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Authors: Oliver Sacks
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reason to it,” she wrote. “How could lemons taste okay but not oranges; garlic, but not onions?”
W ith complete anosmia, rather than exaggerations or distortions of perceived smells, there can only be hallucinations of smell. These too can be very various, and sometimes difficult to define or describe. This was brought out by Heather A.:
The hallucinations generally cannot be described by one smell descriptor (except one night I smelled dill pickles for most of an evening). I can kind of describe them as an amalgam of other smells (metallic-y roll-on deodorant; dense acrid-sweet cake; melted plastic in a three-day-old garbage pile). I have been able to have fun with it in this way, make an art of naming/describing them. In the beginning, I would go through phaseswhere I would access one at a time for a couple of weeks, multiple times a day. After a few months, the family of smells I had gone through had diversified, and now I can reference several different ones in a day. Sometimes a new one will pop up and I may not smell it again. The experience of them varies. Sometimes they will come up strong, like something stuck right under my nose, and dissipate quickly; sometimes one will be subtle and linger, at times barely noticeable.
Some people hallucinate a particular smell, which may be influenced by context or suggestion. Laura H., who lost most of her sense of smell after a craniotomy, wrote to me that she would occasionally have a brief burst of smells that were plausible, though not always entirely accurate from what she remembered sensing before her loss. Sometimes they were not really there at all:
Our kitchen was being revamped, and the electrics blew one evening. My husband assured me that all was safe but I was very worried about a possible electrical fire that might start.… I woke up in the middle of the night and had to get up to check the kitchen because I thought I could smell electrical burning.… I checked everywhere I could see in the kitchen, hall, cupboards, but could see nothing burning.… I then started to think the smell could be coming from behind a wall or somewhere I couldn’t see.
She woke her husband; he could smell nothing, but she could still smell the smoke strongly. “I was shocked,” she said, “by how strongly I could smell something that wasn’t there.”
Others may be haunted by a single constant smell of suchcomplexity that it seems to conglomerate almost all the bad smells in the world. Bonnie Blodgett, in her book
Remembering Smell
, describes the phantosmic world she was plunged into following a sinus infection and the use of a potent nasal spray. She was driving along a state highway when she first detected a “weird” smell. She checked her shoes at a gas station, found them clean, then wondered if there was something amiss with the heater fan in the car—a dead bird perhaps? The smell pursued her, waxing and waning in intensity but never absent. She explored a dozen possible external causes and was finally, reluctantly, forced to the realization that the smell was in her head—in a neurological, not a psychiatric, sense. She described the smell as resembling “shit, puke, burning flesh and rotten eggs. Not to mention smoke, chemicals, urine and mold. My brain had truly outdone itself.” (Hallucination of particularly vile smells is called cacosmia.)
While humans can detect and identify perhaps ten thousand distinct smells, the number of possible smells is far greater, for there are more than five hundred different odorant receptor sites in the nasal mucosa, and stimulation of these (or their cerebral representations) may be combined in trillions of ways. Some hallucinated smells may be impossible to describe because they are different from anything ever experienced in the real world, and evoke no memories or associations. New, unprecedented experiences can be a hallmark of hallucinations, for when the brain is released from the constraints of reality, it can
W ith complete anosmia, rather than exaggerations or distortions of perceived smells, there can only be hallucinations of smell. These too can be very various, and sometimes difficult to define or describe. This was brought out by Heather A.:
The hallucinations generally cannot be described by one smell descriptor (except one night I smelled dill pickles for most of an evening). I can kind of describe them as an amalgam of other smells (metallic-y roll-on deodorant; dense acrid-sweet cake; melted plastic in a three-day-old garbage pile). I have been able to have fun with it in this way, make an art of naming/describing them. In the beginning, I would go through phaseswhere I would access one at a time for a couple of weeks, multiple times a day. After a few months, the family of smells I had gone through had diversified, and now I can reference several different ones in a day. Sometimes a new one will pop up and I may not smell it again. The experience of them varies. Sometimes they will come up strong, like something stuck right under my nose, and dissipate quickly; sometimes one will be subtle and linger, at times barely noticeable.
Some people hallucinate a particular smell, which may be influenced by context or suggestion. Laura H., who lost most of her sense of smell after a craniotomy, wrote to me that she would occasionally have a brief burst of smells that were plausible, though not always entirely accurate from what she remembered sensing before her loss. Sometimes they were not really there at all:
Our kitchen was being revamped, and the electrics blew one evening. My husband assured me that all was safe but I was very worried about a possible electrical fire that might start.… I woke up in the middle of the night and had to get up to check the kitchen because I thought I could smell electrical burning.… I checked everywhere I could see in the kitchen, hall, cupboards, but could see nothing burning.… I then started to think the smell could be coming from behind a wall or somewhere I couldn’t see.
She woke her husband; he could smell nothing, but she could still smell the smoke strongly. “I was shocked,” she said, “by how strongly I could smell something that wasn’t there.”
Others may be haunted by a single constant smell of suchcomplexity that it seems to conglomerate almost all the bad smells in the world. Bonnie Blodgett, in her book
Remembering Smell
, describes the phantosmic world she was plunged into following a sinus infection and the use of a potent nasal spray. She was driving along a state highway when she first detected a “weird” smell. She checked her shoes at a gas station, found them clean, then wondered if there was something amiss with the heater fan in the car—a dead bird perhaps? The smell pursued her, waxing and waning in intensity but never absent. She explored a dozen possible external causes and was finally, reluctantly, forced to the realization that the smell was in her head—in a neurological, not a psychiatric, sense. She described the smell as resembling “shit, puke, burning flesh and rotten eggs. Not to mention smoke, chemicals, urine and mold. My brain had truly outdone itself.” (Hallucination of particularly vile smells is called cacosmia.)
While humans can detect and identify perhaps ten thousand distinct smells, the number of possible smells is far greater, for there are more than five hundred different odorant receptor sites in the nasal mucosa, and stimulation of these (or their cerebral representations) may be combined in trillions of ways. Some hallucinated smells may be impossible to describe because they are different from anything ever experienced in the real world, and evoke no memories or associations. New, unprecedented experiences can be a hallmark of hallucinations, for when the brain is released from the constraints of reality, it can
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