The Nose Is For Eating Too
Volume 3 | Issue 6 [October 2023]

Gita Viswanath

Volume 3 | Issue 6 [October 2023]

As if mother’s bedridden condition was not traumatic enough, the doctor advised us to go in for nasal feeding. As the primary caregiver, my first reaction was revulsion. For one who has lived with rhinitis for the most part of her life, I have always viewed the nose as an annoying organ that produces snot; viscous, yellow-green, obnoxious-looking; something that should be discreetly blown into a tissue and cast away. Taught by mother the decorum of blowing the nose, I realized later in life that the way it is done is also an indicator of class and upbringing. The nose, or rather its shape, is often the main marker of good looks, particularly in the Indian subcontinent. Neither too short, nor too long, neither bulbous nor pointed, these are some of the rather strict criteria while assessing the looks of a person, especially that of women. My bulbous nose has often been the target of ridicule. To cut a long story short, the nose has never been for me anything apart from a site of disgust and discomfort. Given such a backdrop, it became a challenge to overcome repugnance and be able to feed mother who was discharged from the hospital with a polyvinyl chloride tube hanging out of her nose. How could that thing called food, which we all love, cherish and look forward to pass through the nose even if it is through a tube, I wondered. Anyway, I resorted to the wisdom of proverbs and remembered, ‘what cannot be cured has to be endured.’

Artwork – Gita Viswanath

One of the first questions I raised was, ‘Doctor, is this tube going to be permanent?’ His reply shattered me. With touch, taste may be considered as one of the most pleasurable senses; to deny that through nasal feeding seemed like sacrilege. How is mother ever going to enjoy her favourite pachchadis, her chutneys from Andhra Pradesh and Karnataka? So versatile is the pachchadi that it can be made even with ridge gourd peels. Now every two hours a protein shake would pass through a funnel fitted at the end of the tube to sustain and strengthen mother. Gradually, the joy of seeing her coming into consciousness reduced my aversion.

I turned my thoughts to the nose as an alternative route to the stomach and ultimately to sustenance. The history of enteral feeding, that is, non-oral, dates back 3,500 years to Greece and Egypt. Hippocrates was known to have passed nutrients in the form of beef broth and whipped egg whites through a catheter in the rectum. At least in the case of nasal feeding, we use an organ from the same neighbourhood as the mouth. Rectal feeding is literally from the other end, considered across cultures as a filthy, smelly, unspeakable part of the body. The twentieth president of the United States of America, James Garfield is perhaps the best-known recipient of this treatment. He was infused with beef broth and whiskey every four hours for nearly eighty days after a gunshot wound that he sustained in an attempted assassination in 1881. This practice was followed right up to 1940, with infusion of tobacco, meat mixed with wax and starch, brandy and red wine. Today, the most common form of enteral feeding is nasal feeding. The NGT (nasogastric tube), also known as Ryles Tube after John Alfred Ryle who modified the tube from the eighteenth-century brass-tipped tube, is the one used till date.

Artwork – Gita Viswanath

Even if food is a total sensory experience that includes all five senses, taste is still associated with the tongue. Its ultimate certification as good, bad, delicious, bland, and so on comes from the tongue. It’s not uncommon to dislike good-looking food because it was too sour, or aromatic food because it was too salty. Of all the five senses, taste is a sense that comes into being only within our bodies. It is not external to the body the way the other senses are. For instance, we see a landscape and call it beautiful, we hear a piece of music and call it melodious, we touch a silk saree and call it soft. But we cannot see food and call it tasty. We have to necessarily put it into our mouth to be able to say so. What then does this fact tell us about the sense of taste? The interiority of taste perhaps is also the reason why taste is highly subjective. For instance, the routine dal chawal tastes good when we are hungry. Taste is also related to the nutritional needs of individual bodies. How else can one explain a calcium-deficient child’s penchant for eating chalk? This is to say that the question of taste goes beyond the scientific theory of taste receptors, papillae, and buds.

One day, out of the blue, when mother’s cognitive abilities improved, she asked for chaaranam, rasam rice. I was just short of dancing with joy. A staple in South Indian cuisine that crosses the borders of all southern states, the chaaru/rasam/saaru is a thin tamarind-based soup-like dish prepared with tuar dal (pigeon peas), tomatoes and a powder (there are as many variations as there are rasam makers!) of roasted coriander seeds, cumin seeds, red chillies, and black pepper. Its divine aroma comes from the seasoning of mustard seeds, asafoetida, and curry leaves in hot ghee. Several variations of rasam exist: rasam without dal known in the Telugu-speaking parts of Karnataka as chinchaaru, tomato rasam, lemon rasam, garlic rasam, kokum saaru and even buttermilk rasam. Heated debates and threats of divisions within families can occur when this benign, health-restoring liquid becomes the topic of discussion. The Mysore rasam is condemned for its use of coconut and all those who prepare this variety are damned as incompetent rasam makers. The brahmins turn their noses at the thought of garlic in rasam and the purists resist the experimental variations such as pineapple rasam or drumstick rasam.

With this monster of a gustatory baggage that the rasam seemed to carry, I ventured into making the perfect rasam to be fed through the nose. Happy that mother was at least craving for something, I pureed the rasam rice in a mixer and put it into the NG tube. Surely Ryles must be turning in his grave, I thought! I was stunned for a moment when she called it tasty. Quickly I realised, the aroma of food enhances taste; so, she was probably confusing aroma for taste. Still, how could she call it taste? She could have said, ‘It smells good.’ Taste is activated only when food comes in contact with the taste buds on the surface of our tongue through taste receptors that are found on the upper surface of the tongue, oesophagus, cheek, and the epiglottis. The taste buds have receptors that recognise five basic tastes – sweet, salty, sour, bitter, and umami; the last being the taste from glutamates as found in meat, cheese, soya sauce etc. Interestingly, spicy is not a taste, rather it is a nervous reaction to capsaicin, the substance found in chillies and pepper.

So, how could mother taste the chaaranam? I began to tease her, ‘Did the smell of the rasam tickle your nostril hair?’ She smiled. What happens to language when we eat with our nose? It is common to teach toddlers the different parts of the body by pointing them out. The next exercise is usually, teaching them the functions. ‘What do we do with our eyes?’ We ask a child and get the reply, ‘We see with our eyes.’ The tutoring thus repeats with different parts.  If a child answers, ‘eat,’ to the question what do we do with our nose, we call it wrong. I would have done that too some months ago. But the child is not off the mark. There does exist a form of eating from the nose as we have just noted, a form I was to become all too familiar with ever since mother took to the bed after a diagnosis of congestive heart failure. Further, what happens to words such as mouthwatering? Would we say nose-watering, although this could also mean the food is too hot. Would tongue on fire be nose on fire? If you had an uneasy feeling about somebody, would you say, he left a bad taste in my nose? How would you describe the tenderest meat you’ve ever eaten? Wow, that melted in my nose? The mouth, with the tongue within, has a hegemony over taste as is clearly reflected in language.

Was mother recalling the taste of rasam from the nadir of her consciousness? Can the brain store memories of taste? We all have experienced recalling the beauty of a place visually and reliving it. But can we recall taste? If there are centres for sight and hearing in the brain, is there a taste centre too? For long, it was known that the taste buds activate the brain but the specific centres that registered different senses were yet to be identified. The use of functional magnetic resonance imaging has helped researchers discover the taste centre in the human brain. Adam Anderson, a professor in Cornell University says, ‘While we have long known the cortical areas for our external senses, we now have strong evidence for human gustatory cortex.’¹ However, this is still within the realm of taste as sensed by the tongue. My doubts remained unsolved: What happens when the tongue is bypassed as in the case of nasal feeding? Does the brain still get messages about sweet, sour, bitter, salty food?

Mother perhaps no longer experienced taste in the narrow sense that it is mostly understood. I think taste for her became larger than the mere mechanics of the human anatomy. To her, rasam was a mandatory part of her daily meals since childhood; rasam was what she mixed in rice and put into my infantile mouth in the form of soft balls saying, this is for father, this is for mother, this is for the bird, the dog, the cow and so on; rasam rice was that which was sandwiched between sambhar rice and curd rice in the strict order in which food is served in South Indian homes; rasam was that which went into a specific vessel placed on the second shelf on the right side of her kitchen platform; rasam was that which she prepared with a mind-numbing consistency…. I believe it was all of this and more that her brain had stored which aided the recall of taste even when it went through her nose. In her semi-conscious state, mother taught me to relinquish conventional ideas of taste and to open up its innumerable possibilities for a broader understanding of the processes involved in tasting, relishing and, most importantly, remembering food.

Defying the doctor’s predictions, mother recovered sufficiently enough to get rid of the NG tube. Alas! She insists she cannot taste anything now!

1 Anderson, Adam: “Distinct Representations of Basic Taste Qualities in the Human Gustatory Cortex,” in Stephen D’Angelo. “The sweet spot: research locates taste center in brain.” https://news.cornell.edu/stories/2019/03/sweet-spot-research-locates-taste-center-brain