Remembering Smell (22 page)

Hirsch had decided to test top chefs' noses. Surely they'd all be superb smellers. Hirsch gave them each a smell IQ test. He wanted to know how well the chefs smelled compared with ordinary people. Then he'd find out how (and if) they'd trained their exceptional noses. Did any of them claim to have been "born" to smell?

While not all human noses are created the same on the outside—thus the prevalence of nose jobs in a culture obsessed with image—we each have essentially the same innate sense of smell. Exposure to certain odors over and over is what sets professional noses apart from ordinary ones. Wine tasters, for example, train their noses with the wine aroma wheel, developed by chemist Ann Nobel in 1984. The wheel supports the component smells of a certain vintage with words and pictures as memory aids.

Hirsch wasn't trying to overturn the training theory, just flesh it out. He knew it was unlikely that any of the chefs would display the olfactory equivalent of perfect pitch. But he was surprised when four out of ten chefs were unable to tell simple everyday smells apart. Only two were excellent smellers, and two others couldn't put a name to much of anything. This confounding result reminded Hirsch that you don't have to identify an odor by name to appreciate it and combine it effectively with others. Beyond that, he concluded that maybe just as important as a well-trained nose is mastery of time-honored cooking techniques. Other essentials: buy the freshest possible ingredients, understand food chemistry (especially the effect of temperature), and hire a fabulous decorator.

As for the chefs who flunked the test, Hirsch could only speculate that fame and fortune had gone to their heads—or rather, up their noses. "This is a glamorous profession if you make it to the top. These guys"—there was not a single female in the group—"are young and suddenly pulling down six figures. There are temptations too strong to resist."

The last time I saw Hirsch, in the summer of 2008, was on TV. Caroline called me from Madison to tell me "that nose guy in Chicago" was being interviewed on ABC's
20/20.
It seems the show's producers had done some research of their own. When the diet aid was run by an authority on medical scams, he declared Sensa "just another pet rock."

T
HERE'S NOTHING NEW
about homeopathic medicines. Until the twentieth century, doctors offered their patients pretty much anything they thought might bring relief, even if the only active ingredient was grain alcohol. Turpentine is a key ingredient in what is still one of the most trusted names in homeopathy: Vicks VapoRub.

My mother was born one year before the Spanish flu pandemic. Her mother had been a worrier, terrified of infectious diseases: Diphtheria. Whooping cough. Scarlet fever. When she was a girl, Mom had been put to bed if she had even the mildest case of the sniffles. Some of her loveliest memories were of those frequent quarantines when my grandmother plied her with presents and treats and rubbed Vicks on her chest. Its blend of camphor, menthol, turpentine oil, and eucalyptus spiced with nutmeg, cedar, and thyme is as soothing today as it was in 1880, the year a North Carolina pharmacist came up with the pungent formula to treat nasal congestion and named it after his brother-in-law, a prominent physician. Vicks VapoRub is made in Mexico now. The magic formulation hasn't been tampered with in all these years, although it's currently marketed as a cough suppressant rather than a decongestant.

There's no law against selling a homeopathic remedy to make people feel better, even if its effects are purely psychological. When plaintiffs in the Zicam lawsuit asked for an investigation, they received little satisfaction from the FDA. The agency didn't see how a nasal spray consisting of organic compounds could be any different from a skin potion sold as a cough suppressant. They seemed to work the same way, by going up the nose. What could be the harm in that?

Winter was winding down. Minnesota noses are trained to catch the faintest hint of changing seasons: Minnesotans begin smelling spring in the dirty snow melting on the sidewalk as the drifts recede; in rotting newspapers still rolled up and fastened with rubber bands; in cardboard soda-pop cartons left behind on recycling pickup day; in a leather glove, a wool mitten, an old tennis shoe, last year's oak leaves (leaf mulch now). Yes, spring is just around the corner.

In March I was asked to give a talk on late-blooming perennials to a garden club numbering about a hundred women; I decided to do it. Another milestone. Back in the fall I'd turned down several opportunities to expound on the wonders of spring bulbs because I couldn't face an audience. This time I accepted.

A fragrant anemone popped onto my slide screen. Tears welled up in my eyes and the story of my anosmia came burbling out of my mouth. The women were polite, if bewildered. I could see them whispering to one another. Eventually I got back on track. Where were we? Oh, yes, late-fall bloomers.

A few hands shot up at the end when I asked for questions. Every other person, it seemed, knew someone who knew someone ... One woman had lost her sense of smell at about the same time I had. Until I mentioned Zicam, she had suspected but never openly accused the nasal spray in her medicine cabinet of committing the crime. She felt so stupid, she said, falling for the hype that the spray would help her cold. When her nose stopped working, in an odd way she thought it served her right for using medicine in the first place. Since when was a simple head cold so terrible a person couldn't just grin and bear it? Typical gardener, I remember thinking, someone of a certain age and era, old enough to have planted a victory garden with her parents during World War II.

We exchanged phone numbers. When I got home, others called, people who wanted to know what I knew about Zicam, anosmia, phantosmia, and the connection between smell and mood. Some said their doctors had dismissed their concerns about poor smell and taste with the dubious explanation that smell loss was an inevitable consequence of aging, like aching joints and decreased hearing, although of course untreatable. The untreatable part is true, but it's also true that while half of all eighty-something seniors have significant smell loss, smell function doesn't peak until age thirty-five, and decline is barely measurable for many, many years after that. Some people's noses never slow down at all.

When smell does diminish, medications are often the cause. I'm not talking about Zicam. An Australian study assuaged any lingering embarrassment I'd had for suspecting that a blood pressure drug could be messing with my nose. The people in the study who'd been taking drugs to lower blood pressure and cholesterol suffered significantly more olfactory damage than those who were pill-free. Even SSRIs, the family of antidepressants that I was taking, have been suspected of reducing smell acuity.

Such research relies on personal testimony. Smell scientists still don't know enough about how odor signals are processed in the brain to be able to speculate on why certain seemingly random medications diminish smell. The default position is, of course, to toss the whole issue (along with disorders like burning mouth syndrome) into the dumpster labeled
psychosomatic illness.

I told some of the women about a website called nosmell.com, where victims of smell dysfunction compare notes. I continued to visit it whenever I needed company. One recent post brought back all the misery of the holidays. I might have written it myself.

I just recently started having this rotten, rancid smell and/ or taste. It started after a head cold in which I used Zicam. It is driving me CRAZY! The smell/taste never stops. I also worry about my own body odor. I can't even tell if I have any! This is a nightmare.

The post put me over the edge. Before, I had been too distraught to focus on why this had happened to me. Losing confidence in one's sanity is not conducive to waging a legal battle. Now I searched for more recent information. Finding it wasn't hard. An online blogger described losing his sense of smell after taking Zicam for a cold just before Christmas. He was awakened in the middle of the night by the smells of burning coffee and cigarettes. He went to several doctors, had MRIs and CT scans, "was poked, prodded, had blood taken ... all without any evidence of any underlying tumors or other possible causes of the problems." Like me, he finally went to an ENT, who knew immediately what was wrong and told him to get an attorney. Beyond that, the doctor could do nothing to help him. A colleague confided to him that he too had lost his sense of smell after using Zicam and the loss was so devastating he went into hiding and told no one. The blogger was determined "to take the absolute opposite tactic. I'm telling everyone ... and now he is too."

He concluded by warning that all Zicam products, including the new control-tip spray, were worthless or worse. There are now more than a dozen Zicam variations, each one targeting a different nasal annoyance. This strategy has expanded Zicam's reach by increasing its shelf space. Now a sea of orange greeted me at Walgreens when I picked up my FDA-approved prescription drugs. The rows and rows of bold orange boxes shamed me for failing to protest my injury in court or even call the FDA to complain.

Many of these products piggyback on other, more efficacious remedies. Zicam tablets contain vitamin C. Zicam gels, swabs, and sprays contain aloe, which soothes irritated membranes. (Are those membranes irritated by the cold or by the remedy?) There's a Zicam cure for sinus pain, coughing, allergies. Zicam products don't just prevent colds, they relieve them when they're full-blown by means of a decongestant that is probably no different from any other decongestant. During the time I spent researching and writing this book, sales of Zicam products soared from $6 million to $100 million. Sales were projected to grow from the 8 percent annual rate posted in 2008 to 10 percent per year by 2009, despite, as Matrixx Initiatives reminded prospective shareholders, an otherwise horrendous economy. Twelve million dollars—the amount the company spent to settle the lawsuits—is a small price to pay to stay in such a lucrative business.

In 2006 the
Washington Post
published an article called "The Men Behind Zicam." It described the "unusual backgrounds" of Zicam Cold Remedy's two inventors, Robert Steven Davidson and Charles B. Hensley. Both hold patents on the chemical formulation bottled in Zicam Cold Remedy. Davidson said he first met Hensley at Cleveland Chiropractic College in Los Angeles. Davidson received a bachelor's degree from a "virtual" university in New York and earned his PhD from an unaccredited university in Spain that has since been closed by Spanish authorities for legal violations. Davidson declined to discuss Zicam's safety problems with the
Post
reporter. He also claimed to be unaware that one of his alma maters had gone under. He said he'd sold his interest in Matrixx Initiatives and had launched another company.

Hensley's recent track record is even more troubling than Davidson's. While his doctorate (in physiology) is from the University of Southern California, he now runs a pharmaceutical company that received a warning from the FDA in November 2006 to stop marketing its antiviral drug Vira 38, which the company claimed was effective against bird flu. The FDA threatened legal action and "seizure of illegal products" if its letter went unheeded. "Hensley did not respond to e-mails or telephone calls," according to the
Post.

In 2004 Matrixx Initiatives settled the class-action lawsuit against it for $12.5 million; each plaintiff received about twelve hundred dollars (the settlement agreement required that they not reveal the precise sum). Some plaintiffs said they felt let down and angry about the case's resolution and said they wouldn't have settled had they been given a say in the matter. Press coverage was largely confined to the
Washington Post.

If Matrixx Initiatives had messed with any other sense—had its product, say, caused an unceasing din in the inner ear—the outcry would have been deafening and the company out of business in no time flat. A mere whiff of a serious side effect can sideline even the most useful medication, and this product was a nasal spray of questionable benefit. In addition, it contained a chemical that had, decades earlier, damaged the olfactory cells of hundreds of children. In Toronto in 1937, a study was conducted to determine if an intranasal zinc solution might prevent polio. Many of the five thousand children given the spray got polio
and
lost their sense of smell. For a while, doctors thought anosmia was another symptom of the dread disease.

Matrixx spends far more on advertising than on legal costs. Particularly galling to me were the ads claiming that "doctors recommend Zicam to their patients" and the dozens of testimonials from happy Zicam customers. Rush Limbaugh, who promotes the product and whose show is sponsored by its manufacturers, apparently never gets colds. (The reformed user of illegally obtained nonhomeopathic narcotics does wear a cochlear implant, though; it saved his career.)

That polio connection was problematic. Matrixx promulgated its version of the story. The polio-prevention treatment had contained a different zinc compound, the company said. Zinc gluconate (a.k.a. zincum gluconicum), the compound in Zicam's product, was harmless. It's zinc sulfate that causes trouble, Zicam's medical experts said. Medical experts paid by the plaintiffs' side didn't agree.

Moreover, there is no evidence that any compound of zinc works better against colds than it does against polio. Various theories do explain why Zicam Cold Remedy might
seem
to work, although not in the low doses Matrixx Initiatives suggests. And of course, a massive dose can do plenty of damage. Zinc gluconate has been shown to destroy the olfactory sheet in mice. One mysteriously ill woman with extreme fatigue, high blood pressure, low thyroid levels, muscle soreness, mental confusion, and balance problems had been using large amounts of a denture adhesive to keep her dentures in place so that she could indulge in the only pleasure left to her: eating. It turned out that she'd overdosed on the zinc in the adhesive, and that was what was
causing
her problems. Her story, "Fear of Falling," was told in Lisa Sanders's September 6, 2009, health column in the
New York Times Magazine.