Do doctors really use their sense of smell to pinpoint diseases?
Verghese: Absolutely, but perhaps not as much as we used to. There are distinctive odors of liver failure, kidney failure, upper gastrointestinal bleeding resulting in melena, or the diarrhea caused by Clostridium difficile. But physicians of old described a litany of odors, some of which seem pretty incredible—the freshly-baked-bread odor of typhoid fever, the freshly-plucked-chicken-feathers odor of rubella and so on. I do think in this era of dependence on technology, we don’t seem to trust our senses. I joke that if you are missing a finger, no one will believe you until they have an X-ray, bone scan and MRI for good measure 4. Are there any lessons about being a doctor that readers might take from the book? Verghese: It is about the danger of losing yourself in the profession and not keeping a handle on your personal life or, as Yeats said, balancing “perfection of the life, with perfection of the work.” Many of us come to medicine because we are wounded in some way. In my novel,
