In residency I had to memorize different smells that are associated with disease processes. For example, the smell of garlic smell could alarm me for organophosphates. Patient smells like almonds? Well, that patient has cyanide poisoning, or they just ate almonds. The smell of cannibis might trigger you to be careful because those hippies often are covered in lice.
However, as often is the case, things happen more in theory than in actuality.
When I was young, I avidly played video games. Most kids craved candy, I wanted video games. I would get up early so I could play video games before school. Also, since at that time you could only pause games, I would leave the game running during school since I did not want those fifteen minutes of progress to go wasted. Seriously, if you had just gotten the special tires for your car after playing non-stop for hours in Blaster Master, you’d understand.
In roughly half of the games I played, the same obstacle would appear. Quicksand. Always quicksand. I assumed with how often I had to deal with it, the stuff would be everywhere as an adult. I thought I would be having many awkward conversations later in life.
Me: “Hey, I noticed that Bill hasn’t shown up for work for the last few days, what happened?”
Co-worker: “Oh, didn’t you hear, Bill had a tragic quicksand accident.”
Me: “What? That’s the tenth this month. Probably should have stuck to jumping over the scorpion pit instead.”
As it turned out, quicksand has not been that difficult of a problem. Similarly, obscure smells have not been much of a problem either. I am yet to apply my wide variety of ER smell knowledge.
The smell knowledge I use most frequently has been much less subtle. GI Bleeds, beer, and unwashed feet seem to be the top three smells I experience. Some of my colleges can diagnose DKA, by my smell-bility is not that refined. The blast of a patient with C. diff can knock you on your butt, but that is like saying you can identify a skunk by its smell.