The woman who smelled burnt toast

Doctor, I keep smelling things that aren't there." That is not usually how neurosurgical consultations begin.

- Dr MAZDA TUREL

Seizures, headaches, weakness, numbness-those are familiar openings. But smells? Imaginary ones? That belongs more to poetry than medicine.

"What kind of smells?" I asked. She thought for a moment. "Burnt toast," she said. "Sometimes cigarette smoke. Once... wet earth after rain." A pause. All my favourite fragrances, I thought to myself. "And once," she added quietly, "my grandmother's perfumed talc." That last one stayed with me. Anyone with a Parsi grandmother will instantly recognise the fragrance of Yardley London English Lavender Fragrant Beauty Talc.

She was a 34-year-old school teacher: articulate and funny. For nearly a year, she had been having strange episodes. A smell would suddenly appear out of nowhere-intense, vivid, undeniable. Then came a rising sensation in her stomach, like the slow climb of a roller coaster. And then, silence.

Not unconsciousness. Not convulsions. Just absence. For 30 or 40 seconds, she would stare blankly ahead while the world continued without her. Then she would return, slightly confused, profoundly embarrassed, and deeply frightened.

Her husband described it best. "It is like she leaves the room," he said, "without actually going anywhere." The brain, for all its sophistication, is a terrible fan of subtlety. When it malfunctions, it rarely does so politely. Sometimes it whispers through smells. Sometimes through memories or emotions that arrive without invitation. And buried deep within the folds of the brain lies a structure capable of all three.