The Door Dash delivery was on the top of the steps, delivered from a pizza service in San Diego that claimed “New York Style Pizza.” After the ritual disinfection of the pizza carton, the lid was lifted and I was delivered into another time and place. Scotty, the owner of a Queens pizza restaurant 60 years ago, was ensconced in my olfactory memory. He was flipping the dough as his octogenarian mother was lovingly molding a veal parmigiana hero that could make a grown man cry. Melted mozzarella, oregano, sausage and mushroom fumes reawakened a gustatory experience that I experienced for the first time, many years ago. With hops entering my nostrils from my Dad’s 1965 Miller High life, I left the COVID virus prison and entered a happier time when New York City was a palace of gustatory delights and my childhood garden was in full bloom.
Through my nose, to the ethmoid sinuses, onto the olfactory epithelium and 60,000 smell neurons directed my pizza delivery directly to the frontal lobes and limbic system where Scotty’s still lived in vivid memory. This ecstatic experience is being stolen from millions by a renegade virus which has shut down the world for the last year. Expunging the smell and taste in some of the 25 million who have had COVID, which may have long lasting and permanent damage of the olfactory system. Malnutrition, depression and the loss of warning symptoms to natural gas leaks or tainted foods may be the legacy of sufferers of nasal COVID injury.
The least regarded of the five senses, smell and taste have taken a back seat in medical training and in popular culture. Medical school has few lectures on the proper function and diseases of smell and taste. Medical history taking neglects inquiry of one’s nasal and lingual capabilities. Olfaction has been a butt of jokes for generations of comics from the Simpson’s “smell you later”, Hawkeye Pierce’s ridicule on food sniffing in M*A*S*H and Mel Brooks flatulence scene in “Blazing Saddles.”
The dismissal of this forsaken sense is belied by its prominent location. The olfactory nerve, the shortest of the cranial nerves, sits in the front of the brain and sends projections to multiple areas including the emotional hub, the limbic system. Our evolutionary ancestors and current mammalian brethren rely on scent to distinguish friend from foe and food from poison. Our beloved canine, Millie, the Jack Russell Terrier from times past would apply the sniff test and rarely made a bad decision on food or domicile choices.
Obscure medical jargon has entered the mainstream with anosmia (lack of smell), parosmia (smell that fails to correctly match the odor) and phantosmia (phantom smells) appearing on long hauler COVID social sites. “Everything smells like burnt coffee” I heard a patient exclaim. “No longer can I taste the citrus in my tea,” another laments. “I ate a hamburger and I miss the onion smell and taste.” Essential oil kits are hawked on Amazon in the hope that olfactory re-education may hasten recovery. While the long term outcomes are not apparent in so recent a disease, it appears that up to 5% of smell sufferers may not regain perception at 6 months.
“Don’t it always seems to go that you don’t know what you’ve got ’til its gone,” Joni Mitchell’s ballad went in the ’60’s. And so it goes with Scotty’s appetizing, fragrant pies from the same decade. Enjoy your senses and don’t forget to stop and smell the pizza.
Hope to share some pizza and ribs with you post COVID! Great writing, Larry
Excellent well-written piece!