What's That Smell?

Thomas Robey -- Is there another profession where one can expect to routinely encounter such a diverse array of odors as occur in medicine? Clinical aroma may not be the most pungent or revolting of smells –- crime scene cleaners are probably worse –- but in what other career is identifying foul fragrances actually an important skill? The differential diagnosis from one odor could easily include abscess vs. BO vs. foot fungus. Sure, some specialties and patient populations may have an increased preponderance of smelly patients, but it’s a given that medical students and residents encounter a fair share of smells before choosing their practice.

As for me, I hope to refine an olfactory prowess so it may add to my clinical armamentarium when I practice in an urban emergency room. As such, I’ve compiled a list of top twelve smells of medicine. Why twelve? So that this can be converted to a calendar, of course! I’ll leave it to the comments section for proposed images for these smells. Note that I took liberties with some of the Latin medical-sounding words. Some are diagnostic scents, others are odors you just need to learn to deal with.

1.    Ketohalitosis (fruity breath)

2.    Pungent Urine (usually dried into clothes)

3.    Feculent Abdomen

4.    Anaerobic Abscess

5.    Operating Room Flatus

6.    Bromodrosis (smelly feet)

7.    Ichthiosmia (the fishy smell of bacterial vaginosis)

8.    Post-Op Diarrhea

9.    Halitosis (applies to some attendings)

10.   Vomit (ideally, not on your scrubs)

11.   Bromhidrosis (body odor)

12.   The Smell of Labor

Please let me know if you’d like to go in together in marketing a “Smells of Medicine” calendar.