Smell

The ‘hospital smell’ is one of the most famous sensory aspects of the hospital. It has its own relatively well-documented history, associated largely with the rise of disinfectants. Although the primary goal of these disinfectants has been to eliminate germs, there is also a relatively widespread perception that the goal of ‘hospital smell’ has – ironically – been to eliminate unpleasant and unhealthy odours. This cultural belief builds on a longer history of ideas about the health effects of smells, both good (aromatherapy) and bad (miasma).

The question ‘what is hospital smell?’ has various potential answers. One blogger recently answered this through a chemical breakdown of these smells, making it easy to identify exactly what causes the famous odour. There is certainly value in this approach; combined with hospital records, chemistry allows us to understand and even to recreate exactly how the smell of hospitals has changed over time. Another answer to this question might be more cultural, and would think more about what this smell represents rather than what it is in chemical terms. Is any smell innately ‘good’ or ‘bad’, or does this come with association? Smell has always had social and class connotations: ways of describing the smell of other people is particularly revealing in this regard, and also an important part of hospital sensescapes.

Studies suggest that the nose can sense ten basic smells. These are the nasal equivalent of tastes such as sweet and savoury, and include ‘floral’ and ‘citrus’. ‘Chemical’ is one of the ten, and it would perhaps be simple to write a history of the rise of the chemical scent in hospitals. However, the story is not so straightforward or linear. Some hospitals have sought to mask such chemical scents and succeeded in removing aroma to a significant degree. Other have included other, preferred, aromas by distributing them through ward airflow systems or by placing plants in waiting rooms. Some recent studies have sought an evidence base for the link between smell and anxiety in healthcare settings, for example the work of Lehrner et al. on the positive impact of the scent of orange essential oils in dental offices. These aesthetic efforts bring us to some of the same questions posed in relation to the visual: would any smell be better than disinfectant, or is there something significant about the smell of nature? The answer might be that the smells of nature are simply more pleasant to the human nose, but there is undoubtedly a cultural aspect to this question.

Another interesting point for consideration is raised in the work of Anette Stenslund. Her study of perceptions of hospital smell indicates that we should not take memories or narratives at face value. Stenslund notes her surprise at the extent of memories of ‘hospital smell’, but the apparent lack of perception of the smell when speaking to patients ‘in situ’ in the hospital. This finding raises a range of further important questions about senses and hospital. It draws attention to the importance and significance of sensory absence, as a perception and a marker of patient’s preoccupations as well as of their physiological ‘reality’. It also highlights how experience and time can shape sensory memory. These questions have great value in themselves, in indicating that the ‘hospital smell’ is as much a symbolic construction as an embodied experience. Finding points of misalignment between the ‘objective’ chemical smell, the experience of that smell, and the memory thereof may be a productive methodology for historians.

To write a sensory history of smell in hospitals, we cannot simply write of deodorisation or of the rise of chemical scents: we need to understand why and when smells have been perceived and experienced as ‘loud’ or ‘quiet’; we need a critical, cultural history of why specific smells have been conceptualised – and experienced – as good/bad and healthy/unhealthy; and we need to consider what smells have meant in different spaces and for different people over time.

Victoria Bates.

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