests,
in which patients have to prove themselves against actual stimuli,
were able to catch many extra COVID cases among people who failed to realize when their sense of smell had changed.
The better we ask questions about smell, Parma says, the more people we find.
In Britain, Hopkins was growing frustrated.
The weeks kept passing, and smell loss still didn't appear on the official list of symptoms recognized by the National Health Service,
a list that determined who qualified or didn't for coronavirus testing.
One of her patients, a physiotherapist, was told to keep reporting to the ICU where he worked,
even though his family was sick and he had lost his sense of smell. He convinced his team that he should be allowed to self-isolate, but Hopkins wondered how many other people were in similar
situations, sent out into
the world to spread a virus they were assured they didn't have. I can still put in my symptoms into
NHS 111, the portal through which patients access care from the National Health Service, and claim
to have muscle ache, fatigue, loss of smell, diarrhea, and be told that I don't have coronavirus,
she told the BBC in mid-May. I think that is now actually, clinically, negligence.
Months later, after the NHS officially recognized smell loss as a COVID symptom,
I asked Hopkins why she thought that recognition of smell loss as a symptom of COVID had taken so
long. In part, she replied, the trauma of the serious cases had obscured, in the data as well
as from public notice, a symptom that was primarily noticeable
in people with only mild disease. But she also believed that there was another important factor
unrelated to the virus. COVID arrived in a world that had spent far too long not taking smell
seriously. This may be the moment for a belated disclosure. Part of what interests me about the science of smell is that I myself am anosmic.
The outsider to whom smell looks like a superpower? That's me.
I have no idea if my inability to smell is congenital,
or if my olfaction stopped working before I had the chance to remember it.
I did have a lot of ear infections when I was very young, which are known to damage smell.
Infants aren't routinely screened for smell disorders, as they are for hearing or vision.
And it's common for anosmic people not to realize fully that they're different until, on average, their early teens.
That's about how old I was when my sister came home to find me blissfully cuddling our skunk-sprayed dog, and the pieces began to fall into place.
cuddling our skunk-sprayed dog, and the pieces began to fall into place.
Years later, the same sister came home just in time to stop me from lighting a match in a cabin I had accidentally filled with propane. Before I learned what anosmia was, I assumed,
whenever people brought up the things they were smelling, that this was a skill I had
yet to figure out, that I just wasn't doing it right. One thing you notice when you can't smell
is how much time people who can smell spend talking about it.
Friends are always curious about whether I can taste food.
I love food, though I care primarily about textures
and the flavors the actual taste buds perceive.
But that's the main difference they imagine.
They don't seem to realize all the other ways
that smell is constantly on their minds.
Smell is no big deal, until it's missing.
As the pandemic progressed, the GCCR surveys showed that the experiences of patients who lost their sense of smell were beginning to diverge.
experiences of patients who lost their sense of smell were beginning to diverge. There were those,
about three-quarters of COVID patients, Reed says, who recovered their olfaction fairly quickly,
from a few weeks to a couple of months after losing it. Then there were those who gained it back slowly, over the course of many months. But there was a smaller percentage who, at six months,
didn't seem to be recovering it at all. This was what Chrissy Kelly, another GCCR
member, feared might happen. In 2012, she lost her own sense of smell after fighting a virus she
caught on an airplane. She spent the next two years feeling depressed, forgetful, and like a
fundamentally different person than she was when she could smell. Life lacked color, luster, she told me. My sense of humor had deserted me.
The experience was so destabilizing that she began digging into scientific papers about smell loss
— there weren't many of them and there was almost nothing for a lay audience — and contacting their
authors, searching for possible treatments. She started practicing smell training, a little-known
technique for recovering some
olfaction by regularly smelling strong odors, and she started a support group on Facebook for
other people with the condition. Before COVID, the group, called Absinthe, had grown to around
1,500 members, most of whom lost olfaction after a head injury, a virus, or a sinus disease.
And then the pandemic began.
It soon became a nearly full-time job just to process the flood of thousands of distressed
people who were asking to join Absinthe. In the group, people mourned specific smells and flavors,
shared their struggles with nausea and weight loss or gain as they navigated an altered
relationship with food. They commiserated about the new dangers of life, food poisoning, gas leaks, not noticing that dinner was burning. This month, a Texas family
whose members lost their sense of smell to COVID narrowly escaped a house fire after the only
uninfected member, a teenager, smelled smoke and woke everyone else up. Many people also struggled
with depression, symptoms similar to those of post-traumatic stress disorder, and feelings of relentless isolation and disconnection from the world around them.
It felt, some people said, as if they were living their lives in black and white,
or trapped behind a sheet of glass. Their sense of normalcy and well-being had disappeared with
their olfaction. I feel alien from myself, one person wrote, detached from normality,
Feel alien from myself, one person wrote, detached from normality, lonely in my body.
It's so hard to explain.
Another described feeling discombobulated, like I don't exist.
Kelly kept the group closed, out of respect for what she described as the profound depths of sorrow and anger and anxiety that people shared there.
Kelly sometimes noticed that requests to join the group would suddenly increase from a certain city or region, only to later read about a new spike in cases.
She committed herself to responding to each person individually, spending hours every day.
It still feels like an emergency response, she said over Zoom more than six months after the
official start of the pandemic. As the numbers ballooned and the COVID patients began to overwhelm the discussion, Kelly started a separate support group just for
them, which quickly dwarfed the original. And then, quite suddenly, many people in the group
began reporting something new. Their sense of smell seemed to be returning, yet it was coming back
broken. Things no longer smelled the way they had, and usually
the new smell was bad. Food smelled like gasoline or cigarettes, or scented body wash was like
burning rubber. Terrible smells even intruded when nothing odorous was around. A boyfriend no longer
smelled or tasted right, and the poster had begun to avoid kissing him but had not told him why.
had begun to avoid kissing him but had not told him why.
Poo now smelled better than coffee, another person noted.
Analysis of the GCCR surveys later found a similar pattern.
As the pandemic progressed, the symptoms, known as parosmia,
incorrect smells, and phantasmia, phantom smells,
went from nearly unknown to incredibly common.
Kelly and Hopkins and other researchers collaborated on a paper analyzing the posts in Absinthe
and found that on average,
three months elapsed between smell loss
and the arrival of faulty smells.
To manage what she called the rising tide of parosmia,
Kelly spun off yet another support group.
In all three groups,
as people shared their tips and experiences, Kelly noticed
them sharing something else as well. Overwhelming relief at having at last found others who
understood what they were going through. Many had been told by friends or family that smell was no
big deal, really, and they should buck up and be grateful that they hadn't lost one of their really
important senses. A University of Warwick researcher noticed something similar 20 years ago,
A University of Warwick researcher noticed something similar 20 years ago, writing that what seemed to unify anosmics was the expressed feeling that each was the only person in the world to be affected by the condition.
This appears to be a direct reflection of the lack of sympathy that anosmics encounter concerning their condition.
This was difficult, but worst of all was hearing something similar from doctors, who basically shrugged while explaining that there was no treatment.
When we talked, Kelly searched for a way to describe how excruciatingly frustrating these dismissals felt to the group's members, then said,
Before the pandemic, Sandeep Robert Dada, who runs a neurobiology lab at Harvard, was studying what he described as both the basic mechanisms and the ongoing mysteries of olfaction. Just how neural receptors
capture smells, how that information travels to the brain, how the brain puts it all together
to create an integrated smell that we recognize as pizza or gasoline. We still understand so
little about how our noses detect odors, he told me.
As part of that work, the lab sequenced cells in the epithelium,
a sheet of neurons and supporting cells lining the upper nasal cavities,
and olfactory bulb of mice to determine what RNA each cell expressed.
Data's attention, like that of most other researchers,
was focused on the receptors that actually perceive odorants,
the ones whose discoverers won the Nobel. He never gave much thought, he said later,
to the cells that surrounded them. In the early days of the pandemic,
while Datta was quarantined away from his lab, he spent his time reading updates on the new virus and scrolling the discussions on the GCCR message board. Early analyses of the coronavirus showed that it used its distinctive spikes
to attach to the cells of its hosts via a certain protein,
known as an ACE2 receptor.
Data's thoughts drifted to those mice epithelia.
He realized that he, as well as a few other researchers
who had collected similar troves of data,
already had information that could show whether the sensory neurons of the olfactory system
were vulnerable to a direct attack by the virus,
what he saw as the natural hypothesis
to explain the sudden smell loss.
The data, however, showed otherwise.
There were no ACE2 receptors on those all-important neurons,
but they were expressed on some of the other,
barely studied cells that
surrounded them. Some were stem cells, which allow the sensory neurons to regrow when they're damaged.
Olfactory sensory neurons are the only type of neuron directly exposed to the outside world,
so they sustain an unusual amount of damage. They're also a rare part of your nervous system
that is able to renew itself. Others were sustentacular cells, which seemed to provide
various kinds of support to the neurons, metabolic and physical, plus maintaining the right salt balance in the
mucus that is essential for odor detection. Studies on hamsters, which unlike mice are
naturally susceptible to the coronavirus, confirmed that these cells were indeed capable
of being infected by the virus. This could be an explanation for the different paths that
patients' olfaction tended to take after being impaired by COVID, data and other scientists
hypothesized. For some people, olfaction might simply have been interrupted for a few weeks
while their sustentacular cells were knocked temporarily out of commission, either by the
virus or by the body's own immune response as it tried to fight it off. For others, the cells might
have been so damaged in the fight
that the neurons they supported actually died
and had to regrow slowly over the course of months.
This theory could also explain the belated but widespread wave of parosmia.
When the axons that connect the olfactory epithelium and the brain are disrupted,
they're known to reconnect in strange ways,
as if an old-timey telephone operator plugged a wire into the wrong call.
Still, no one knows why the wrong smells
are so often such unpleasant ones.
And then there might be people whose epithelia,
and especially their stem cells,
sustained so much viral damage
that their neurons would never be able to regrow,
and their sense of smell never able to recover.
It's a compelling and even likely theory, other researchers told me.
But they stressed that there's a lot about olfaction,
just as there is about the new virus, that we simply don't yet understand.
Sensory neurons could turn out to be infectable after all,
or the virus could be using other unknown cells as an entry point.
There is evidence that the virus may have found a way
to overcome the protective barrier around the brain
to invade the central nervous system directly,
perhaps even via the pathways provided by the olfactory system.
That, too, could explain smell loss,
as well as some of the other troubling neurological effects
that patients have experienced.
We also still don't know what's happening
to disrupt taste and trigeminal sensations, though there is some debate that the virus could be similarly targeting the support
cells for taste and smell receptors. If smell scientists have learned anything in the recent
Renaissance, it's not to underestimate how much, or how intimately, the chemical senses intertwine
with the rest of the brain. While what we see must pass through various parts of the brain
before it reaches our centers for memory or emotion,
smell has a nearly direct pathway.
They're built together, data set of the brain and the chemical world that it perceives.
They're meant to function as a unit.
It's common to lose smell acuity as you age.
Nearly 1 in 5 Americans over 40 reports a changed sense of smell.
1 in 8 has a measurable olfactory dysfunction.
1 in 15 experiences phantom odors.
Before COVID, an estimated 3% of Americans had little or no smell at all.
We don't have good data on how many people are born without a sense of smell,
though the National Institutes of Health estimates that it may be one in 10,000. We also don't know how to cure congenital anosmia,
which parts of the olfactory system usually fail to work, or how the condition interacts
with things like genetics, chemical signaling, memory, or neural diseases. That, Sobel of the
Weizmann Institute told me, is kind of pathetic.
As the science of smell has expanded, researchers have learned that olfaction,
far from being an unimportant sideshow, is interlaced with many diseases that concern us
deeply. Smell loss is an early warning sign of neural diseases like Alzheimer's, Parkinson's,
and schizophrenia, which is also
strongly associated with parosmia and phantasmia. People with depression have decreased olfaction
and smaller olfactory bulbs on average, and the size decreases according to the severity of the
depression. Children with autism have different automatic sniff reactions than those who are
neurotypical, and they use more parts of their brains to process odors. They can also follow social cues better if they can smell a
mother's odor, even if she isn't present. Olfaction is also bound up, in ways that
we're only beginning to understand, with our immune systems. Both, after all, depend on the
body's ability to recognize and respond to chemicals in the environment.
And some immune cells even depend on olfactory receptors to respond to invaders.
In fact, there are olfactory and taste-sensory receptors scattered throughout the body.
In the kidneys, the small intestine, the lungs, the stomach.
They seem to be smelling and tasting their surroundings to alert tissues when there are pathogens or other dangers nearby.
A wide spectrum of autoimmune or immune-mediated diseases, from multiple sclerosis to rheumatoid arthritis to lupus to recurrent pregnancy loss, are associated with smell loss or irregularity.
a pioneering smell researcher at the University of Pennsylvania, told me that the link is so strong that he has sometimes wondered if it's a sign that some of these diseases might have undiscovered
viral causes. There are also unexplored links to the thyroid and hormones.
Untold questions are still waiting for answers, wrote the authors of a 2013 meta-analysis.
The different connections between smell and autoimmunity, genes and
hormones, may suggest that this is another tessera of a mosaic which is waiting the answer of Oedipus.
We used to think, said Dalton, the experimental psychologist, that the chemical senses were the
poor orphan or poor cousins of the sensory world. Lately, though, smell scientists more often
refer to olfaction as the Cinderella sense, one that is perceived completely differently
once you stop ignoring and disparaging it. So why are we so convinced that humans are
bad smellers? Many scientists believe that it comes down to how intensely personal our
experience of smell is, how difficult it is to share it with others.
Research shows that people are much better
at differentiating among different smells
than correctly identifying a single one,
a problem I heard researchers call the fuzziness of smell,
the tip-of-the-nose feeling we get
when we encounter something familiar that we can't quite name.
We may not be bad at smelling,
but we are bad at putting what we smell into words.
Kant again.
Smell does not allow itself to be described, but only compared through similarity with another sense.
With vision, we have a concrete vocabulary to lean on, red or blue, dark or bright.
As I was writing this, I noticed how much I and the people I interviewed relied on visual metaphors.
Smell is overlooked, the world loses color, even when discussing a distinct sense. Even if we're perceiving a color
differently from the way someone else is, which is in fact pretty often the case, we still have
a shared language that we can all lean on to discuss it. With smell, we find ourselves flailing.
The subjectiveness of our experience means that coherent analogies can
be hard to find. The same molecular compound can, for a variety of reasons, smell totally
different to two people. In fact, even the very same person can experience it differently at
different times, especially if their own chemistry is altered by being, say, hungry or hungover
or pregnant. Our genetics determine
whether we can smell cyanide and whether we will experience the pheromone androstenone as smelling
like vanilla or like a grim combination of dirty socks and urine or like nothing at all.
Genetics plus life experience, the natural attrition and regrowth of your epithelium,
it may be that the more you smell an odor, the more receptors you develop that can perceive it—
mean that 30% of your receptors
may be different from those of the person next to you.
Culture, too, plays a role.
Whether you think lemon smells clean or not
may depend on whether you grew up associating it
with cleaning products or with hot, overripe citrus groves.
Our descriptions of smell also lack resolution.
Mainland, the neuroscientist notes,
though Pantone lists dozens of shades of blue,
each of which can be quantified precisely in hue and saturation,
we can really describe a banana scent only as banana-y.
If our experience of vision were as dissolute as smell,
the philosopher Daniel Dennett has written,
the sky would go all birdish when a bird flew by.
Yet the intensity of a smell can completely change the way we experience it.
Mainland, who often asks volunteers to describe smells in his lab,
told me that he has one vial that is perceived as grapefruit at low concentrations,
but rotten egg at high ones, and another that slides from black
current to cat pee. As Parma says, with vision we agree on where we stand. With odor, it's like a
kaleidoscope. That turns out to matter quite a lot. Being able to describe and discuss what we smell
helps us smell it better. Think of sommeliers who learn to pick out the distinct aromas of wine in large part by
learning a language for them. Or consider, as the cognitive scientist and philosopher A.S. Barwich
explains in her book Smellosophy, that beer experts have lots of descriptors for bitter flavors,
which they prize, while wine drinkers, who consider bitterness a sign of a failed wine,
have few. Asifa Majid, who studies language a sign of a failed wine, have few.
Asifa Majid, who studies language and cognition at the University of York,
has written about languages in Southeast Asia that have genuine lexicons for odors,
sets of words that work much like color words,
each describing something inherent in the experience of a smell rather than comparing it to other things.
While Westerners trying to
describe smells tend to hem and haw and squint into space, searching for descriptors, speakers
of these languages are declarative and decisive. Majid described, to The Atlantic, how her own
ability to name smells looked in comparison. Some kids were following me around and laughing,
like, how can you be such a moron?
Huehuetla Tepewa, an indigenous language in Mexico,
likewise has at least 45 different words that express specific olfactory experiences.
People who grow up in such cultures are better at detecting, discriminating, and naming odors.
One also doubts that they would require a scientific renaissance to tell them that smell matters.
Western psychology is frequently and justifiably criticized for being skewed because such a disproportionate number of its study subjects come from just a few weird countries.
Western, educated, industrial, rich, and democratic.
Smell scientists have also begun to talk about what it means that many early
scientists and theoreticians of perception, as well as the people they studied, were also ODD.
They were older people whose senses of smell were therefore naturally diminished.
They lived in deodorized societies where many natural smells were unwelcome. And they were
also generally desensitized to smells because of living in cultures that paid little attention to them,
and because of the dulling effects of urban pollution and even, perhaps, their common affinity for smoking.
It may be no wonder at all that they found smell so unworthy of consideration.
This leads to some interesting questions.
What if we've spent so much time dismissing the importance of smell because of some odd, or ODD, accident of
history? And what if we might rediscover it, in part, because of another? As the virus ripped
through New York City last spring, Pablo Meyer, another GCCR member, stayed inside his apartment,
listening to ambulance sirens. Every morning, he tested his own sense of smell to assuage the persistent fear that he,
like so many of his neighbors,
had contracted the coronavirus.
He then spent his days reading replies to the GCCR survey
as they poured in from around the world.
One person's sense of smell disappeared entirely
over the course of cooking a single meal.
Someone found a boyfriend's signature pasta dish
suddenly disgusting, while someone else doused a worryingly bland breakfast with hot sauce to no effect.
A sommelier failed to notice that the cat's litter box was full, and a self-described former
bloodhound, always the first in any group of people to notice an odor, nearly gagged on food
that smelled of nothing. Nothing is savory anymore, someone wrote. Coffee is just bitter.
A cake is just sweet. A burger is just salty. Meyer began to feel as if he knew the people
personally, the ones who described smells in terms of tea and fruit, or meat and gasoline,
or blue Powerade and lollipops. The way they described their senses felt so intimate,
he said later, you could almost see the type of person they are.
He was becoming convinced that people believe they are bad at describing smells
simply because they so often are asked to do so in labs,
sniffing single, isolated molecules,
when the more familiar odor of coffee is a blend of many hundreds of them,
cloistered away from the context of their real lives
and the smells that actually mattered to them.
Given the right opportunity, he said, people become very, very verbal.
For Meyer, an IBM researcher who specializes in using algorithms to analyze biological data,
and who was one of the people who insisted that the GCCR surveys should include open text boxes,
this was exciting news.
For years, scientists studying smell have been working
off just a few deeply deficient data sets that link different chemicals and the way humans
perceive them. There was, for example, a record created in the late 1960s by a single perfumer
who described thousands of smells, and study after study relied on a single
Atlas of Odor Character Profiles published in 1985. It drew on the
observations of volunteers who had been asked to smell various single molecules and chemical
mixtures, rating and naming them according to a supplied list of descriptors that many scientists
felt was flawed and dated. More recently, Meyer and many others had been using a new dataset,
painstakingly created by scientists at the Rockefeller University in New York
and published in 2016.
I visited the lab in 2014
while Leslie Vosshall and her colleagues
were building their data
and was surprised to find I could smell one of the vials,
though it probably just triggered my trigeminal system.
When I told Vosshall that it seemed minty,
she replied,
really, most people say dirty socks.
But while the new data set was a significant
improvement, 55 people smelled 480 different molecules, rating them by intensity, pleasantness,
familiarity, and how well they matched a list of 20 descriptions, including garlic, spices, flour,
bakery, musky, uranus, and so on, it was still a sign of how limited the field was.
and so on, it was still a sign of how limited the field was. This was why Meyer, along with his colleague Guillermo Secchi, pushed for those open text boxes in the GCCR survey. They were interested
in the possibilities of natural language processing, a branch of machine learning that
uses algorithms to analyze the patterns of human expression. Secchi was already using the technology
to predict the early onset of Alzheimer's,
when it is most treatable,
by analyzing details of the way people speak.
Many researchers had written about the possibilities
of using artificial intelligence
to finally make a predictive olfactory map,
as well as to look at links between changes in olfaction
and all the diseases to which those changes are connected.
But sufficient data was never available.
Now COVID had provided researchers with a big, complicated data set
linking olfactory experience and the progression of a specific disease.
It wasn't constrained by numerical rankings, monomolecules, or a few proffered adjectives,
but instead allowed people to speak freely about real smells
in the real world, in all their complex and subjective glory.
When Meyer and Secchi's colleague, Raquel Norrell,
finished analyzing the open-ended answers from English-speaking respondents,
they found, with surprise and delight,
that their textual analysis was just as predictive of a COVID diagnosis
as people's
numerical ratings of smell losses. The algorithms worked because people with COVID used very
different words to talk about smell than those without it. Even those who hadn't fully lost their
olfaction still tended to describe their sensations in the same ways, repeating words like metallic,
decayed, chemical, acid, sour, burnt, and urine.
It was an encouraging finding,
a proof of concept that they couldn't wait to explore in a lot more depth.
First, in the GCCR responses in other languages,
and then in the future, in other data sets related to other diseases.
Meyer got excited when he talked about it.
Anything where smell changes, he told me,
depression, schizophrenia, Alzheimer's, Parkinson's, neurodegeneration, cognitive and neuropsychiatric disease.
The whole enchilada, as they say.
I had a hard time imagining the olfactory map that scientists have dreamed of for so long.
Would it, I asked Mainland, look something like a periodic table?
He suggested, I think, instead of the maps that scientists have made of color space,
which arrange colors to show their mathematical relationships and mixtures.
We didn't know how useful color space was until people started inventing things like color
television and Photoshop, he explained, adding that the map itself isn't the goal, but rather
the ability to
use it to understand why we smell what we do. After that, what will be really interesting are
the applications we can't yet imagine. It's hard to understand the utility of the map, he said,
until you have the map. At the beginning of October, I watched on a webinar as Veronica
Paredaloth, a GCCR member, shared a different type of map, which
she and other researchers had created. Using data from France, where an especially large number of
people had filled out the survey, researchers overlaid the timing and geography of self-reported
smell and taste loss with lockdowns and hospital admissions. They found that increases in anosmia
had been a more timely indicator of surges in
viral transmission than the data the government was using. They could also see the effects of
lockdowns clearly in the surveys. New-onset smell and taste loss began to decline five days after
lockdowns began, while it took 15 days for the government's hospital-based indicators to show
that they were working. Smell and taste tracking could be a crucial tool for detecting next waves,
Pareta-Loth argued.
Yet it remained difficult to get smell taken seriously.
When someone asked how that fact
was being communicated to governments,
there was a lot of rueful laughter.
Europe's autumn spike,
which eventually brought new lockdowns,
began shortly afterward.
Parma thought that the GCCR message board would start to quiet down once lockdowns, began shortly afterward. Parma thought that the GCCR message board would start
to quiet down once lockdowns ended and people went back to their own labs. But instead, she saw more
and more proposals for ways to study the group's data, and more small groups of new collaborators
spinning off to chase new questions. Dalton imagines a future in which smell checks on
infants and children, which could give far more insight into their overall health than a hearing test,
become routine.
She and Reed, as well as some other researchers,
have begun developing coronavirus screening tests for public places,
based not on fevers, but on ability to smell.
Hopkins, who partnered with scientists from Belgium, Italy, and elsewhere
to publish more than 30 papers about the way the virus and olfaction intertwine,
expects more attention to the study of smell training
and other as-yet-unknown treatments for people who have lost their sense of smell.
It's a problem that she thinks will be taken much more seriously in a post-COVID world
in which many people, possibly millions of them, never fully recover their olfaction.
If smell was ignored before,
off in the hinterlands,
you could say that COVID put it on the map.
But studying smell,
scientist after scientist told me,
had already reshaped the way
they thought about the world
and their place in it.
They went, they said,
from thinking of smell as a bonus sense
to a dominant one,
and from a secondary sense to one of the primary things that influences our life.
The geography had shifted even as they were working to chart it.
This was recorded by Autumn.
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