Spence’s choice not to eat worries medical experts
When the body is malnourished for long enough, it starts to go after major organs for fuel
Some depression. Bizarre dreams. Abdominal cramps and sporadic swelling in the legs.
Doctors who work every day with people who starve their bodies say Attawapiskat Chief Theresa Spence could be experiencing symptoms such as these as she enters Day 32 of a liquid diet Friday.
What she isn’t doing is a traditional hunger strike, they say.
It is not known just how many calories Spence is ingesting, subsisting on fish broth and medicinal teas (a true hunger-striker drinks only water). But when the human body is malnourished long enough and fat stores are depleted entirely, it begins to go after the major organs for fuel.
“What you die from in complete starvation is catastrophic multiorgan failure,” says Dr. Blake Woodside, medical director of the program for eating disorders at Toronto General Hospital. People become so protein depleted, “your organs start to shut down — usually liver, kidneys and then heart.”
Woodside and other physicians say it’s impossible to predict how long Spence could survive on her reported diet. Woodside said most existing data come from “gruesome things” such as the starvation deaths of Bobby Sands and nine other Irish republican prisoners in 1981. Sands, who took only water and salt, lasted 66 days.
By contrast, when people reduce their caloric intake, their body compensates by slowing its metabolic rate. Since Spence is walking and talking, Woodside suspects Spence is getting more than a few hundred calories a day from the broth; otherwise by now she would be bedridden and not moving, he said.
Others say Spence may be ingesting as few as 50 calories a day. “We call that fasting,” says Dr. Laird Birmingham, a professor of psychiatry at the University of British Columbia and medical director of the Woodstone Residence for the treatment of eating disorders on Galiano Island.
“There’s no way that what she’s eating is adequate to be healthy.”
Generally people can survive between 40 and 50 days on water alone; people who refuse water usually die within five to seven days.
Prolonged and severe calorie restriction can also lead to serious complications.
Psychologically, Spence could be feeling disassociated, “a little separate from things,” Birmingham said. “She could be getting palpitations, she could be fainting.”
If the liquid diet continues, “she’ll feel more and more fatigued, she’ll become confused” as the weeks progress, he added. She could experience problems with her memory and judgment. Her kidneys could stop functionally normally.
Liberal MP Carolyn Bennett visited Spence this week in her teepee on Victoria Island. “I was more worried Monday because she was lying down. She was having some trouble with her stomach,” Bennett said.
But on Tuesday “she seemed very good,” Bennett, a doctor, said. By Wednesday, “she was sitting the whole time, but you could see the resolve. … You worry that people’s eyes lose their sparkle or that they lose their brightness and she’s pretty impressive, to still look that strong, and with such determination, this many days without solid food.”
If Spence is consuming 800 or 1,000 calories a day in fish broth, “her body will slow itself down,” Woodside said.
“She’ll get cooler; her heart rate will slow down. She won’t feel like moving around much and that will reduce her caloric needs for the day.” Her body will shed excess muscle as it essentially chews up muscle for energy, “and that will lengthen out the period she can survive on whatever caloric intake she’s taking.”
Jean Sock, a 57-year-old aboriginal, has been subsisting on water and broth since he travelled from New Brunswick to join Spence 23 days ago.
He says his waist size has dropped from 42 inches to 34 inches, and that he feels dizzy all the time. He’s spending most of his time lying down in a tent, drinking water and the occasional sip of broth.
“I feel weak, hungry. … There are a lot of emotions going through me all the time,” he said Thursday. “It’s a hard thing.”
A third person, Raymond Robinson, an elder from Cross Lake, Man., started fasting soon after Spence, and travelled to Ottawa on Dec. 31 to join her in person.