Sniffing out medicine

By BBC Doctor Colin Thomas

Anyone who's ever walked in to a hospital must have experienced that classic smell, once described to me as spit and polish with disinfectant.

But for me my primitive sense tends to evoke past memories of the "good old days".

The first medical smell I encountered was one many years before I started training when as a young child I was cowering behind my Mum at the clinic waiting for my vaccinations.

There was a musty church hall type aroma mixed in with a sickly sweet smell of ether.

In those days ether was used to sterilise the skin before injections. It was freezing cold on the skin as I remember, and then the sudden contrast as the hot sensation of the needle pierced through.

Ether is now very little used, if at all, although when I trained as an anaesthetist there was one consultant who did still use ether very rarely for certain operations.

One day I was working with him, and that familiar smell that greeted me as I opened the anaesthetic room door immediately transported me back to the fear I once knew.

As you start training in hospital smells start to be a routine occurrence. The first attendance at a post mortem examination is, to say the least, a shock to the system.

Yes, there is an irresistible urge to throw up, but somehow, quite quickly you get accustomed to the whiff.

Within a few weeks I would happily have my hospital dinner (now there's another smell altogether!) and then parade off to the labs to watch our demonstrator show us a nutmeg liver or a sago spleen!

Sizzling flesh

Further on, you start to assist with surgical operations.

As the diathermy cut through and cauterised small blood vessels a familiar smell appeared.

I couldn't place it initially until a few days later when I accidentally burnt my bacon one morning on the grill. However, bearing in mind how many genes we seem to share with our porcine relatives I'm not surprised.

Patients can have smells too. And this can play a part in diagnosis.

Those with liver failure are said to have an aldehydic smell which in the books has been likened to mouse droppings - Goodness knows how many of us had smelled mice droppings, by the way.

In fact it was more likely if someone had asked us to smell mouse droppings we would probably have described them as smelling of patients with liver failure!

Not all smells were bad though, there was something very soothing about the whiff of milky Horlicks as you entered the geriatric wards just before bed-timeż...and if you were on the right side of sister you might get a cup, if you were lucky!