THE POWER OF THE NOSE

THE BALTIMORE SUN

CHICAGO - About 15 months ago, Betty Dayron says, "the whole world started to smell like Italian soap."

In August, Bill Daniels stopped tasting his wife's baklava, a tooth-rottingly sweet Greek dessert. Confused, he experimented, placing a few grains of sugar on his tongue.

"Nothing," he says, sighing at the memory. "It was just texture - like sand, almost."

And Pat Mazzeffi can't get over the "slimy, pasty feel" on her tongue that she says leaves her with a constant metallic taste.

After numerous visits to their physicians and fruitless appointments with ear, nose and throat specialists, these three Chicago residents - and hundreds of others from all over the world - have ended up here, in the odorless Water Tower Place suite of Dr. Alan R. Hirsch.

Twenty years ago, Hirsch, dubbed "the Magellan of the nasal passages," started the Smell and Taste Treatment and Research Foundation. It is one of just a handful of organizations in the country devoted to diagnosing individual smell and taste problems and conducting broad research on the two senses.

"Really what we're looking at is the scientific basis of aromatherapy," Hirsch said recently at his clinic.

The foundation's two missions work hand in hand; the doctor says each of his 85 studies was inspired by patients.

For example, Hirsch noticed that about a quarter of his patients who had experienced smell loss also had a diminished sex drive. That observation led to clinical studies that culminated in Hirsch's second book, Scentsational Sex, which asserts that women find the smell of cucumber arousing while pumpkin pie puts men in the mood. Oddly, it finds that neither sex is turned on by a variety of colognes and perfumes.

Another study-turned-book is Scentsational Weight Loss, and Hirsch's third book, published in 2001, is called What Flavor Is Your Personality?

Hirsch doesn't wear cologne and favors brownies to ice cream flavored like banana cream pie - even though his book on food and personality says people who like that kind of ice cream tend to be empathetic and easygoing.

"It's a lot easier to change your favorite food than it is to change your personality," Hirsch jokes.

The commercial aspect of his lighthearted studies has caused some doctors to wonder if Hirsch is more publicist than scientist or medical professional.

"He has achieved considerable popular notoriety," says Dr. Richard L. Doty, who founded the nation's first smell and taste research organization in 1980. "He's done lots of creative research that isn't really mainstream."

Doty's Smell and Taste Center is based at the University of Pennsylvania in Philadelphia and was financed by a grant from the National Institutes of Health. Hirsch's foundation is affiliated with Rush-Presbyterian-St. Luke's Medical Center in Chicago but has no ties to a university.

Hirsch defends his work, saying he does research that helps people, though he acknowledges that much of it does have the potential for commercial interest.

And, he says, he helps patients overcome problems that are, at a minimum, frustrating and confusing and that can even become dangerous. Smell and taste, he points out, are used to detect poisons, smoke and spoiled food.

"A lot of patients who come in here have already seen six to eight doctors," he says. (One of his newest patients has seen 22.) "The doctors don't know what the problem is, their family doesn't necessarily believe them - they're at their wits' end by the time I see them."

That desperation may explain why Mazzeffi, 50, a teacher with the metallic taste in her mouth, doesn't seem to mind when Hirsch holds her tongue between his latex-gloved fingers and dyes it bright blue and green.

"You have a very high number of fungiform papillae," Hirsch declares after examining a small area of Mazzeffi's tongue in a darkened room. "You might call them taste buds." (The dye helps him get an accurate count of them.)

Mazzeffi, who says she has a number of medical complications, tells Hirsch she can't continue taking a vitamin he had recommended because it upsets her stomach. She'll try a different prescription - one suited to her abundance of taste buds.

"The good thing about coming here is that he gives you hope," Mazzeffi says. "Not knowing what the problem is, or if there even is a problem, is terrible. My family is supportive, but they think I'm nuts."

Just when the diagnostic techniques - which also include dabbing sweet, salty, sour and bitter solutions in different parts of the mouth - are starting to seem as if they belong at a middle school science fair, Hirsch sets an electrogustometer on the counter.

He uses the Japanese machine - it looks a lot like a torture device once its plastic arm is clamped across a patient's neck - to perform an electrical test on Daniels, 60, a telecommunications professional who says he can't taste sweet flavors anymore.

Daniels' tongue cowers as the machine's thin metal arm approaches. He is supposed to nod his head - speaking is out of the question because his tongue is otherwise occupied - whenever a metallic taste fills his mouth.

Based on the results of that test and the one employing different solutions, Hirsch proclaims: "Your sweet taste is actually very good. I think it's your bitter that's off. It's overpowering your sweet, and your brain just isn't putting it all together."

After prescribing a medicine for Daniels that "should help stabilize the tongue," Hirsch ducks back into his office for a few minutes.

His presidential-sized desk is littered with paperwork for studies, messages from patients, and an army of tiny glass bottles of fragrances.

The bottles are labeled simply, but some of their contents sound complicated: "New Mown Hay," "Chicago Lemon Cheesecake," "Grandma's Parlor."

The scents are used in studies, Hirsch says, offering a candy-lipstick-shaped tube of strawberry to sniff.

Hirsch, 46, a soft-spoken, self-described "compulsive sort of guy," has been interested in the science and psychology behind smell and taste since his days as a medical student.

While a psychiatry resident at Rush-Presbyterian, Hirsch wondered why a number of neurological and psychiatric patients lost their sense of smell. Could it be linked to psychological problems?

Actually, as he eventually learned, it was the numerous medications that rendered the worlds of the patients unscented. But by the time he realized this, he says, he was hooked.

Two decades later, his mistake has made him famous. He has appeared on The Oprah Winfrey Show and Dateline, and he sees about 1,000 patients a year, some of whom fly in from as far as South Africa and United Arab Emirates. An appointment with Hirsch can cost more than $200, and insurance doesn't always cover treatment.

New patients, like social worker Dayron, 62, lounge in the doctor's dark, contemporary office, which is accented with mirrors and green sculptures.

Dayron flops onto a modern black lounge chair and details her medical history for Hirsch.

She is here because ever since she returned from a lengthy trip to Italy more than a year ago, "things don't smell right and some things don't smell at all." The last thing she remembers smelling - a fragrance she still catches once in a while - is the powerful soap she used in Italy.

A doctor she saw this fall said her sinuses look fine, and a CT scan was normal. She is hoping Hirsch can give her some insight.

"My problem, if you can call it that, is more intriguing than it is serious," she admits when the doctor steps out of the room.

Hirsch asks her a series of questions from "Do you think you can smell natural gas?" to "Do you feel depressed?" As she ticks through the answers, Hirsch is formulating a diagnosis, which he will use to treat her - and which, if her answers interest him, may become his next study on smell and taste.

Smell and taste research findings

Here are 10 findings from Dr. Alan R. Hirsch's 85 studies:

The odor of baking bread, cookies or cakes triggers the most childhood memories.

Male shoppers are more likely to linger at a jewelry counter if there is a spicy fragrance in the air.

Female shoppers are more likely to linger at a jewelry counter if there is a floral fragrance in the air.

The combined odor of lavender and pumpkin pie has the greatest effect on increasing sexual arousal in males.

The smell of cucumbers produces an increase in female sexual arousal.

Floral odors can increase learning for some people.

Sniffing peppermint, banana and green apple helped some people lose five pounds per month.

Eating garlic bread during dinner reduced the number of negative remarks by 22.7 percent per family member.

Head trauma is the top cause of smell loss.

About 90 percent of taste is smell.

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