Anosmia affects a quarter of all brain damage patients and leaves many with a total loss of taste and smell.
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"I have no sense of smell now, but in my dreams I can smell."
Five years, ago, Steven was coming out of a Toronto restaurant with some friends from culinary school.
"I was studying to become a sommelier in culinary school," Steve says. "And one night I took my wine class to a restaurant called O.Noir which is a place where you eat in the dark and you are served by blind waitstaff, which allows people to understand food in a different way—without your usual senses."
Within seconds, he would soon be permanently deprived of one of his other senses. "As we were leaving this restaurant, a guy approached us who thought we made fun of him—but we didn't—and he just sucker-punched me. He hit my head so hard that it cracked into the building and then into the pavement," Steven says.
I was dedicating my life to the nuance of aroma and this thug took it from me.
The brutality of this hit severed the nerves that connected Steven's brain to the olfactory information entering his nose via the outside world. The resulting neurological condition is known as anosmia, which literally means "no smell" in Greek.
Given the very intimate relationship between smell and taste, it's no surprise that Steven's brain damage has had a devastating impact on his culinary aspirations. "I was studying wine. I was dedicating my life to the nuance of aroma and this thug took it from me for no reason and there is no getting it back."
What ensued was only the beginning of a very dark period for Steven, who was forced to reconsider the most basic assumptions about his relationship with food and work. "It was a crucial moment. Everything was taken away from me and it forced me to step back and evaluate what was left. I couldn't even move for the first month because it was so painful and I was so devastated, I vowed I would never cook again, and even tried to take my own life."
While Steven's case is an extreme one, it's not at all uncommon for those suffering from anosmia to go through a difficult emotional period after their brain trauma.
One of the things I recommend to my patients is to try things that have more of an extreme taste, to try and see if they can get some enjoyment.
Dr. Brian Greenwald is the Medical Director of the Center for Head Injuries, and Associate Medical Director of JFK Johnson Rehabilitation Institute in Edison, New Jersey. Greenwald says that emotional issues are not purely the result of losing the ability to enjoy food.
"There is definitely unhappiness related to losing your sense of smell. But depression is also linked to frontal lobe damage and those with frontal lobe damage also have a higher instances of behavioural or emotional difficulties after these kinds of incidents."
Despite the specificity of anosmia symptoms, it affects a staggeringly high amount of all brain damage victims, "about 25 percent," according to Dr. Greenwald, and most of the nerve damage is done by the skull itself.
"The main reason why they lose their sense of smell is damage to the olfactory nerve. The olfactory nerve is a cute little wispy nerve that goes from the membranes of the nose up into the brain and helps our brain understand what we are smelling. The nerve goes through this solid plate called the cribriform plate and when someone falls, it can cause serious damage to those nerves." This would also explain why Steven can smell while he is dreaming.
Needless to say, it's a type of injury that presents a pretty unique set of challenges for clinicians. "The loss of smell or taste can be partial or total, and sometimes people can lose just the richer tastes and it makes it harder to enjoy food," says Greenwald. "One of the things I recommend to my patients is to try things that have more of an extreme taste, to try and see if they can get some enjoyment."
That's because sensations like heat are perceived through a different mechanism than flavour. "Hot foods don't just trigger your taste buds, they also trigger pain centers in your brain and other sensors in your mouth, so people with anosmia are probably able to appreciate that even if they can't smell or taste the food."
I can tell if something is sweet, or salty, or spicy especially. Sriracha is my best friend and it doesn't really matter where it goes.
Two years ago, Maria Davis fell off a 15-foot cliff and hit her head on a boulder. Almost immediately, she realized that her sense of smell and taste were gone. "You'd think that it would make me less interested in food but I still eat a lot," Davis says. "I still love food, but I can't really taste the difference between flavours that well.
"I put hot sauce on everything and I heavily season everything and it still doesn't make that much of a difference—food is really bland for me if I don't. I've always wanted to do one of those really hot wings competitions, but haven't gotten around to it yet."
This is something that Steven can also relate to. "I can tell if something is sweet, or salty, or spicy especially. Sriracha is my best friend and it doesn't really matter where it goes."
But it's not just hot foods that can help anosmic people got some enjoyment from eating. "I like things like popsicles and ice cream," says Davis. "I feel like texture and temperature have replaced taste for me. I can't really taste but I can feel the difference between hot and cold."
In 1977, Ben Cohen, also anosmic, started making super-rich ice cream with big crunchy pieces. Cohen, along with his buddy Jerry, would turn his fixation with texture, temperature, and richness into a billion-dollar business called Ben & Jerry's. "Because of this disability, I have an excellent sense of mouthfeel," Cohen told the New York Times in 1994. "Creaminess and crunchiness are very important to people who can't taste."
But this is a rare silver lining for a condition which affects one of our most evolutionarily important senses.
When I managed a restaurant, I had to constantly ask coworkers to taste everything. It was like my disability was coming forward every minute.
"It's a big loss," says Dr. Greenwald. "Even when it comes to romantic partners, smells like perfume are very important. But the other things to think about are, like, if the socks still smell OK. And then there are all of the safety issue for things like gas. There are multiple levels that you have to worry about. I always have cereal in the morning and sniff the milk before I pour it. It's one of those basic things that you wouldn't consider otherwise."
This is something that Steven is still adjusting to as he is working with food while being anosmic. After returning to culinary school, sommelier classes became "a personal hell" for him. "I had to drop that future. I have a riesling tattoo which is a terrible memory."
"When I managed a restaurant, I had to constantly ask coworkers to taste everything. It was like my disability was coming forward every minute. Eventually, I switched to baking which is more about technique."
Eventually, Steven began to focus his food on community instead of gastronomy and got involved with local initiatives to feed those in need. "After five years, I still connect with food, but I really had to realize why I was cooking in the first place, and the answer is community and resiliency."