Authors: Molly Birnbaum
In the first hours after the accident, my family had not known what to expect. When my father, a doctor, had raced into the Intensive Care Unit after hearing the news, he saw me lying on the cot with needles in my arm and monitors blinking behind. I looked to be in one piece, but he knew bleeding, broken bones, or punctured lungs could be lurking beneath my bruised skin. With one glance at the full-body CT scans, hung on the wall by another physician, though, he felt relief. My injuries had been rendered visible by the ghostly black and white of film, and he knew that though it might take a long time, my broken bones would heal. My knee could be fixed. Physically, my family knew that I would be all right. And despite the fact that they listened to me tell the same story over and over, cringing because each time I thought it was the first, they knew the effects of my head contusion would soon fade.
It took two weeks for me to regain control of my mind. When I did, it was sudden. The world came into focus one morning in mid-September. My pelvis and head both ached and, for the first time, I wondered why. The fog had burned off.
What is going on?
I thought.
Alex came over later that afternoon after a day away and though I sat in bed as I had for weeks, he found me different.
My eyes were focused and my voice was drawn. Alex held his body stiffly, which seemed both familiar and distant. The last time I saw him was fuzzy in my mind.
“How are you?” he asked.
“Okay.” I waited a moment. “I hurt.”
He looked at me with surprise. My strange giddiness of the previous weeks had evaporated. I was coherent and I was depressed. It was like I had just woken up.
I couldn’t believe that an entire month had passed. It shocked me that my body was so delicate, that an event so violent could have come so close. I was surprised to find that I wasn’t immortal, that the mobility of youth was permeable, that it was no longer mine.
It almost felt good to be hobbling into surgery those weeks later. At least I was moving. At least there would be change. They would fix the tendon and ligament, the ropes of fiber and tissue running up the outer edge of my left leg that had been mangled in the accident. When the car tore into my side it had yanked my knee in at an unnatural angle, like a marionette at rest, like a linebacker struck from the side. “We really only see this injury in football players,” my doctor had said with a little sigh.
I breathed easily as I lay on the hospital cot. When the gas mask covered my mouth and the anesthesia began to flow, I slid smoothly toward unconsciousness. It was only later—after the five-hour procedure, after the plastic surgery stitches closing the eight-inch incision that would glow in reds and whites for years to come, after the fog of my imposed sleep melted away—that I really felt the pain.
The pain began in the deep snaking hole where the doctor had pulled and prodded and reattached the tendon and bone that had receded up my thigh. It was immediate and intense and soon it expanded everywhere. I couldn’t think beyond the screaming of my toes, the tension in my neck, and the nausea in my stomach. It was excruciating and encompassing, and my memory of that time is framed in a shade of burning red. The medication, handed to me in small paper cups by the nurses throughout the night, did not cut the debilitating ache. I listened to my father yell in the hallway. There had been confusion over my prescriptions and he was angry. He yelled at doctors, nurses, and orderlies. He was angry that I hurt, and that there was nothing any of us could do. I hyperventilated when I tried to move my leg.
“Breathe,” the nurses said. I tried.
But after a week of thick beige curtains, thin polyester blankets, and a frequently replenished stream of gossip magazines read to me aloud by my mother, the raw edge to my panic began to fade.
I went to my father’s house in New Hampshire to recover.
It was there that I was finally able to focus on the world around me. I lay in a bed with a soft green cover. The television mounted on the wall in front of me was large. I watched
The Princess Bride
one afternoon and didn’t fall asleep after five minutes. I even remembered it the next day. Things were looking up.
But the reality of my situation soon sank in. I was lucky to be alive. I was lucky to have family close by. But with a smashed pelvis and recently sutured leg, I lacked all mobility. I remained completely dependent on my family and friends, and I had never felt so low. I couldn’t recognize my own voice, dark with a baritone sadness. I certainly wouldn’t allow myself to think about Maws in the kitchen of the Craigie Street Bistrot, or my impending starting date at the Culinary Institute of America. They were too far from the immediacy of my pain. I wasn’t ready for fear.
But I soon realized how much more was gone.
My stepmother, Cyndi, who was perpetually calm and composed except for the first time we tried to wrap my bandages in plastic so that I could take a shower and we both ended up in tears, baked an apple crisp one afternoon in early October.
My best friend was there for the weekend. Becca had come bearing books and CDs, bravely cheerful in the face of my deepening depression. Ever since we first met, as pale and frizzy freshmen in college, she has been a skilled administrator of comfort. Once, on a bone-chilling winter weekend we had taken a road trip to Montreal. It was the week before Alex and I got back together after our painful break. Becca led us to La Chronique, a restaurant with white tablecloths and dim, sparkling lights, one evening. We had dressed up for the occasion, and I felt elegant in my high heels and fitted skirt.
Our waiter uncorked a bottle of white wine that smelled fruity and young. I had only recently begun to explore flavors unfamiliar to the safe suburban diet I knew, and as I sipped, breathing slowly in and out, the depth of flavor surprised me. We ate salmon and seafood risotto, which was rich and creamy, and monkfish and duck ravioli, laced with the deep undertones of foie gras. With each course, with each bite, with each giggle emitted for no reason beyond being young and full of life, my anxiety melted. Before dessert, our waiter placed a small plate in front of us both, each with a different kind of cheese. Becca’s came bearing a small craggy round of bleu, while mine held the more familiar wedge of brie, which oozed from beneath a pale yellow crust. I inhaled over my plate. I leaned in to sniff over hers. I had never before tried any kind of mold-encrusted cheese. It smelled rich, pungent, like milk gone wrong. I made a face.
“Just try,” she said.
Gingerly, I took a nibble. Again, I was surprised. Both tangy and smooth, the flavor danced in my mouth.
In the years since Montreal, Becca and I had eaten our way through Providence, Paris, and Prague. We ate Parmesan-rich risotto and delicate lemon tarts, puffed carrot soufflés and gooey cheese crepes. She introduced me to truffles and pâté. We spent a year sharing a kitchen and a fridge, learning how to cook as inventively as possible together on a student budget. There were four-layer banana-chocolate cakes and fresh pasta doused with sage and butter we browned into a deeply fragrant sauce on the stove. The joy I experienced in food had arrived in tandem to our friendship. We had eaten a lot together.
That afternoon at my father’s house in New Hampshire, Cyndi had baked her apple crisp because she knew I loved the dessert so reminiscent of fall. For over a month I had had to be coaxed and cajoled into eating and my stepmother hoped that this would help. When she took the crisp out of the oven, one room over, everyone began to exclaim. “That smell!” they said. “It’s delicious!”
I sniffed.
What?
“The crisp,” said Becca, pointing toward the kitchen.
“What about it?”
“Can’t you smell it?” she asked.
I sniffed again.
I must not be in the right seat,
I thought.
There must be something in my way.
I inhaled and exhaled.
“The crisp?” She pointed.
“What?” I asked again, like I couldn’t hear her words.
For me, there was nothing.
Soon Cyndi brought the steaming pan into the family room. She held the fresh baked apples, ripe with cinnamon and sugar and spice, close to my face. I leaned over and inhaled. I could feel the heat on my chin and in my nose. The air felt different, thick and humid. But there was no scent.
“I can’t smell.” I said it softly.
There was silence. I remember the silence. It was white hot and long. No one said a word.
“I can’t smell a thing.”
When I took a bite, concentrating intently on the food in my mouth for the first time since before the accident, I mainly registered the texture. I could feel the softness of the baked fruit and the crunch of the crinkly top. But the flavor? It tasted of nothing but a dull sweet, a muted sugar. The cinnamon, the nutmeg, the lemon had vanished. The honey was unattainable and the oats, gone. Where was the rich cream of the butter?
“I can’t taste,” I said.
Later that night, Becca and I sat among pillows and blankets on my bed. My leg in its brace fanned out in front.
“What if I never smell again?”
Chapter 2
Sour Milk and Autumn Leaves
IN WHICH I START FROM SCRATCH
THE INNER WORKINGS OF THE NOSE
are delicate and complex, a chain of connections and cascading signals that operate on a molecular level. Scientists have struggled to understand the process of olfaction for hundreds of years. But even as far back as the Greek philosopher Aristotle, who felt that it was the least useful of the senses, smell is often forgotten, pushed aside in favor of sight, sound, and touch.
Today, much remains a mystery.
Every smell begins with a molecule. Whether it is a charcoal whiff of the smoke off a grill on a summer evening, the lemon dish soap in my mother’s kitchen, or the acrid breeze that greets me at the garbage dump, every aroma is made up of invisible particles. A single scent can hold more than a hundred of them, combining to create the complex aroma of
Chanel No. 5,
of ham roasting on Christmas day, of the brined ocean shore in Maine.
Smell is the most direct of the senses. Aromas must literally enter the body before they can be consciously identified. With every inhalation, molecules travel through the thin craggy pathways that begin at the nostrils and head toward the brain. They speed past the olfactory cleft, a narrow opening toward the top of the nose. They hit the olfactory receptors, which are housed on the hairlike tips of the millions of neurons that peek through a gold-hued mucous membrane called the olfactory epithelium.
Every human has around 350 different types of these receptors, which are unique proteins on both the left and the right side of the upper nostrils. These receptors are the gateway to the complex dance of perception. They connect to the smell molecules upon arrival and then transfer signals toward the brain by chemical impulse. Every human has between six and eight million neurons in the nose to do just that. These signals are fired rapidly, by many neurons at a time, forming a pattern not unlike a line of musical notes, or the HTML coding of a webpage. When combined, the brain interprets the signals as a smell, an “odor image.”
These patterns are both complicated and minute. Scientists have found that if the chemical structure of two smells are identical except for just one carbon atom, the patterns sent in response are nonetheless distinguishably altered. Nonanoic acid, for example, is a nine-carbon chain that yields the salty smell of cheese. Decanoic acid, with only one carbon atom added to its structure, however, smells rancid, like sweat.
These patterned signals travel on pathways made by neurons, which snake from the nose through a thin sheet of bone called the
cribiform plate,
and are deposited in the olfactory bulb, which lies toward the bottom of the brain. The bulb takes these patterns, like reading the score of a piano concerto or lyrics to a lullaby, and sends them farther on to the olfactory cortex. The cortex, in turn, relays an interpretation to other parts of the brain like the thalamus, which deals in conscious perception, and the limbic areas, for emotional response.
Scent molecules had been entering my nose and traveling up to my brain unhampered for twenty-two years before the accident. When I breathed in the scent of chicken stock while working at the Craigie Street Bistrot, those rich poultry particles hit my olfactory receptors and spurred a slew of signals to my brain. I would stop, sniff, and think:
I smell chicken stock
. I never thought about the process. I never thought about how I could tell the difference between the scent of chicken and veal stock, between lard and butter. It was a movement too complicated, too minuscule, and entirely too invisible for me to notice, let alone to care about.
But it’s a process that is of intense interest in the scientific community today. How is the chemosensory world represented in the brain?
Each step in the path of a single smell from the nose to the brain is known. What is not clear, however, is exactly how the body begins with these molecules and ends with the conscious thought
I smell chicken stock
. The process of recognizing and identifying smell, from the first neuronal firing to the higher workings of the brain, is still quite mysterious, even to the most advanced researchers and experts.
We know that it begins with just one molecule. Just one molecule of the scent of a rose, a wet dog, an old book on the top shelf at the library enters the nose. It travels up the nostril to the olfactory receptors. And that’s where the first puzzle takes place.
Theories about how, exactly, the olfactory receptors recognize and connect with odor molecules have been debated for decades. Researchers have found that each of the 350 different types of receptors expressed in the nose can pick up a specific number of odor molecules. Some can recognize a handful, while others are attuned only to one type. Similarly, some odor molecules can react with just one receptor; others, many more. Today, it is widely believed that the receptors and molecules bind to one another based on shape.