by DR JOHN MORRISSEY at the Catholic Herald
Smell memory is very persistent. We can all perhaps remember the smell of our childhood comfort blanket, our mother’s perfume on the saliva moistened hankie that dabbed our chops, the incense at church.
And for doctors like me, smell memory can even save lives.
A few years ago, I was urgently summoned to the “resus” room in A&E at about 6am. (I refer to ITU doctors as “resus monkeys”.) There, a number of junior medics, nurses and I found a puzzling sight. On the ambulance trolley lay an extremely sick two-year-old-boy. His skin was a peculiar chocolatey-purple colour. He was comatose, gasping for breath, and his heart rate was 200 beats per minute – the maximum. His blood pressure was unrecordable. None of us knew what on earth was going on.
His parents stood in the corner of the room looking terrified, but also a bit sheepish. Then the smell hit me. It was the unmistakeable sickly sweet odour of amyl nitrite. This is a medical drug originally used to treat angina and more recently to treat cyanide poisoning. It also is used as a legal high, known as “poppers”.
The child’s clothing reeked of it and so did his breath. I ordered his clothes to be removed and double-bagged for our own safety, and for his body to be washed clean. Amyl nitrite can be absorbed through the skin as well as by inhalation.
I took a sample of blood from the artery in his groin and sent it off for urgent blood gas analysis. I then gave a paralysing drug and passed a tube into his windpipe and ventilated his lungs with 100% oxygen. He remained comatose and critically ill. We might have been too late.
The blood gas result came back: more than 95 per cent of his red blood cell haemoglobin was poisoned by the amyl nitrite and therefore unable to carry oxygen. His blood was racing around his body but failing to deliver life-giving O2. This child was about to die. There was no time to phone a poisons helpline. What could I do?