Editor's Comments on 'Pathology’s Other Sense'

 , December 04, 2017

The first time I ever smelled melena was during my first code when I was in medical school. A woman who was admitted to the neurology floor had been found without a pulse, and we were the responding medical team. As I leaned over her bed compressing her sternum, trying to remain a constant piston in a sea of chaotic yelling around me, I was suddenly hit with the smell of what I later learned was melena, stool that contains digested blood, often the result of a bleed high up in the gastrointestinal tract. The iron content of blood gives the stool both a characteristic black color and a unique, nauseating, smell.

Since that day, I have smelled melena a handful of times, and it always brings me back to that room. To the feel of cartilage cracking under my palms, adrenaline coursing through my chest, fear and panic clouding my attempt to count my compressions. To feeling small, scared, overwhelmed, and lightyears beyond my comfort zone. To the moment when I looked up and saw the patient’s daughter in the hallway and all of those same emotions reflected in her expression. I have never forgotten that moment. What I never realized until reading Mazer’s “Pathology’s Other Sense” is the critical role that smell has played in my emotional connection to it. As Mazer points out in his essay, nothing connects us to memories quite like smell. And memories make us who we are.

The other day, as I walked by a basin full of coffee grounds in the hallway, our half-hearted attempt to diminish the often unpleasant smells that accompany the practice of medicine, I found myself thinking of Mazer’s essay and smiling. He has reminded me that smells are as much a part of the job as they are a part of life. As such, they are worth noticing and savoring.

I am not at all surprised that it took a pathologist’s perspective to help me notice and appreciate some often overlooked detail of patient care that I encounter daily. I am, however, pleasantly surprised that it took a pathologist to remind me once again that the work we do is fundamentally human, and that so are we.

Mara Feingold-Link