Comment by vanc_cefepime | Hacker News Reader

Comment by vanc_cefepime | Hacker News Reader

In primary care, I used to smell sinus infections/strep as a patient walked in the room for their “sick visit” and felt confident enough to diagnose without swabbing but I still swabbed anyway to avoid antibiotics for viral infections. I’ve long left primary care for hospital and concierge medicine so now c diff stool and melena get me usually.

There was this one time in residency I had a tiny older lady from a very rural town come in with a festering breast wound. One breast was normal sized and the other was 4x size of the normal one. Almost the size of a medium watermelon. Turns out it was necrotizing breast cancer and severe cellulitis. She didn’t recall much about why it took her this long to seek help. Her kids pleaded her to get it checked out but she had a deep mistrust of healthcare workers it wasn’t until the smell was unbearable for her family that they brought her in. The whole ED smelled of rotten infected flesh and no amount of winter fresh and peppermint oil was able to help the smell. That was about 10 years ago and I still remember that day and smell.

As a paramedic, have dealt with the same thing, patients with obvious severe infections (TMI for people with sensitive stomachs - the worst being an older lady who spent her days in a recliner, and had 'bed' sores on her legs as a result, couldn't get up because of the pain, so had defecated herself, which had melted due to body heat and run down her legs into the bed sores) but was still resistant to going to hospital. Irony was, she was a founding part of our fire department many many years ago. "Ma'am, if you don't come with us, the next time we'll be here is quite possibly because you'll die right in this recliner".

She didn't come with us that night, so we cleaned her up, as best we could, and came back the next morning after having done some outreach (our department had a pastor who knew her and was also a PA and responder), and were able to convince her to go.

I'll never forget that smell.

You can do things like putting icy-hot or ben gay ointment on your upper lip. Unpleasant sensation and smell, and doesn't fully work, but ... it helps.

My cat threw up three times in just over 24 hours. I was not best pleased.

So, thank you,. I now have a needed dose of perspective.

Do you still have this knack of smell or did it develop into something else? I spent a lot of time in the hospital growing up because of my brothers being admitted and stuff so I used to people watch often and got pretty good at just being able to see someone and guesstimate what they have/needed to be treated for.

He probably learned it. When I worked at one, I used to be able to smell what power a nuclear reactor had been operating at.

{{asking nicely}} do you credit this for something else that’s developed in your life? Just wondering if things like these help us do something else..{{not so serious}}

No, not at all. I mean, I could think of reasons why I could smell it, but any application of it is probably noticing that stuff is about to catch on fire in an industrial setting..

I teach engineering undergrad now.

There are just distinct smells you start to pick up on as you treat a variety of illnesses. There is no superpower to it. Scents tend to form a long memory, so if you catch a good whiff of a suppurative exudate you'll never forget it. For many of us we probably pick up on some VOCs emitted by various bacteria and it can give us the strong intuition the poster above describes.

Yes, kinda assumed that a bit, since illness do give out a certain smell,,was just wondering what else blossomed from that. Maybe the only superpower is having awareness,,

Still got the knack of smell from years of seeing/smelling it in med school and residency. I don’t think it developed into anything else. It’s just repetition I suppose. Now a days, when people go see a provider for “sore throat” they automatically get a throat swab and wouldn’t be surprised if the provider doesn’t even look in your mouth. Pre-covid, I was always looking into people mouths and rarely wore a mask unless it was proven flu or RSV and I think that’s where I was able to hone my smelling skill. Now things like c diff and blood in stool doesn’t require any skill. You smell it once and you know.

Edit: sorry for delayed response. I hope this answers your question.

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