First Bite: How We Learn to Eat. Bee Wilson

central food memories are, both to the way we learn to eat and the way we relate to the world. When I met her, Abi Millard was nine. In most respects she is a self-assured, happy girl. She likes swimming and Tae Kwon-Do. She lives with her mum and dad in a rural village and goes to the local primary school. Yet her experience of life is different from most. Without the ability to smell or perceive flavour, Abi experiences food more or less as pure texture. Blindfolded, she can’t tell the difference between houmous and strawberry yoghurt. Salad leaves tickle her throat and tomatoes are slimy, though she will eat broccoli and carrots and peas. She has few of the drives that motivate most people to seek out certain beloved foods because she lacks the memories that would make her expect them to be rewarding. Dawn says she lacks any real enjoyment in food – except for one time when they were out at a restaurant and Abi ate a gammon steak and said, ‘That’s lovely’, perhaps because it was intensely salty (Abi can detect strong concentrations of salt or sugar on her tongue, but without any of the flavour nuances). Dawn worries that when Abi is grown up, she may forget to eat. The illness is also isolating: when Abi’s friends at school talk about favourite meals, it’s hard for her to join in. She has no idea what a batch of warm vanilla shortbread smells like; or chocolate; or garlic. She has no memory of the taste of her own mother’s cooking.

      It is extremely rare to have anosmia from birth, as Abi does. What is far more common is to develop anosmia later in life, often after a head injury (though it may also be caused by sinusitis, nasal polyps, dementia, chemotherapy, stroke, liver disease or sometimes for no clear reason at all). At a conference organized by the anosmia support group Fifth Sense in spring 2014, anosmia sufferers spoke of how doctors were often dismissive of their condition: ‘be thankful you’re not deaf’ was a common refrain. But it’s hard to be thankful for a malady that separates you from the food memories that define so much of who you believe yourself to be. One woman at the conference who had been in a cycling accident talked about how her marriage had broken down after she became anosmic. Her relationship could not survive her inability to share her husband’s continuing pleasure in food. Before the accident, they had both loved throwing dinner parties, but her husband couldn’t understand that elaborate cooking now did nothing for her. Every meal was a cruel reminder of what she had lost. The predicament of those who are born with anosmia, like Abi Millard, is that they can’t share the pleasurable food memories that the rest of us have. The predicament of those who develop anosmia later in life is that they have the memories, but no means to access them. They are cut off from their own past.

      It was a bright spring day in San Francisco in 2011 when Marlena Spieler, a food writer with more than twenty cookbooks to her name, was knocked down by a car at a crossing. Both her arms were broken and she suffered concussion. As the initial excruciating pain gradually lessened, Marlena – a sunny optimist with Marilyn-platinum hair – noticed another injury, which to her was far worse than the broken limbs. The head trauma had damaged the nerve connecting to her olfactory bulb – the part of the brain that interprets flavour – and she could no longer enjoy food. Coffee had been one of Marlena’s great pleasures since she was very young. Now it was tasteless. ‘Cinnamon drops, a childhood favourite, were bitter, horrible,’ she wrote in the New York Times. ‘Tamales were as bland as porridge. Bananas tasted like parsnips and smelled like nail polish remover.’ As for chocolate, it was ‘like dirt’.¹

      I got to know Marlena in 2002 on a press trip to Parma organized by the consortium of producers of Prosciutto di Parma. For three days we ate ribbons of pink salty ham at every meal and Marlena, with great Californian ebullience, talked about the foods she loved the most. These were long – very long – conversations. She spoke of artichokes and lemons; earthy dried mint and pungent truffles; bread and cheese; and how she would rather be in Italy than anywhere in the world. She ate with a dainty slowness, as if trying to extract the essence from each bite.

      After the accident, she could still perceive the heat of pungent spices such as mustard, Aleppo pepper or cinnamon, because her trigeminal nerve, the part of the body that tingles when you eat hot food, was not damaged. But without the flavour to offset it, the tingling sensation was offensive. Her beloved cinnamon felt abrasive. Meanwhile, she developed new cravings, for intensely sweet desserts and for fish. When I first knew Marlena, she was indifferent to desserts and hostile to fish. Now, suddenly, she had yearnings for smoked mackerel and anchovies. She also developed a very sweet tooth. A scientist working on flavour and the brain told her that this might be because she could no longer detect the qualities in fish and sweets that she had previously been disgusted by. They only seemed desirable because she couldn’t recognize the ways they had once repelled her.

      People sometimes speak of anosmia as ‘loss of taste’ but damage to the taste buds themselves is actually very rare. More than 90 per cent of cases of taste-related disorders involve a weakening or loss of the sense of smell. The taste buds in our mouths only supply a fraction of the complex pleasures that we enjoy as ‘flavour’. The rest is perceived via our noses, through something called retronasal olfaction. We smell coffee by breathing in – is any scent better than a warm bag of freshly ground beans? But we taste a cup of coffee by smelling it backwards, or retronasally. The hundreds of chemical compounds that go together to make up the flavour of a particular blend and roast of coffee travel to the back of our mouths and sneak backwards through the nasopharyngeal passage into the nasal cavity.² As we sip and swallow, we are not conscious that the splendid flavours – the nuttiness of the roast, the notes of cherry and peach – are created in the nose, not the mouth. This spectrum of retronasal joy is lost to anosmia sufferers. All they have left are the harsh and basic tongue-notes of sweet, sour, bitter and salty. Like Abi Millard enjoying a salty gammon steak, anosmia sufferers often seek out extremely salty or sweet foods to compensate for the loss of flavour.

      Anosmia is a surprisingly common problem – as many as 2 million people in the US have some form of smell or taste disorder.³ It is not a trivial disability. The ability to pick out the jasmine aroma in a cup of espresso or to spot the difference between grapefruit and pomelo might seem of little importance to anyone except for food writers. But medicine and neuroscience are now starting to recognize that anosmia can be an extremely traumatic condition, and not just because of the danger in emergencies of not detecting the smell of smoke or gas. Sufferers often end up depressed and malnourished. Without flavour, the motivation to eat is lost. When nothing can be smelled, there is a yearning for familiar tastes that can never be satisfied. Christmas goes by without the background aroma of turkey or spice; summers are no longer marked by the perfume of strawberries and cut grass. Sufferers often describe it as a deep loss. Duncan Boak, the founder of Fifth Sense, who became anosmic after a head injury, said that he feels as if he is looking at life through a pane of glass.⁴

      Part of what is missing for the anosmia sufferer is the safe place of childhood, which the rest of us can return to whenever we eat the foods we have always loved. A couple of years on from the accident, Marlena Spieler found that glimmers of her former responsiveness to flavour were returning. Depending on the level of damage to the brain, some anosmia sufferers do recover. Marlena slowly trained herself to love chocolate again, starting with the blandest milk chocolate and working onto 70 per cent cocoa solid dark chocolate. Occasionally, her morning coffee gave her pleasure rather than just blankness. We met for lunch at an Italian restaurant and she seemed well, exclaiming over the blood orange slices in our cocktails and nibbling on a deep-fried sage leaf. But even as her flavour perception was improving, she continued to feel unsettled, she said. It wasn’t just that food tasted bad. It was that, she told me, she no longer felt quite ‘like Marlena’. As she explained to the BBC Radio 4 Food Programme, our sense of taste is something that anchors us to the person we have always known ourselves to be: ‘Your world has a certain taste. Your mother makes something a certain way. You’re used to certain flavours in your life and if you take that away, you start saying who am I?’⁵

      Memory is the single most powerful driving force in how we learn to eat; it shapes all our yearnings. Sometimes the memories are very short-term ones – for instance, whether or not we’ve just eaten. In one study, when a profoundly amnesiac patient was offered another meal only minutes after he had completed the first, he willingly took it.⁶ Minutes after that one, he ate a third meal. Only when a fourth meal was offered did he refuse, telling the experimenters that his ‘stomach