Body learns to survive when conditions are dire

To the detectives who found her, the starving teenage girl looked like a concentration-camp survivor — skeletal, pale, stunted.

She learned to survive on half a Dixie cup of water per day. Her body clung to a scant caloric intake from a diet made up mostly of toast, according to charging papers.

While it's difficult to imagine how a child could survive under such conditions, medical experts say, think of the body as the ultimate energy conservationist. When food is scarce, all functions slow to a snail's pace.

It's survival on a cellular level.

"Your body is doing everything to preserve resources," said Carole Jenny, professor of pediatrics at Brown University and chairwoman of the American Academy of Pediatrics' committee on child abuse and neglect.

People who starve can experience a decrease in brain mass and bone density. The gut loses its ability to digest food. Victims suffer from anemia, fatigue and kidney stress. Thinking and reasoning are dramatically diminished.

All this "doesn't even begin to get at the emotional part," Jenny said.

When starvation happens to a prepubescent girl, for instance, it can siphon off hormones during a critical developmental stage, she said. Puberty and menstrual cycles stall, as does growth.

Developmental delays are also likely — but more so if the child is 2 years old or younger, when such critical structures as the brain are forming, said Sajjad Yacoob, chief medical information officer for Children's Hospital Los Angeles.

He's not involved in the care of the Carnation girl. But after hearing about her case, coupled with his own experience of seeing patients who have been in a similar situation, he believes she has a long road of recovery ahead of her.

"Her internal bodywork has to relearn how to handle all those calories," he said. "It's a remarkable thing, but our bodies adapt to these [traumatic] situations."

Authorities say the girl, who weighed 48 pounds when they found her, has gained more than 20 pounds since she was removed from the home two months ago.

Doctors also extracted six eroded and chipped teeth and capped the rest.

But mentally and emotionally, the damage can go deep.

Combine starvation, social isolation and depression. In such cases, a child's sense of trust is annihilated, said Debra Schilling Wolfe, executive director at the University of Pennsylvania's Field Center, which focuses on child-welfare reform.

"Being a 14-year-old girl is difficult under the best of circumstances," Wolfe said. "A lot of her [healing] depends on what happens with her from here on out."

Starvation affects brain patterns, which can cause behavioral problems and other emotional setbacks, Wolfe added.

Wolfe has seen the gamut of abuse in her line of work. And she's watched results go both ways. Sometimes, the kids are able to make it through, learn to trust, and lead productive lives.

And other times, not.

"It's not a clear, rosy path for this child because she has been, quote, rescued from this situation," Wolfe said. "Gaining weight and having her teeth capped is just the beginning ... but you always have hope."

Sonia Krishnan: 206-515-5546 or skrishnan@seattletimes.com