Tag Archives: blood

Scents and Scents-ability

What I started writing at 2am the night after my knee surgery

There are many unforgettable scents I’ve come across throughout life that I can imagine just by my memories. How many do you recognize?

Babies and puppies have their own warm, comforting scent, like that new car smell without the chemical outgassing.

The Sonoran desert in Arizona is home to a variety of hardy aromatic plants: desert willow; creosote bush; mesquite trees. I still remember what Sabino Canyon, northwest of Tucson, smells like in the searing midday heat.

Sonoran Desert landscape, Arizona

I found a decaying animal carcass along the Route 80 bypass just above Spring Canyon Road in Bisbee, Arizona when I was eight. There wasn’t much left, just a ribcage and desiccated but still rotting flesh, but the acrid smell was unforgettable.

Dead skunk in the middle of the road. Stinkin’ to high heaven!

I sometimes roamed the drainage ditch that ran along Tombstone Canyon in Bisbee. I would build earth dams across areas of flowing water, creating a reservoir I’d then destroy with imaginary Allied bombers (usually a stick). I remember the smell of wild mint among the sparse fauna. Now I would be afraid of contracting some water-borne illness like Naegleria, the brain-eating amoeba.

Eddie Rojo’s tavern in Bisbee had a shuffleboard table I’d play with while my stepfather indulged in his favorite pastime, soaking his regrets in Falstaff. The table had fine sawdust in the gutters which competed with the smell of old beer in the tavern’s floorboards. I liked sliding the heavy pucks up and down the butcher block playing surface that was smooth as glass.

I used to have an olfactory hallucination at night when I was little, which I can only describe it as “spoiled mustard.” I’ve never run across that smell when awake.

My grade school in Arizona had an auditorium that doubled as the lunch room. Kids’ sack lunches sat there unrefrigerated until noon. The pungent, nauseating odor coming from the contents usually made me puke on the table. The lukewarm milk cartons also had their own unsettling smell.

Mrs. Frost, my first-grade teacher, wore a very distinct perfume which I found very comforting. Thirty years later I instantly recognized that scent when my medical assistant Eileen wore it one day. She told me it was White Shoulders, created during the 1940s and still popular.

There was nothing like the smell of ditto ink coming from a warm test paper, fresh off the printer. We hold them against our faces and inhale before starting the exam. Generations of schoolchildren will never experience it.

I don’t remember my grandparents’ concrete house in Puerto Rico having window screens. At night our beds were enveloped in tents of mosquito netting laced with pyrethrum, an insect repellent derived from chrysanthemums. I can still smell it.

Family in Vega Baja, PR 1957

One didn’t need a clothes dryer in the desert, even in the winter. One of life’s greatest pleasures is taking in the fresh scent of bedsheets or clothes after they’ve dried outside, something no laundry product can match.

Winter in Bisbee, AZ, 1960

We were friends with a couple that had seven children, five of which were crammed into several beds in a small room. The mattresses were old and likely peed on several times over the years. I remember being 8 years old sleeping on one of those mattresses with one of their girls while our parents played cards into the night.

Back during the 1950s and 1960s most doctors’ offices had a strong antiseptic smell, most likely from isopropyl alcohol. It always made me think of those long, reusable hypodermic needles soaking in those stainless steel trays and the big glass jars of cotton balls and tongue depressors.

The scent of blooming flowers in the spring – roses, lilacs, apple and cherry blossoms – represent new life after a soul-killing winter.

Lilac Blossoms

That comforting, clean air smell after a fresh rain is called petrichor.  Some it comes from lightning splitting atmospheric nitrogen and oxygen, which recombine into ozone and nitric oxide. Another component is geosmin, produced by Actinomycetes, a bacteria found in soil.

Mount Washington, NH

Most people in temperate areas look forward to burning dead leaves in the fall. Those of us with chronic lung disease dread the smoke and many municipalities have outlawed open burning. Burning the evil weed, along with the red eyes, giggling and munchies, is a different story.

Autumn leaves in Gorham, NH

Wood-fire smoke comes in several varieties:

  • the hot, dry wood smell of a sauna
  • cozy when sitting around a fireplace in winter or a fire pit in the summer
  • oddly unsettling when it permeates everything in a house that has been heated solely by firewood
  • terrifying when it comes from the raging forest fire beyond the horizon

The air at sub-zero temperatures has a crisp smell largely because there are so few odiferous molecules in the air.

Svalbard Island, Norway

Everyone remembers having the pine scent of a fresh Christmas tree filling the house. I stopped getting real trees thirty years ago because the pesticides and preservatives caused bronchospasm. I take solace in the bags of cinnamon-scented pine cones that Jewel sells every year.

Christmas 1962

The dead mouse in the wall behind our range had an unmistakable musty odor. My two “helpers,” a cranky Lhasa-Apso and a greyhound with “a great nose,” tasked with helping me locate the carcass, sat in the family room and laughed while I drilled three holes between the studs before finding it.

The pseudomembrane of the upper respiratory tract produced by diphtheria infection is said to smell like a wet mouse, though I’ve never encountered either.

I reached a milestone in 7th grade when I realized that foul body odor was coming frtom my own armpits and it was time to start using deodorant.

The eye-watering rotten-egg smell of hydrogen sulfide, is “rancid” when in reference to a particularly noxious fart, but “smells like money” if you own a petrochemical refinery.

I stopped at a turnout on a back country two-lane and sat at the lone concrete picnic table under the trees. I noticed a slightly sweet but pungent odor nearby; it came from a cool, dusky pile of human feces about ten feet away. Someone must have been really desperate to drop a deuce on the side of the road. Well, when you gotta go…

There is absolutely nothing like the intoxicating, primal scent of an aroused woman’s vaginal secretions, now indelicately known as “wet-ass pussy.” I’ll never forget my first encounter, forbidden yet exciting! Regrettably, women lose that aspect of arousal with age.

Abstract vulva in fabric

Not everyone likes it; many young men who lack both discriminating olfactory epithelium and finesse find it “disgusting.”  The “personal hygiene” industry preys on women’s insecurities to sell crap, promising they’ll smell “fresh as a daisy.”

Fresh semen has its own unique odor, though I doubt most women find it alluring.

Human blood has a slightly metallic odor, especially when encountered in large quantities, such as after a postpartum hemorrhage, or on the floor around the operating table on which the dead guy with a .22 hole through his heart lay.

Para-dichlorobenzene gives mothballs and urinal cakes their pungent smell, which I’ve also detected in a couple of really poorly-maintained home bathrooms.

The black knobs on the lids of some cooking pots are made of phenolic resin, made from combining phenol and formaldehyde. They emit a very unpleasant odor after being heated in an oven.

It’s been said everyone has opinions and they all stink. Also that politicians and dirty diapers need to be changed frequently for the same reason.

Photo Credits © Can Stock Photo
Lavender field: Ariec
Sonoran Desert: ancientimages
Lilacs: sagasan
Arctic: carlosobriganti
Fabric vulva: mikhail_sheleg
Other photos: my collection

© Can Stock Photo Inc. / Frankljunior

Crimson Tides

Another day in the life…

Few things in my profession are more terrifying than obstetrical hemorrhage.  Every year more than 144,000 pregnant women bleed to death, even here in the U.S. Sometimes we anticipate problems; more often we have no warning.

I aged ten years one afternoon treating one such woman.

Marylou was in labor with her third child and everything was going well.  Her cervix had dilated to 6cm and I thought she’d deliver in the next two hours or so.  Suddenly, she said, “I can’t breathe,” and the baby’s heart rate dropped to 60 beats per minute or bpm (normal baby heart rate is 110-160 bpm).  Her cervix was completely dilated but the baby wasn’t looking any better and too high in the birth canal to deliver with forceps, so we took her to the operating room.

The baby came out screaming and we were all relieved…for the moment.  We closed the uterus but the suture line slowly oozed blood.  The bleeding seemed to improve after a few minutes, so we finished.  We noticed a little bit of blood around the staples that closed her skin, but it wasn’t unusual.  The nurse pushed on her uterus to expel any remaining blood before taking Marylou to the recovery room. Everything seemed fine.

Blood started gushing from Marylou’s vagina about 30 minutes later and it wasn’t clotting. I ordered another four units of blood—we had two units already waiting from before surgery—while her nurse started a second IV.  We then wheeled her to the Intensive Care Unit (ICU) and called one of the critical care specialists.

The specialist was a man of few words who, until that day, wasn’t known for anxiety under pressure. When he pulled the sheet off Marylou, blood was visibly welling up between her thighs.  His eyes widened as he quietly said, “We need more blood.”  That’s when we knew Marylou was in trouble.

I ran to the blood bank and came back with four units, but her blood was pouring out as fast as we replaced it.  I was starting to worry she might bleed to death and took her back to the operating room. I asked a physician on the unit, who had also been my senior resident in training, for help. We tried packing her vagina with laparotomy sponges, but the blood soaked through them and ran onto the floor. He looked at me and said, “I think it’s time to give up and take it out.”  We quickly prepared her for surgery.

One of the hospital’s hematologists brought a portable refrigerator to the operating room and directed the transfusion while we took her uterus out.  We emptied the hospital blood bank of Marylou’s blood type; then we emptied out the local Red Cross. By the time Marylou was stable and out of danger, she’d received 30 units of blood and several liters of IV fluids.

Marylou suffered from the “anaphylactic syndrome of pregnancy,” something we used to call an “amniotic fluid embolism.”  Baby’s skin cells and amniotic fluid get into the mother’s circulation, causing a severe reaction in a small number of women, much like that in someone with an allergy to penicillin, peanuts or bee stings. The afflicted patient has trouble breathing and her blood pressure can fall low enough to put her into shock.

Marylou’s blood wouldn’t clot because the reaction used up most of the blood’s clotting factors, creating a potentially fatal complication called disseminated intravascular coagulation (DIC). Red blood cell packs lack those clotting factors, so we need to transfuse other blood products—fresh frozen plasma, cryoprecipitate and platelets—to treat massive hemorrhage.  Since then hospitals have developed transfusion protocols based on the military’s battlefield experience.

The survival statistics for amniotic fluid embolism have never been good.  One hundred percent of women with an amniotic fluid embolism who aren’t treated die; up to seventy percent die in spite of treatment.  Sometimes babies have been delivered by Cesarean section after the mother has gone into cardiac arrest and died.

Marylou woke up in the ICU four days later and asked me, “Did I scare you?”

More than you will ever know.

 

 

Image:© Can Stock Photo Inc. / Frankljunior