Smell ya later: living with anosmia

Artwork by Olivia Bessant

After losing his sense of smell in an accident, Matt Cross shares what life is like without smell and explains why we have it and why we should never undervalue it.

“Just think of it as gone”.

The neurosurgeon sat opposite me makes a sweeping gesture with his hand as he tactlessly delivers the bleak prognosis for my recent loss of smell. That’s it? I think as I try and digest this sledgehammer of news I’ve just been served. Surely that can’t be it?

The date is September 2017 and about eight weeks ago I’ve been struck by a car whilst riding a bike and sustained a serious brain injury (amongst other things). The recovery’s been slow and painful but, one-by-one, the symptoms are fading and I am returning to who I was before the accident. But one issue persists. I can’t smell. For a long while, it was the least of my worries but my concern grows with each passing day. I attempt to seek answers during a consultation with a neurosurgeon but his clinical response sadly reflects the trivial view many of us have when it comes to smell loss, or anosmia.

Without smell, one of the ways I understand the world has gone. I can go about my life as usual but the day lacks pizzazz, colour and depth. It is somewhat isolating – rather like observing the world behind a pane of glass not truly immersed and emotionally connected to a place or person as you should be. At first, I assumed it was losing the ability to perceive flavours in food and drink that would be by far the most difficult part to accept – and perhaps if I had plans to pursue a career in a culinary industry it would have been. But I still do have a sense of taste, I just lack the full picture one gets when taste is allied with flavour via retro-nasal olfaction. So I still look forward to food and take great pleasure in it even though I wouldn’t be able to distinguish, say, Coca-Cola from Fanta in a blind taste test. However, when McDonald’s mistakenly served me a hot chocolate recently instead of a coffee, I was able to detect that instantly because the two drinks have different tastes.

But the nose does so much more for us than giving food flavour.

Imagine you’ve just woken up. You get out of bed and wander over to pick up yesterday’s shirt and press it against your nose to check if it’s wearable. Later that morning, you notice your milk’s use-by date has passed so you give it a quick whiff to check whether it’s still safe to consume. While munching away on your cereal, your heart drops as you begin to smell burnt toast and you promptly spring to your feet to try and salvage it.

These are just three examples in a typical morning routine where smell has given useful information on the changing chemistry of one’s environment. But obviously humans had an olfactory system long before we had to worry about how we smelt or whether our toast was overdone. 

So why do we have it?

For the majority of the animal kingdom, smell is the most important sense. It can alert them to danger, lead them to food or help identify a potential mate. The flowers of plants use volatile scents to attract pollinators and fruit eating animals. One of these is needed for fertilisation, the other helps with seed dispersal but the bottom line is the same; the more attractive the odour, the more likely the plant will pass on its DNA over its less fragrant rivals. Similarly, an animal which fails to identify the scent of an approaching lion amongst the background odour of plants and trees will not leave descendants to preserve its genes.

And this is why animals have smell – to understand the survival implications of the odour they detect. In other words, food or poison, predator or prey.

But one shouldn’t assume that just because humans don’t rely on smell to stay alive that the sense is superfluous. Smell is the unsung hero of our five senses allowing us to achieve a higher level of emotional connection to people, places and objects owing to how our brains are wired up. The olfactory bulb, the part of the brain that translates the molecular information of an odorous compound into a mental percept, is directly connected to the limbic system; a set of structures in the brain responsible for our emotional life and the formation of memories.

And this gets to the bottom of what I have found to be the most difficult aspect of smell loss. Smells can conjure up memories archived deep in our brains with the most fleeting of whiffs almost like hitting a tripwire on a long-forgotten landmine. Nothing is more memorable. And, once we associate a smell to a loved one or even to an event like Christmas Day, that stimulus alone can help us feel more settled, grounded and content.

Losing these sentimental pathways to memories and deeper emotional connections to people is profoundly impactful but, as I touched on at the start of this piece, many anosmia sufferers are turned away by those in the medical profession. After all, the condition isn’t necessarily harmful to your health nor is there a cure. However, in a recent study of 496 anosmia sufferers in the UK, 43% reported depression and 54% indicated that smell loss has negatively impacted their relationship with friends, family or a partner.

Outside the medical world, anosmia is often viewed with curiosity as an interesting oddity. Some are awash with questions sometimes loaded with myths such as “does losing one sense enhance your others?” (No, is the answer by the way). Others make an attempt to spin it into a positive. “At least you can’t smell manure or vomit etc.” Then there are those that go with the angle of “at least it wasn’t your sight!” or “if you had to lose a sense, smell’s the best one!”. Whilst this is true, smell probably is the best sense to lose, it is never particularly comforting to hear. Rather like if you were mourning the loss of a grandparent and in an attempt to console you someone said, “at least it wasn’t your mum!”.

As with many things, I didn’t fully appreciate smell until it was gone. Losing it was a unique and devastating bereavement, but one that I am now ultimately at peace with. My only plea to anyone reading is to not take it for granted. Cherish the freshness of country air, the comforting scent of your loved ones and the rich, mouth-watering aromas ebbing out of the kitchen on Christmas Day.