The Parosmia Edition

Ryan McManus (RMM) is a product designer at Ford and longstanding friend of WITI. He has previously written about the end of spare parts, the simple elegance of SecuriCode, and how to start your own town. He smells pretty good, actually.

Ryan here. Like just about all of you at this point, I caught a case of Covid-19 a couple months back. And, like many of you, the infection led to me completely losing my sense of smell and taste. But what happened after that was the twist I did not see coming.

The initial infection was what we are now calling “mild”, meaning I stayed in bed for a week and rewatched Loki and felt pretty shitty. The loss of smell was a trailing symptom, one I didn’t notice until about a week after I had felt better and was testing negative. It was unsettling, of course—akin to walking around with earplugs on or an eye covered, a dulled sense of my existence—but I managed. And then one morning I poured myself a cup of coffee, took a sip, and wretched.

My sense of smell had returned, but something was wrong. Instead of the superlative scent of Dunkin’ Midnight, I smelled…garbage water? Disease? It was literally impossible to describe what it smelled like, because I would later discover it didn’t smell like anything else (More on that in a bit). I had my wife come and smell the coffee to see if I had, I don't know, accidentally dropped a dishwashing detergent pod into the pot while brewing it. But she said it was fine, it was normal. I was crazy.

Later that evening, I poured myself a nightcap of bourbon to find it, too, was off. It smelled acrid, chemical, almost like acetone. I could hardly finish it. 

What the hell was going on?

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Why is this interesting?

Parosmia is the name for the condition when your brain’s interpretation of a scent is misunderstood, corrupted, or otherwise incorrect. (Para from the Greek meaning “contrary” and Osme, “smell”). The condition was actually fairly rare, historically, with cases cropping up with people who’d had some serious upper respiratory tract infection or even head trauma. But like so many things after Covid-19 entered our world, Parosmia and its cousin Phantosmia (phantom scents) has become far more common as a lingering effect of the virus’ infection of our bodies. (The incidence is still pretty uncommon, considered a “rare side effect”, but not so rare that the NYT hasn’t written several articles on the subject).

This is what had happened to my coffee and bourbon—or, to be more precise, what had happened to my brain. Because parosmia isn’t a nose problem, it’s a bad data problem.

Let me lay it out in a loose metaphor: When you smell something, anything, the olfactory nerves capture the scent molecules as encoded data, and pass that data signal along to your brain, which decodes it and matches it to a known scent, like chocolate or feet. If the scent is new, it gets a new file. If there are adjacent scents, like something smelling sweet, the brain tells you it’s probably good to eat. If it smells like burning rubber or durian, it is a warning to stay away.

Why it is so hard to describe how incredibly foul smelling things can be with parosmia is because they are literally unknown scents. The data of the coffee small is getting garbled and turning up at my brain as something totally unknown, like scrambling a QR code. And, at a survival level, a good default for “this smell is unknown to us and confusing” is “stay the hell away from this”. 

This is probably why so many of us who suffered this condition find everything smells horrible. In researching my symptoms, I have yet to find anyone who said their compost heap smelled like Chanel No.5 (Sorry, Cass). And this kind of makes sense—when the brain is getting bad data, it defaults to a warning. 

This is also true of phantosmia, which is the persistent sensation of smelling something that isn’t actually there. And when I learned more about it, I had this moment of realization: In the early days of the pandemic, before testing was available, I had had a cold that was pretty mild and wrote it off as nothing serious. But for months afterward, I felt like I was always smelling smoke. Sort of a lingering, acrid smell like living in a house that used to belong to a chain smoker—just inescapable. And I never knew why. 

This was unpleasant for me but downright crippling for others, who find not only food but their romantic partners or their own bodies smelling repellent, and no amount of hygiene will cover the smell (frustratingly, toothpaste is often one of the biggest offenders). This has strained social relationships, marriages, and caused people to become recluses while they try to figure out how to fix it.

The good news is there are treatments starting to emerge, and I had some luck with one of the most popular, called smell training. Pioneered by a professor named Thomas Hummel who runs the Smell and Taste Clinic at the University of Dresden, and championed by the excellently-named UK charity group AbScent, smell training is a simple protocol where you sit quietly and take short sniffs of 4 different essential oils (lemon, clove, rose and eucalyptus) for about a minute, twice a day, for about 4 months. It also helps if you say the name of the scent aloud before sniffing. 

I get it, this sounds ridiculous. But back to my data metaphor—essentially smell training is like any other rehabilitation protocol when nerves are damaged. By smelling the oils and saying the names, you are retraining your neural pathways to understand that the molecules its receiving map to a thing that might have been corrupted by the virus.

The training doesn’t work for everyone, and there are other treatments being developed. But I was one of the lucky—my sense of smell eventually corrected, and the first time I had a cup of coffee that smelled like coffee again was actually kind of emotional. Like some part of the world had been restored to me.

Parosmia was a stark, sometimes cruel reminder that our experience in this world is always an interpretation, that the quality of the data our bodies and brains receive has a foundational impact on how we experience life, and how absolutely fragile that translation can sometimes be. So don’t take it for granted—go take a big whiff of the ones you love. (RMM)

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Thanks for reading,

Noah (NRB) & Colin (CJN) & Ryan (RMM)

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