In primary care, I used to smell sinus infections/strep as a patient walked in the room for their “sick visit” and felt confident enough to diagnose without swabbing but I still swabbed anyway to avoid antibiotics for viral infections. I’ve long left primary care for hospital and concierge medicine so now c diff stool and melena get me usually.
There was this one time in residency I had a tiny older lady from a very rural town come in with a festering breast wound. One breast was normal sized and the other was 4x size of the normal one. Almost the size of a medium watermelon. Turns out it was necrotizing breast cancer and severe cellulitis. She didn’t recall much about why it took her this long to seek help. Her kids pleaded her to get it checked out but she had a deep mistrust of healthcare workers it wasn’t until the smell was unbearable for her family that they brought her in. The whole ED smelled of rotten infected flesh and no amount of winter fresh and peppermint oil was able to help the smell. That was about 10 years ago and I still remember that day and smell.
As a paramedic, have dealt with the same thing, patients with obvious severe infections (TMI for people with sensitive stomachs - the worst being an older lady who spent her days in a recliner, and had 'bed' sores on her legs as a result, couldn't get up because of the pain, so had defecated herself, which had melted due to body heat and run down her legs into the bed sores) but was still resistant to going to hospital. Irony was, she was a founding part of our fire department many many years ago. "Ma'am, if you don't come with us, the next time we'll be here is quite possibly because you'll die right in this recliner".
She didn't come with us that night, so we cleaned her up, as best we could, and came back the next morning after having done some outreach (our department had a pastor who knew her and was also a PA and responder), and were able to convince her to go.
I'll never forget that smell.
You can do things like putting icy-hot or ben gay ointment on your upper lip. Unpleasant sensation and smell, and doesn't fully work, but ... it helps.
Do you still have this knack of smell or did it develop into something else? I spent a lot of time in the hospital growing up because of my brothers being admitted and stuff so I used to people watch often and got pretty good at just being able to see someone and guesstimate what they have/needed to be treated for.
Still got the knack of smell from years of seeing/smelling it in med school and residency. I don’t think it developed into anything else. It’s just repetition I suppose. Now a days, when people go see a provider for “sore throat” they automatically get a throat swab and wouldn’t be surprised if the provider doesn’t even look in your mouth. Pre-covid, I was always looking into people mouths and rarely wore a mask unless it was proven flu or RSV and I think that’s where I was able to hone my smelling skill. Now things like c diff and blood in stool doesn’t require any skill. You smell it once and you know.
Edit: sorry for delayed response. I hope this answers your question.
There are just distinct smells you start to pick up on as you treat a variety of illnesses. There is no superpower to it. Scents tend to form a long memory, so if you catch a good whiff of a suppurative exudate you'll never forget it. For many of us we probably pick up on some VOCs emitted by various bacteria and it can give us the strong intuition the poster above describes.
Yes, kinda assumed that a bit, since illness do give out a certain smell,,was just wondering what else blossomed from that. Maybe the only superpower is having awareness,,
{{asking nicely}} do you credit this for something else that’s developed in your life? Just wondering if things like these help us do something else..{{not so serious}}
No, not at all. I mean, I could think of reasons why I could smell it, but any application of it is probably noticing that stuff is about to catch on fire in an industrial setting..
Bless you, all who are in the medical profession. It's hard work, and at least here in the US it's made even harder by understaffing, brutal work hours, and getting pulled around by big business interests. Everyone from janitor to EMT to phelobotomist to anesthesiologist: you have my deep and sincere gratitude. May you have the strength to keep doing what you're doing.
Let's make sure to exclude the business people that make the health system more and more inhumane for workers and patients in search of ever growing profits.
20 years ago, my marketing professor was talking about scent being the sense most strongly linked with memories. The smell of exhaust taking him back to his country of origin. Sticking with medical smells, my sister can smell bladder cancer. Not sure how common that is, but she used to work in urology and after a urine sample was turned in, she could tell ahead of time who was sick.
I imagine that smell has helped shape how we find food and avoid disease and has been reinforced since some long ago ancestor likely common to many mammals or even further back. We often think of dogs or bears for their well developed sense of smell or even sharks sensing blood in the water.
Fun fact: humans are more sensitive to the smell of petrichor (fresh rain on dry ground) than sharks are to blood.
One of my core memories was standing in an elevator in college, deep in to my second or third LSD trip.
My friend handed me a tin of Japanese green tea, which I opened slowly and then inhaled very intentionally.
It instantly transported me back to being 14 and in Japan for the first time. Will always remember that feeling of smells blending with nostalgia, adventure and discovery. :)
I've suffered some pretty severe mistreatment in a hospital setting before, and there's a certain cleaning chemical that's commonly used in hospitals that absolutely sets my teeth on edge. It's wild how a scent can not only trigger a memory but a flood of emotions to go with it.
This is from a doctor's point of view on the front lines.
For the rest of us when we walk in the door, it's the bouquet of delicate notes above the isopropyl alcohol, sometimes with a very complex finish that can be impossible to forget.
There's clean, then there's hospital clean. The sterile smell sure is something. In one way, it's a comforting "home" smell, even when I show up at one as a patient.
from my memories, i can recommend gauze with embedded rotting flesh from a gangrenous wound. we used to get one or two of these a year at the microbiology lab i worked in, and there were few volunteers to open the container. exploding stool containers, packed full up with shit and then left in sunlight for several hours were another non-favourite.
I've had to send in stool samples several times for various reasons, and every time I imagined some poor lab tech having to handle it. Too bad they never did a "Dirty Jobs" episode about that profession.
actually, it was really easy to send in a simple to deal with. the NHS used a stool sample container that had a little spoon attached to the top (whole container is about 4 inches long and 1.5 wide, spoon about big enough to hold a pea) - procedure:
- crap, but catch some on toilet paper
- scoop some with little spoon - tests need almost nothing
- send off to lab
it was astounding how few samples we got, even from hospitals, that managed this.
Have you ever tried to catch something behind yourself, or under yourself in a high squatting position? Something your body has some deep learning about not touching? Seems like labs would get a better response with putting some used TP in a bag.
>> it was astounding how few samples we got, even from hospitals, that managed this.
Yeah, I'll tell you why. I was asked for a stool sample once (don't ask). I looked at that tiny perspex cylinder with the tiny little fairy spoon in it and it was immediately obvious: nuh-huh. No way. I'm not handing my shit in a tube to some poor health person. Nope. No. Never. No way.
TFE: Too Fucking Embarassing!
You medical people have to think harder about all the things you ask your patients to do. Colonoscopies? Specula? Prostate exams? Shoving a rod up your nostrils to get samples for Covid? Come on. The human body is not just a machine. There's a little person inside that feels every single thing.
There was this one time in residency I had a tiny older lady from a very rural town come in with a festering breast wound. One breast was normal sized and the other was 4x size of the normal one. Almost the size of a medium watermelon. Turns out it was necrotizing breast cancer and severe cellulitis. She didn’t recall much about why it took her this long to seek help. Her kids pleaded her to get it checked out but she had a deep mistrust of healthcare workers it wasn’t until the smell was unbearable for her family that they brought her in. The whole ED smelled of rotten infected flesh and no amount of winter fresh and peppermint oil was able to help the smell. That was about 10 years ago and I still remember that day and smell.