horrifyingly common in the treatment of prisoners. In a 1984 paper on “hostage hallucinations,” Ronald K. Siegel pointed out that such hallucinations can be magnified sometimes to madness, especially when combined with social isolation, sleep deprivation, hunger, thirst, torture, or the threat of death.
2 . There may be severe visual impairment or complete blindness without a hint of CBS, and this might seem to imply that visual deprivation alone is not a sufficient cause for it. But we are still ignorant as to why some people with visual problems get CBS and others do not.
3
A Few Nanograms of Wine: Hallucinatory Smells
T he ability to imagine smells, in normal circumstances, is not that common—most people cannot imagine smells with any vividness, even though they may be very good at imagining sights or sounds. It is an uncommon gift, as Gordon C. wrote to me in 2011:
Smelling objects that are not visible seems to have been a part of my life for as long as I can remember.… If, for instance, I think for a few minutes about my long dead grandmother, I can almost immediately recall with near perfect sensory awareness the powder that she always used. If I’m writing to someone about lilacs, or any specific flowering plant, my olfactory senses produce that fragrance. This is not to say that merely writing the word “roses” produces the scent; I have to recall a specific instance connected with a rose, or whatever, in order to produce the effect. I always considered this ability to be quitenatural, and it wasn’t until adolescence that I discovered that it was not normal for everyone. Now I consider it a wonderful gift of my specific brain.
Most of us, in contrast, have difficulty summoning smells to mind, even with strong suggestion. And it may be oddly difficult to know whether a smell is real or not. Once I revisited the house where I grew up and where my family lived for sixty years. The house had been sold to the British Association of Psychotherapists in 1990, and what used to be our dining room had been turned into an office. When I entered this room on a visit in 1995, I immediately and strongly smelled the kosher red wine which used to be kept in a wooden sideboard next to the dining table and drunk with Kiddush on the Sabbath. Was I just imagining the smell, assisted by these once intensely familiar, beloved surroundings and nearly sixty years of memory and association? Or could a few nanograms of wine have survived all of the repainting and renovation? Smells can be oddly persistent, and I am not sure whether my experience should be called a heightened perception, a hallucination, a memory, or some combination of all these.
My father had an acute sense of smell as a young man, and like all doctors of his generation, he depended on it when seeing patients. He could detect the smell of diabetic urine or of a putrid lung abscess as soon as he entered a patient’s house. A series of sinus infections in middle age blunted his sense of smell, and he could no longer rely on his nose as a diagnostic tool. But he was fortunate that he did not lose his sense of smell entirely, for total loss of the sense of smell—anosmia, which affects perhaps as many as 5 percent of people—causes manyproblems. People with anosmia cannot smell gas, smoke, or rancid food; they may be beset by social anxiety, not knowing whether they themselves smell of something rank. They cannot enjoy the good smells of the world, either, and they cannot enjoy many of the subtler flavors of food (for most of these depend equally on smell). 1
I wrote about one anosmic patient in
The Man Who Mistook His Wife for a Hat
. He had suddenly lost all sense of smell, as the result of a head injury. (The long olfactory tracts are easily sheared as they cross the base of the skull, so loss of smell can be caused by a relatively mild head injury.) This man had never given much conscious thought to the sense of smell, but once he lost it, he found his
2 . There may be severe visual impairment or complete blindness without a hint of CBS, and this might seem to imply that visual deprivation alone is not a sufficient cause for it. But we are still ignorant as to why some people with visual problems get CBS and others do not.
3
A Few Nanograms of Wine: Hallucinatory Smells
T he ability to imagine smells, in normal circumstances, is not that common—most people cannot imagine smells with any vividness, even though they may be very good at imagining sights or sounds. It is an uncommon gift, as Gordon C. wrote to me in 2011:
Smelling objects that are not visible seems to have been a part of my life for as long as I can remember.… If, for instance, I think for a few minutes about my long dead grandmother, I can almost immediately recall with near perfect sensory awareness the powder that she always used. If I’m writing to someone about lilacs, or any specific flowering plant, my olfactory senses produce that fragrance. This is not to say that merely writing the word “roses” produces the scent; I have to recall a specific instance connected with a rose, or whatever, in order to produce the effect. I always considered this ability to be quitenatural, and it wasn’t until adolescence that I discovered that it was not normal for everyone. Now I consider it a wonderful gift of my specific brain.
Most of us, in contrast, have difficulty summoning smells to mind, even with strong suggestion. And it may be oddly difficult to know whether a smell is real or not. Once I revisited the house where I grew up and where my family lived for sixty years. The house had been sold to the British Association of Psychotherapists in 1990, and what used to be our dining room had been turned into an office. When I entered this room on a visit in 1995, I immediately and strongly smelled the kosher red wine which used to be kept in a wooden sideboard next to the dining table and drunk with Kiddush on the Sabbath. Was I just imagining the smell, assisted by these once intensely familiar, beloved surroundings and nearly sixty years of memory and association? Or could a few nanograms of wine have survived all of the repainting and renovation? Smells can be oddly persistent, and I am not sure whether my experience should be called a heightened perception, a hallucination, a memory, or some combination of all these.
My father had an acute sense of smell as a young man, and like all doctors of his generation, he depended on it when seeing patients. He could detect the smell of diabetic urine or of a putrid lung abscess as soon as he entered a patient’s house. A series of sinus infections in middle age blunted his sense of smell, and he could no longer rely on his nose as a diagnostic tool. But he was fortunate that he did not lose his sense of smell entirely, for total loss of the sense of smell—anosmia, which affects perhaps as many as 5 percent of people—causes manyproblems. People with anosmia cannot smell gas, smoke, or rancid food; they may be beset by social anxiety, not knowing whether they themselves smell of something rank. They cannot enjoy the good smells of the world, either, and they cannot enjoy many of the subtler flavors of food (for most of these depend equally on smell). 1
I wrote about one anosmic patient in
The Man Who Mistook His Wife for a Hat
. He had suddenly lost all sense of smell, as the result of a head injury. (The long olfactory tracts are easily sheared as they cross the base of the skull, so loss of smell can be caused by a relatively mild head injury.) This man had never given much conscious thought to the sense of smell, but once he lost it, he found his
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