Pre-COVID, the loss of smell was often dismissed as a trivial medical complaint. But an expatriate Italian-Australian living in the UK is helping to rewrite the textbook on anosmia.
By Cathy O’Leary
Journalist Paola Totaro remembers being puzzled at smelling nothing from the fragrant hand moisturiser she used every day in her London home. That feeling turned to panic when even the ammonia-based toilet cleaner yielded zero response at nose-level.
It was March 2020, and she was about to find out she had COVID and would be one of millions of people around the world to suddenly find they had lost their fifth sense, seemingly overnight.
Her experience trying to recover her ability to smell would take many months and include ‘smell training’ to rewire the brain to recognise smells, both pleasant and otherwise.
With her co-author husband – former WA journalist turned author Robert Wainwright – Totaro has put pen to paper to enlighten people – including GPs – on the huge impact of losing the ability to smell in the book On the Scent.
“Locked down at home in London, I could smell nothing of my domestic world either, which made life feel alien and flat,” she writes. “In normal times, walking the dog each day is a stop-start affair (much to my husband’s irritation) because I revel in slowing down and inhaling the smell of the outdoors, whether it is freshly mown grass, the heady scent of cherry blossom, new eruptions of daffodils or the first sprigs of climbing rose. Flowers without scent felt like a cruel mockery, their beauty visible but lacking the dimension I love most.”
She felt bad complaining when people were dying of COVID but “the few pleasures left during lockdown – food, booze, the outdoors – had lost their joy.”
“At the dinner table, red wine tasted like salty water, white wine like a mild, odourless vinegar. My favourite aperitif, gin, was barely perceptible in the overwhelming, cloying sweetness of the tonic.
“Steak felt like biting into a slab of flabby leather, chicken a horrifying, bony, rubber, while dark chocolate, my favourite, tasted like unscented soap.”
Wainwright takes over the narration, briefly, to describe the devastation he saw when his wife – their household’s chief sniffer – lost her sense of smell.
While initially motivated to investigate anosmia out of self-interest, Totaro was also journalistically intrigued by this ‘Cinderella’ sense, soon learning of the interplay between our senses of taste and smell, with the process of tasting starting when we first chew our food, with the true flavour coming from the chemical mix of odours released.
On the Scent covers in entertaining detail how the olfactory system works, and how devastating it is when it stops.
Totaro explains that from the moment we take our first breath, we inhale and exhale around 22,000 times a day, flooding our olfactory system with odours.
“The outside world can tell us immediately if our room smells musty or our clothes need a wash; if the baby’s nappy needs changing or the jasmine outside is in bloom,” she notes.
Totaro has interviewed some of best olfactory specialists in the world such as Aarhus University’s Professor Alexander Fjaldstad, a specialist physician and co-founder of Denmark’s first outpatient clinic for taste and smell disorder, one of many to explain that smelling is as much about the brain as the nose.
He likens the process to a program or app running on a laptop or smartphone. Smells have a direct shortcut into the part of the brain that relates to ‘liking’ and pleasurable appreciation but also, importantly, to ‘bad’ smells.
In the course of her journey to recovery, Totaro explains how she learnt there was no quick fix from anosmia, and it took months of retraining for familiar scents to return. Smell training is like learning a new language.
Totaro discovered that her father, Paolo, had also lost his sense of smell, many years before he was eventually diagnosed with Parkinson’s disease.
She ponders whether her father’s olfactory loss might have been a red flag missed by the GP at the time, citing solid research suggesting smell loss is often a very early symptom of Parkinson’s.
Totaro argues the case for smell testing to be incorporated into routine health checks as part of a measure of overall physiological and emotional wellbeing, perhaps at the GP surgery, particularly if a patient presents with a smell or taste concern.
She makes a strong case for smell being the poor cousin in medical research labs for too long, only now changing because of the big number of cases of anosmia fuelled by COVID.
“If there is a silver lining to this terrible chapter in modern human history, it is that it has forced a re-evaluation of our sense of smell,” she concludes, “not just for its importance to our quality of life but as a powerful sentinel and hitherto unsung surveillance system that when properly read can tell us so much about our physical and mental health.”
On the Scent is published by Elliott & Thompson, with Simon & Schuster distributing, and is available now.(RRP$29.95)