The price of being alive

What is the price we pay for being alive? Death is the ultimate price we pay at life’s checkout counter. But even before we exit, we also pay in installments — in denominations of pain. Pain can be physical or emotional and when there’s a sale, it can be both — you can buy one and also take one, all packed in one big breakdown. But for this week’s column, I found out something rare and interesting about physical pain. Did you know that there are people born without the ability to sense pain? What is different in their biological make-up? Scientists found out and were also surprised to find something else missing in these pain-free individuals.

Three people who were born without the ability to feel pain were examined by scientists to find out how this happens. The scientists found out why but also were a bit shocked to find out what else was missing in these individuals. They found out that these people who did not feel pain even after multiple broken bones and with two of them having given birth, also could not smell. This inability smell is called anosmia. The scientists were Jan Weiss, Martina Pyrski, Eric Jacobi, Bernd Bufe, Vivienne Willnecker, Bernhard Schick, Philippe Zizzari, Samuel J. Gossage, Charles A. Greer, Trese Leinders-Zufall, C. Geoffrey Woods, John N. Wood, Frank Zufall and the results of their study is detailed in the journal Nature last March 23 entitled “Loss-of-function mutations in sodium channel Nav1.7.”

The scientists have known for a while before the study what gene codes for a certain protein that sets of the process that makes us feel pain. In fact, this is the process that painkiller drugs target. There is a gene called SCN9A that produces a protein called Nav1.7. This protein is called a sodium channel because it allows sodium to pass through our nerve cells when something is causing us pain. When sodium floods our nerve cells, they send an electrical signal to our brains recognizing it to be pain. For the subjects who were born without this ability to feel pain, this protein was missing. There was some mutation in their genes that curbed the making of the sodium channel. Without sodium channels, messages of pain do not have a highway to pass through to go to the brain. Sounds ideal to be pain-free but there is a catch. It also turns out these sodium channels are also necessary in recognizing smells. These channels control the release of a neurotransmitter called glutamate which sets of the electrical charges that the brain needs to smell something. In other words, without sodium channels, you lose both the ability to feel pain and to smell. The subjects were asked to smell balsamic vinegar, coffee, mint, orange and perfume in suffusing strengths to normal people but the “pain-free” subjects were not able to smell anything.

The inability to feel pain may seem wonderful but it could put you at greater risk because unless you feel pain, you will not be alerted that something is wrong and needs attention, particularly medical care. I also wonder about emotional pain because studies on the brain have proven that the brain parts activated by physical pain also get frenzied by emotional pain. So is the ability to sense emotional pain somehow also compromised by this missing sodium channel? Not being able to smell things may also add to your risks since sensing odor is one way to recognize danger. But the scientists noted that the subjects had normal hearing, vision and tactile abilities. They are now thinking about testing their sense of taste since flavor is 75 percent smell and they suspect that this would be affected.

I have seen a show that featured someone who lost his sense of smell and because of it, he contemplated suicide. When asked why when it seemed so harmless to lose his sense of smell, he replied: “I performed drudgery all my life. But I get up every morning all these years awakened by the smell of breakfast that my loving wife cooks for me. That is the only thing that I wake up for. Now it is gone.”

In Alzheimer patients, the sense of smell is one of the first to go. The link seems to make sense as studies have shown that the sense of smell evokes memories deeper than the sense of touch, taste, sight or hearing. I myself have also encountered Alzheimer patients who to my untrained eye seem to have every cause to feel pain, yet do not seem to be feeling any.

It seems that the price we pay for being alive is not just in the form of searing experiences of pleasure and pain, but also when we find that some of the sensory pockets that are filled in other people, are empty in ours. Life is indeed an extravagant affair.

* * *

For comments, e-mail [email protected]