Corned beef, pastrami, honeyed hams, marinades of infinite variety, stuffed peppers, chopped liver, and pickled herring brought images of lunch with Louis Roth, my grandfather. “I love it here, grandpa. It smells so good.”
“Kosher deli’s the best, Arnold. Trust me, if you like it, you don’t want to wind up in Corpus Christi.”
Lunch with Nick Martin, my best friend, in his father’s deli, brought the redolences and the images of antipasto, Genoa salami, Provolone and Mozzarella cheese, and of course gnocchi.
I was the mad maven, the cognoscenti of these glorious emissions. Only one thing could surpass this experience, the marriage of these delights with my taste buds. Olfaction was a charming long distance romance, but I was eager for the honeymoon.
You’ll excuse the especially apt sensory cliché that this wasn’t all roses, as every delight had its offensive mother-in-law. They found me with equal regularity. I’ll not offend you with the specifics, but the world’s full of disagreeable aromas. Often and without forewarning, the odor transported me to the rendering plant or the sewage processing facility whose putrid stenches made my urge to escape irresistible.
One evening, I sat before my computer searching the Internet for information about the olfactory system. “The only thing I learned about smell in medical was the basics. Maybe it’s because our culture says that there’s something vulgar about odors.”
Lois smiled. “It’s a scentsitive subject, if you can ignore the pun. Look at women’s magazines. It’s one thing to deride the offensive body odor of someone with poor personal hygiene, it’s another to disparage all natural human aromas. The manufacturers designed the manipulative marketing schemes to convince women (and men too) that they’d never catch a guy/girl or make a friend, or get the job unless they cloaked themselves with their artificially created fragrances. It ignores the fact that I love the way you smell, Arnie, and I love the unique aroma of each of our girls. I’m only guessing, but I have reason to believe you don’t find my taste and smell to be unpleasant.”
“That’s a scentsational image, babe.”
Lois groaned.
“Smell’s role in disease is leading to a better understanding of the process. A variety of illnesses are associated with unique odors, and the loss of the ability to smell is linked with certain psychiatric illnesses and with Alzheimer’s in particular.”
“Dad lost his sense of smell early in the course of Alzheimer’s.”
I studied the computer screen. “Here’s a study of changes in penile or vaginal blood flow when researchers exposed subjects to different aromas. How come we didn’t get to participate in these studies when we were in college?”
Lois laughed. “Bad timing. It’s good to see how we’re expanding the use of our tax dollars.”
“Guess what aromas produce the greatest increase in penile blood flow in men?”
“Perfume?”
“Partly right. Lavender is on the list, but also on top are pumpkin pie and cinnamon buns.”
“I guess I know what to cook when I’m feeling horny.”
“What about women?”
“I haven’t got the foggiest.”
“Good and Plenty, you remember, the licorice candy.”
Lois laughs. “So that’s why Bobby Howard insisted on buying them for me at the movies.”
“I think the surveys and their conclusions in Cosmo, Elle, and O Magazine sets the stage or the bedroom for disappointment. I’m guessing that you and I are more active sexually than most, but who really knows. What I learned about sex as a kid was worthless. What I learned in medical school was better, but if you want to know what’s happening in the average bedroom, I see only two approaches; become a professional who deals with sexual problems or a woman in an intimate group of female friends like the ladies in Sex and the City.”
Lois and I never talked much about sex. It wasn’t as if we avoided the subject, it just wasn’t necessary. We made love frequently, but not on a schedule. With all the complexities of work, children, and modern living, sexually, we remained in sync. She always responded to my needs with joyous acceptance. Any hint of interest on her part brought me to full arousal in seconds.
“I don’t know if it’s cause and effect,” Lois said, “but your libido and your sense of smell are on the same accelerated trajectory.”
“You’re complaining?”
“Never. In fact, it’s, as the kids say, awesome.”
“The medical literature describes a relationship between smell and sex. People with anosmia, the loss of the ability to smell, have diminished sex drives, while surveys correlate sexuality with our sensitivity to smell.”
“I love your smell. Sometimes when you’re not here, I grab your sweatshirt to get that unique Arnie aroma.”
“I found an interesting study in the British Medical Journal suggesting that smell and sex are complementary. After sex, the body produces increased amounts of the hormone prolactin. That in turn stimulates stem cells in the brain to form more olfactory lobe nerve cells.”
“With your nose, Arnie, you ought to have a hell of an olfactory lobe by now. Let’s get a CT or an MRI so we can hang it over the mantelpiece or post it on You Tube.”
“Maybe there’s a picture of another part of my anatomy we’d want up on the wall, babe.”
“You mean your nose?”
“Of course, what else?”
Each trip to the supermarket was a sensory safari. The produce and bakery sections were delightful with their individual aromas, splendid bouquets, and the amalgamation of scents. Many aromas had an affinity for each other, often producing a unique symphony of fragrances, while for others, their fusion brought the disharmony of a Chinese opera.
When we went to the food market, Lois’s shopping strategy for choosing fruits and vegetables amazed me. Shopping has been her responsibility, not because this was ‘woman’s work’, but simply because she savored the task, especially when she could do it at her leisure. She enjoyed inspecting labels, checking calories, fat, and carbohydrate content with each selection.
After several minutes observing this painfully slow process, I usually complained, “If you don’t need me, I’ll be out in the car reading.”
Lois especially enjoyed selecting fruits and vegetables. After visual surveillance, she grasped each item, gave it a gentle squeeze, and then brought it to her nose for final approval. I’m not sure why, but after a few constructive comments about her selections, Lois reassigned me to the produce section.
I’ve made sure to keep cilantro at arms length, never fully understanding how anyone could eat the vile aromatic herb. Even before I developed this new sensitivity, I could smell it immediately during transit through the produce section, and was happy to get away from it as quickly as possible. Now, as I looked at the vegetables, five aisles away, the strong, ammonia-like, urinous soapy cilantro smell made me feel like vomiting. I had to send Lois back for the veggies.
As I rounded the corner and turned into the next aisle, a young woman was pushing a cart with a boy who looked about three years old. He sat in the child seat squirming and dangling his legs with delight. One whiff was all it took, and thoughtlessly I said, “You’ll find a present for you in that diaper,” and started away.
“Excuse me!” she shouted.
I blushed. “I’m sorry, but that’s pretty potent stuff your son has in there.”
“Why of all the nerve. Mind your own damn business.”
I should have let it go at that, but instead, a demon possessed me. “It is my business when you let your child stink up this store. You may find the aroma appealing, but I can assure you that others do not.”
She turned equally red, thrust her middle finger into my face, and then wheeled her cart away. This new sensory skill was turning out to be of doubtful advantage, a costly ride into uncharted territory.
The next morning during rounds on the fifth floor medical unit, I visited Sarah Jackson. I’d transferred her from ICU last
night.
“Hey, Dr. Roth, how are you doing this morning?”
“Doing well, but more to the point, how’s my favorite patient?”
“Aren’t you too much,” she smiled? “I’m sure glad to get out of that noisy ICU and back to civilization. When can I go home?”
Before I can answer, Ritchie Brown, Sarah’s nurse entered the room. “Hey, Doc, how’s our girl doing?”
As he leaned over to check Sarah’s IV, the strong, unique scent of marijuana hit my nose.
He looked fine, I thought, but if he’s loaded…
“I’ll have Ritchie remove the IV and your bladder catheter, Sarah. If your temp stays down through the next twenty-four hours, I’ll discharge you in the morning.”
I looked at Ritchie, and then moved my eyes away as he caught me staring. “Can I have a word with you, Mr. Brown?”
“Mr. Brown?” he said, looking puzzled.
I walked into the small dictation room. Ritchie followed.
“I don’t care what you do on your own time, Ritchie, but if you’re coming to work stoned, you’re in for big problems.”
He avoided my eyes. “I don’t know what you’re talking about, Arnie.”
“That’s strike one, Ritchie. Don’t lie to me. I can smell it. Keep this up and you’re out the door.”
My mind froze for a second. When I said I smell it, I meant the marijuana, but suddenly my nose detected something else. Smelling a lie was no longer a metaphor for me. Ritchie’s body was emitting something distinct—the acrid ammonia-like stench of his lie.
Ritchie blanched, and then reddened. In a voice barely audible he said, “Okay, I smoked a joint last night, but Arnie,” he took a deep breath, “I’d never come to work stoned. You know me better than that.”
“I thought I did. Think of the hospital’s liability if something happened to one of your patients and they discover that you used pot. It wouldn’t matter that you did nothing wrong. Legally, you’d be dead. Your career would be over. You don’t want any part of that.”
“Arnie, it was one joint, and one joint only. If I was stinking drunk last night nobody would give a damn.”
“I understand the hypocrisy, but I didn’t make the rules, and I don’t want to see you hurt, Ritchie. This is between you and me. I believe you, but for God sake, don’t let anybody suspect that you’re using that stuff anywhere near your job. That’s suicide. If you’re going to smoke, do it so that nobody can raise the question about its effect on you, change your clothes or whatever to hide the aroma.”
“Thanks, Arnie. I won’t disappoint you.”
“You’re a talented nurse, Ritchie. Be smart.”
My new life was more interesting for sure, but also more complicated. Each day brought new sensory information. For a compulsive personality, it came with a burden of responsibility. The sense of smell was our first defense organ. It allowed our evolutionary single cell progenitors to avoid exposure to harmful chemicals and to move toward nutrient rich areas. Evolutionary theorists credit human brain development to this first environmental reaction that led to the development of specialized detector cells. Over millions of years, these cells became internalized with nerve cells to form the primitive animal’s olfactory system.
As I entered my office this morning, a couple in their mid twenties, with a small thin girl, stood at Sarah Ettinger’s door. Sarah was a child psychiatrist, my tenant, and a good friend.
I approached the couple. “Is Dr. Ettinger expecting you?”
“Excuse me,” said the man, “but who are you, and how is this any of your business?”
Before I had a chance to respond, the maple syrup aroma hit me and my mind wandered back to my childhood home and a tall stack of pancakes and the Aunt Jemima-shaped bottle.
“I’m so sorry. I’m Dr. Roth, and this is my building. I was going to say, that if she’s expecting you, I’d open the door and let you into her waiting room.”
“I’m so sorry,” Penny said. “Roger gets a little surly when we drag him to our family counseling sessions.”
“I apologize,” Roger said, “and yes, we’ll take you up on your kind offer.”
The intensity of the maple syrup aroma increased when the girl, Kirsten, past immediately before me as she moved into the waiting room.
“This may sound a little strange to you,” I began, “but did any of you have maple syrup or a maple syrup product today?”
“No,” said Penny, looking at me oddly.
Before I could say another word, the front door opened. It was Sarah Ettinger.
“Thanks for letting them in, Arnie. Traffic’s a bear this morning.”
She inserted the key into her office door and turned to the Brewers. “I’ll be with you in a moment.”
“Do you have a second, Sarah?” I said.
She stared at me with interest. “Come into my office. You’re not going to raise my rent, are you?”
“This will sound like a weird request, Sarah, but if you bear with me, I’ll explain.”
She removed her jacket, hung it on a coat tree, and then plunked herself into her soft desk chair. “Shoot.”
“I don’t want any confidential information, but can you tell me a little about that girl.”
“Why on earth do you want to know, Arnie?”
“Please, Sarah. Just a whiff of information is all I need then I’ll tell you why I ask.”
“Kirsten’s growth and development had been normal, although in the lower percentiles. About six months ago, she started having behavior problems at school; acting out against other children and her teachers, decline in her school performance, and the resumption of bedwetting. Something’s eating at this child. I’ve been seeing her for four months and I still can’t tell if it’s the chicken or the egg; have her emotional problems compromised her performance or has poor performance left her anxious and unable to concentrate?”
“What I’m about to tell you will sound odd, Sarah, but I only tell you this so you won’t recommend that I need the couch.”
“I don’t use a couch, Arnie.”
“I know. After I recovered from the encephalitis, my sense of smell has improved dramatically. As you might expect, this poses opportunities and difficulties. When I met Kirsten this morning, she strongly smelled of maple syrup.”
“Maple syrup?”
“Yes, and nobody in the family had used it, spilled it, etc. I remember from a lecture that scientists have described a rare genetic metabolic disorder called Maple Syrup Urine Disease, where due to a defective enzyme, certain amino acids are improperly broken down and appear in the urine with the distinct aroma of maple syrup.”
“My mind’s racing back to school,” Sarah said. “This is a disease like PKU, phenylketonuria, which causes mental retardation. We can control it by diet.”
“Exactly. That girl needs a workup ASAP. If she has that diagnosis, we could save her and her family a lifetime of grief.”
Three weeks later as I was finishing my paperwork for the day, Beverly knocked on my door. “I have someone here to see you.”
I stood behind my desk.
Roger and Penny Brewer entered with Kirsten who wore a big smile, a white flowered sundress, and pink Mary Janes. She carried a small, gift-wrapped package, and with a little encouragement, brought it over to me.
“Why thank you. You look so pretty. Is that a new dress?”
She smiled, and then looked down, saying softly, “My shoes are new too.”
I looked up at the Brewers. “This wasn’t necessary.” In an instant, I could see their disappointment, so I added immediately, “But I sure do appreciate it.”
“Open it,” Roger said.
I unwrapped the box labeled, Ipod touch. This was an amazing gift. One that I wanted, but felt too guilty to buy for myself. “This is too much…I mean it’s wonderful…I mean I love it, but it’s too much.”
“This is nothing,” Peggy said, “compared to giving us our daughter’s life. We can neve
r repay you for what you did, Dr. Roth.” She walked to me and gave me a hug and a kiss on the cheek. Roger approached and grasped my hand as his eyes filled with tears.
My own eyes filled. I wanted to say more, much more, but words were inadequate and could only diminish this joyous moment for all of us.
Chapter Thirty-One
Into the fifth week of hospitalization, Connie Rinaldi relied entirely on the ventilator to breathe. The week before, Connie’s parents agreed to replace the ET tube with a surgical procedure called a tracheotomy. During this surgery, they made an opening in her windpipe to make breathing easier. An added benefit was the possibility that Connie’s might talk. That had not yet proven possible. The infection had finally cleared, but each time they tried to get her off the ventilator, weaning they called it, she became desperate—unable to breathe on her own.
The Rinaldis tried to talk with their daughter by asking her to block the trachea, but after a few seconds, Connie panicked from the stress of trying to breathe on her own. The nurses gave Connie a clipboard with a pencil attached so that she could write. It was awkward, but effective.
Connie wrote in hesitant and irregular block letters. “What’s going to happen to me?”
Tina caressed Connie’s hair. “The doctors say you’re doing well. The infection’s better and so is your breathing.”
Why is the tube’s still in me?
“You need it to breathe. They tried to have you breathe on your own, but I guess that your lungs aren’t ready yet.”
When will they be ready?
Joseph looked at his daughter, raised his shoulders, and turned up his palms in the universal gesture of the unknown.
Tears streamed from Connie’s eyes. They ran onto the clipboard staining the notepaper as she wrote, I don’t want to go on this way, Daddy. I can’t live like this. Don’t make me do this!
Joe bent over his daughter and cried.
Brier’s social service department was pushing Jim McDonald on Connie’s case. The hospital had collected all it could from her insurance and they were looking for a way out. Additionally, the Rinaldis were begging for answers.
The Sixth Sense (Brier Hospital Series Book 3) Page 14