The Nose Knows

Yes, I know, lately I've had an obsession with smells. Firstly, with the new smell of cousin. The day after his party, I shopped for new colognes. And now, I've discovered that medicine also has it's peculiar smells.

I've been studying the little clues that some physicians use to tip them off towards a proper diagnosis. There are laboratory clues, the body areas a patient might point to as a source of pain, their description of pain, onset of pain, duration of pain etc, etc... The most bizarre of these clues is the smells given off by certain diseases.

I remember when I was going thru my surgery rotation, one of the physicians told me that once I smelled gangrene, I would never forget it. I would know gangrene the instance I smelled it and would recognize it from there on out. I thought to myself, it probably smells like really bad body odor. That ideal could not have been further from the truth. This smell was the worst thing my nostrils ever came into contact with. I can remember walking into the emergency room and being slapped, no knocked out by an odor so powerful that it lifted me and my co-fourth years off our feet. I actually said, "Who's ass was blended and smeared with limburger cheese onto a sardine". Yes, this physician was correct, I won't forget that smell.

While studying today I came upon some diseases in which scent was given as clues. The first disease is Bacterial vaginitis (Gardnerella vaginalis). This is a vaginal disesase in which a greenish vaginal discharge is noted. Microscopically, vaginal epithelial cells covered with bacteria can be noted. Okay enough of a clue for me--especially the microscopic clue--no other vaginitis would do that right? The next clue was--the discharge emits a fishy odor. WTF? I didn't know that smelling a patient's discharge was involved with presenting a diagnosis as well as it's differentials. I'm just going to go with the microscopic clue.

The next disease I studied today was maple syrup urine disease. As the name implies, a baby's urine would be sweet tasting. Someone back in history, and I'm guessing one of the people who first discovered this malady must have been dipping fingers into the beakers and testing the samples. WTF? What would drive a person to taste test urine? I've heard that rumor that if a person is stranded without water, they can drink their urine several times before it becomes poisonous (I'm thinking the Phoenix can maybe show us the light on this urban legend). Was it the same researchers who thought of this same theory?

Finally there is the bacteria Pseudomonas aeruginosa. This is a common cause of urinary tract infections. The bizzare clue here is the fruity odor it gives off when cultured. Not once during my second year in the laboratory did I ever put my nose to a cultured plate of disease. I wore a mask and googles.

There you have some of the diseases with scents as their clues. I wonder when Febreeze is going to come out with their hospital line of air freshners.