Dr. Michael Pourfar, an assistant professor of neurosurgery and neurology at NYU Langone Health, was used to patients reporting a loss of taste and smell. It's a symptom of Parkinson's disease, a focus of his work. But he was shocked when he suddenly experienced these symptoms himself a few months ago. Like many health-care workers, Pourfar contracted COVID-19. Loss of olfactory senses is one of the most common symptoms of the illness.
An ardent wine lover, Pourfar vividly recalled that a bottle of Williams Selyem Pinot Noir was the last wine he experienced before coronavirus took away his olfactory senses. And while scarier virus symptoms such as fever, aches and chills went away with time, the lack of taste and smell lingered. During his convalescence, Pourfar realized just how important wine was to his daily sense of well-being as one of the most comforting rituals in his daily life and one of his most reliable pleasures.
I can sympathize with Pourfar's struggles: My own “normal” was upended when I contracted the virus in mid-March and suffered the same loss of sense of smell and taste. The senses are returning, albeit slowly, but they are altered and distorted—something that became especially clear to me when I tried to enjoy wine again. The following conversation with Dr. Pourfar was especially comforting because it reminded me that my walk to recovery isn't alone.
Wine Spectator: Could you give us a medical explanation as to how a virus could alter sense of smell?
Dr. Michael Pourfar: I don't think we have a full understanding yet of how specifically the virus causes anosmia [loss of sense of smell]. The nasal passages appear to be a common entry point for the virus and it's a pretty direct connection from there to the key neural connections that transmit smell to the brain. Early research suggests the virus may damage vascular support of the olfactory epithelium and bulb.
One of the first manifestations was a burning in my nose, as if it had been torched. A day later, my sense of smell was essentially wiped out. So I would postulate that the loss of smell occurs very much at the level of the nasal passages and disconnects the distal olfactory elements from the central connections in the brain, but I can't be certain. I would think the fact that it improves, in many cases, over days to weeks, would also point to a kind of local inflammatory response. But for some the loss is more long-lasting. So perhaps there is some variability in how the virus impacts olfactory function.
WS: Your sense of smell has been returning, little by little. Where is your sense of smell now? Have there been changes you believe may be long-lasting?
MP: I keep thinking my sense of smell is more or less completely back until something reminds me that that's not quite the case. Strange things like not tearing up when I cut an onion. I guess a sensory analogy many might relate to is thinking your eyesight is pretty good and then going to the optometrist and seeing something with a sharper lens and going, "Oh man, that's a lot clearer!" I think my nose could probably use one additional adjustment to get to full olfactory clarity. Maybe it will get there, maybe not. Still, I'm grateful I can once again determine when the milk is spoiled or the dinner is burning. The rest is luxury.
WS: Is it true that you can train yourself to regain these senses?
MP: I suspect my improvement was more a result of recovery than of any training, but I'd like to take some credit for moving things along with my concerted efforts at olfactory "training" (if I can ennoble sniffing with that term). I think psychologically it helped me feel like I was actively participating in my recovery.
WS: In an attempt to measure your rate of recovery you adopted the Cognac classification. V.S. meant a slight return of smell, V.S.O.P. a modest return and X.O. equaled back to normal. What gave you the idea to classify your recovery? And as a wine lover, why the choice of Cognac classification? (Mind you, this is a no-judgment zone.) You could have used wine classifications like Bordeaux or Italy ….
MP: Neurologists love rating scales and love to track progression. I think it's in our DNA. So it was hardly a stretch for me to come up with my own scale. Wine was initially just too elusive. It smelled like nothing. I happened upon [smelling] Cognac. It imparted a kind of vaporous nuttiness that somehow got through my dulled senses.
As I improved, I extended my curiosity to wine and it was interesting to see how patchy the results were. I wondered whether recovery was a threshold phenomenon (e.g., the smell simply had to be strong enough) or a more smell-specific phenomenon (e.g., certain scents would return faster than others).
Though I can't claim the results to be rigorously scientific, I concluded it was a little of both: Some distinctive aromas (like New Zealand Sauvignon Blanc) registered earlier than subtler ones. But some very particular scents, not necessarily strong, also registered earlier than others, like that "lead pencil" quality of Bordeaux wines. So yes, eventually I could have created a Bordeaux rating scale, but regularly opening fine Bordeaux for the sake of scientific curiosity seemed a dicey and expensive proposition.
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WS: Since your recovery, you've started appreciating wines you'd previously not normally gravitated to, like New Zealand Sauvignon Blancs and Zinfandel. Have you discovered any others? And which wine has been the greatest rediscovery, and why?
MP: I have a pretty adventurous palate and enjoy new discoveries. But I think when you lose something, you become acutely aware of the comforts of the familiar. I'm not really looking for the next great thing so much as the last great thing right now.
That's why it was so exciting to discover, after a couple months of enophilic no-man's land, that I could again appreciate that very particular lead-pencil fragrance of a Bordeaux. Like a lot of people of my generation, I started with and then moved away from Bordeaux. So in a way, it was my most welcome rediscovery.
In general it seemed, if I could borrow an analogy from another sense, that wines with more bass notes were easier to process than wines in a higher key. More acidic flavors overwhelmed my diminished sensory state. Gamay and Pinot Noir, two of my pre-COVID favorites, just smelled and tasted—to my chagrin—strangely off-key. Some wines that I found more appealing than before included fleshier wines from Ribera del Duero and Gigondas, which I always liked but found more in sync. I've returned now to some of my pre-COVID favorites but have a newfound appreciation—and gratitude—for the wines that accompanied my recovery.
WS: Is there a specific bottling that you tasted as you were recovering that has become a new favorite?
MP: I think one thing this has taught me is how fragile our love of wine is. So many of us have poured so much time, energy and money into this passion and have certainly been enriched by it well beyond what's in the glass. But I've seen how it can all be so quickly undermined by the loss of smell, the loss of health or any number of factors. All those special bottles I'd been saving … what exactly was I waiting for?
But then again, I'm struck by how resilient that love is even if we need to adapt to changed circumstances. Tastes change. In that light, what I've come to enjoy most is not a particular bottle but the pleasure of opening any bottle with a loved one, breathing it in and thinking, “Yes, thank you.”
WS: What advice would you give other COVID sufferers who are experiencing diminished taste and smell?
MP: I think it's important to acknowledge that people have lost much more than their sense of smell. They've lost their lives, their livelihood, loved ones. But that should not take away our ability to empathize with those who have experienced lesser losses, whether it's missing a graduation or losing one's sense of smell.
To those who have lost their sense of smell, I'd certainly convey my empathy and try to give them hope that in most cases it will return even if not to what it was before. Hopefully you will find little preserved islands of sensory pleasure that remain or emerge or maybe even awaken a new receptivity. I can certainly say that if and when it does return, wine will never taste the same. No matter what you're drinking … it will taste better.
WS: Finally, as a physician, how has this affected your own journey dealing with patients with COVID?
MP: My specialty is Parkinson's and, interestingly, loss of smell is often a very early manifestation, so for years I've been asking patients about it without really appreciating the significance on a person's quality of life. It seemed that there were always too many other issues that pushed it into the background—trouble walking, difficulties with speech.
Now I've come to understand how loss of smell and taste impact appetite, impact emotional well-being. We all instinctively know—without reading Proust or understanding neuroscience—how smell serves as a powerful gateway for memory and emotion. When that gateway is shut, even for a brief period of time, you realize what a devastating loss it is. It's certainly made me more sensitive to how integral smell and taste are to our sense of self.