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A battle over a life, so fraught with irony


© St. Petersburg Times, published May 3, 2001

Behind the story of the fight over whether Terri Schiavo should live is another story.

Behind the story of the fight over whether Terri Schiavo should live is another story.

This one is about how she came to exist in this terrible twilight, not fully dead but not really alive.

Terri Schiavo apparently had an eating disorder.

Even some of her family members have said they think so.

Eleven years ago, when she was 26, Schiavo collapsed with the disease of the middle aged, the old, the overweight.

The St. Petersburg woman had a heart attack when her body ran low on potassium, the chemical needed to make the muscles work. No muscle matters more than the heart. This is the way women with eating disorders usually go. Whatever the cause, they die at rates 12 times higher than women who eat normally.

Potassium is why sweaty athletes guzzle Gatorade. It contains potassium. You also find it in bananas, potatoes, oranges. They are ordinary foods, to ordinary eaters. But women who suffer from anorexia -- who starve themselves -- or from bulimia -- who vomit what they eat -- regard even a Ritz cracker as a threat.

Family members have said Terri Schiavo put herself on a liquid diet in high school because she was overweight and dateless. She was a size 12 when she married three years later, but that wasn't enough. She kept dieting so she could finally wear a bikini at the beach. She lived afraid of what all dieters fear, that the pounds will return.

Schiavo had other red flags signaling the possibility of an eating disorder, said Susan Mullins, who counsels women with eating disorders at Tampa's Hyde Park Counseling Center.

Schiavo suffered abdominal pains before the heart attack. They occur when you throw up a lot or your stomach, so used to no food, finally gets some.

Her period was intermittent. If you don't eat enough, your body doesn't produce what's necessary to create the uterine lining that is shed every month in menstruation.

And if you don't have a uterine lining, there's no place for a fertilized egg to attach itself. Terri Schiavo wanted to get pregnant, but couldn't.

Schiavo's family didn't see her problem before her heart attack. Her husband has insisted he saw nothing wrong at all. That's also common.

"We've had women in treatment who were married for 15 years, and their spouses have not known," said Mullins. "There's a lot of hiding, a lot of secrecy, shame, embarrassment associated with eating disorders."

Not even Schiavo's doctors knew her problem. This is also typical. They don't know what to look for.

"Medical ignorance is pretty widespread," said Robin Piper, who runs the Turning Point of Tampa, another clinic that treats women with eating disorders.

Eating disorders are another stop in that crazy house of distorted perceptions called addiction. Women can't stop using food to hurt themselves the way drunks and junkies can't stop using liquor or crack to hurt themselves. Yet this thing that has a woman out of control is, to her, about being in control.

"If I can't control what happens to me or my family, I can control what I eat. You can't make me eat," Piper said.

We live in a culture where zero is a dress size and a status symbol. That's why I tell you all this. It might save a life. The appeals may go from the Pinellas circuit courts to the U.S. Supreme Court again, but it's almost certainly too late for Terri Schiavo.

Her parents and the growing circle of strangers around the country who call themselves her advocates say they are fighting for what Terri Schiavo would want. They are so sure they know. But if you understand that she had an eating disorder, what she would want is a disturbing, tantalizing question.

Said Robin Piper: "She spent all her life fighting whether to eat, and now people are fighting over whether to feed her or not. What would she think if she knew?"

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