On New Year’s Eve, my mom made two meat pies—tourtière, she would want me to call them. They looked beautiful, but they didn’t taste right. To her, the flavors seemed blunted—ashy.
A few years ago, this would read like the setup for a COVID-19 story. But mom didn’t need a nasal swab. She knew what was eroding her sense of taste and smell: 24 hours earlier, she’d had her first chemotherapy treatment for an especially aggressive form of breast cancer.
Did you know chemo can damage your taste buds? That was news to me. Cancer is like an IRS audit, or the music of Ted Nugent—we all have some baseline awareness of it, but if we’re lucky, we never have to learn the particulars. Until mom was diagnosed, I thought cancer was cancer and chemo was chemo—both blunt instruments of destruction that one could wield on any part of the body. I didn’t understand why it mattered that the mass the radiologist found on her kidney wasn’t metastasized breast cancer but a different cancer altogether.
But breast cancer is not kidney cancer much in the way that a shallot is not a scallion. And the chemo drugs that treat the shallot might have no effect on the scallion at all.
What chemo drugs do seem to have in common is a puritanical penchant for vacuuming up joy. Roughly 75 percent of people who receive chemotherapy experience some change in their sense of taste, though the effects vary by person and by drug. Women, for example, are more likely to be tasteless than men *looks directly into camera.* Docetaxel, one of the drugs in mom’s cocktail, is a notorious taste-killer, responsible for some of the strongest and longest-lasting taste alterations of all the chemo drugs.1
While they’re busy destroying your taste buds, chemo drugs can also create tastes of their own. Many people receiving chemo via IV report tasting something metallic or bitter while the drugs are seeping into their bloodstreams. I experienced a mild version of this phenomenon a few years ago when I did a couple recreational IVs for a magazine assignment. Almost as soon as the dubious fluids began seeping into my arm, I tasted the unmistakable Fruit Metal of a Flintstones vitamin. Parts of our body are connected in unpredictable, unsettling ways. (This is true for the human organism, but also for human organization. We’re chained together in ways we often don’t understand, or particularly like.)
Mom is through her first round of chemotherapy, now, but her taste still hasn’t returned. I called her a couple weeks ago and asked her to run down the changes. Mostly, she said, things taste flatter, if they taste like anything at all. Desserts have been simplified into one ur-flavor: sweet. Spices and peppers have lost their complexity and become especially harsh and strong.
“Eating barbecue ribs would be like rubbing the roof of my mouth with hot sandpaper,” she said.
I asked her if other meats were any better.
“Rotisserie chicken tastes better than chicken breast,” she offered.
“Mom, I think that’s true generally.”
“I never tried tofu,” she said. “It probably still tastes like nothing.”
For mom, the things that taste the most like themselves are certain vegetables—broccoli, lettuce, pickled beets—and potatoes of any kind. When I go home to visit, now, grocery store potato salad is almost always in the fridge. It was never her favorite food, but it’s become an unlikely symbol of normalcy. If everything else has to change, at least potato salad tastes the same.
Can you see where this is going? Five points to anyone who darkly muttered “potato salad for one.” I set out to customize a potato salad for mom’s maimed taste buds, and I’ve emerged with the recipe linked in a separate post below. It’s a hybrid between a Japanese and American potato salad, which means the potatoes are mostly mashed but also overdressed.
While this potato salad has been designed for the tastebuds of exactly one chemotherapy patient, some of the principles are transferable. The big one is to not be precious about flavors. Even now, I can hear you fussbudgets clicking through to the recipe and clawing at your throats. “Do you really expect me to use YELLOW HOT DOG MUSTARD, like some kind of peasant concessionaire?” To that I say: Chemo is not the time for subtle, nuanced flavors. It is a time for blunt instruments wielded with precision.
I suspect people don’t talk much about chemo’s taste and smell changes—dysgeusia, dysosmia, anosmia, and all the other disgusting words for it—because it seems frivolous compared with the nausea, the fatigue, the sores, the hair loss. Taste, we’ve concluded, is a tertiary concern, of little interest to people who are working very hard not to die. This seems to me like poor accounting. We only have one head of hair. We have over a trillion different smells to lose.
But you see similar sentiments all over the place. When one’s life is on the line, the things that actually make it worth living—food, sex, laughter, videos of cats dancing to “party on u”—get treated like embarrassments, or worse, impossibilities. A playwriting professor of mine once spent a whole class lecturing on a (likely misattributed) Chekhov quote: “A man with a toothache cannot be in love.” I got periodontal surgery the summer my high school boyfriend dumped me, and I promise this is not true.
I’d rather hear a lecture on the slogan from the 1912 Lawrence Textile Strike: “Bread for all, and roses, too.” Subsistence has always been about more than just biology. We need the conditions for life and the conditions for joy.
I’ve been thinking more lately about what’s frivolous and what’s essential, and what we gain in drawing firm distinctions between the two. Over the past few months, I’ve watched so many friends and fellow artists hand-wringing and apologizing for doing lifestyle journalism or promoting a show they’ve been working on for years while people are suffering and dying. But suffering and dying are not the only things suffering and dying people do. They laugh. They read the paper. They play stupid little games on their stupid little phones. By and large, they don’t need our ghoulish sacrifices. We attend to suffering in so many ways, and very few of them are by staring at it without blinking.
Right now, my mom is at the Mayo Clinic for three weeks of radiation therapy. She’s staying with her sister, who just lost her husband to ALS in May. I don’t know the depths of the pain they’ve experienced. I do know that last night, they went to see an ABBA tribute band. It was 71 degrees in Minnesota, Mom said. It was a beautiful night.
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Chemotherapy isn’t the only cancer treatment with this effect. My friend Taylor, who was undergoing radiation while my mom was just starting chemo, had weeks where everything tasted like pennies.
“I had all these kind deliveries of soup and food because many of my friends use food as a love language, and I would just sit there, slurping pennies, frustrated that I couldn’t taste the effort I knew they’d put in,” she said. “It felt like an insult on top of everything else that I couldn’t even enjoy my food.”
You’re right. No one needs our ghoulish sacrifices. What a great way to express this illogical fear. I hope you and your mom are able to share all the love and laughter and potato salad.
Much love to both you and your mom. My dad had radiation, forehead and neck cancer, and the only thing that tasted good to him for years after was tomato soup. Losing these things of joy in our life sometimes doesn’t seem like the best bargain. Thank you for nuanced discussion of the yin and yang of suffering and happiness. They are never separate and they both need to be experienced.