Surviving the Extremes: A Doctor's Journey to the Limits of Human Endurance (18 page)

False impressions can be as convincing as real ones. Enclosed in a protective skull, the brain cannot see, hear, smell, taste, or feel. Just as a military commander inside a bunker must rely on reports from his soldiers in the field, the brain depends on incoming electrical and chemical signals to piece together a picture of what’s going on outside. If the information received is false, the picture will be false. The only way to know that, though, is for the commander, or brain, to apply logic and deduce that the picture painted by the information is impossible.

The battle to survive requires your brain to continually interpret incoming signals for danger or opportunity. Your brain remains sensitive even while you sleep, albeit at reduced vigilance. It is designed for constant activity. If the level of outside stimulation falls too low, it will pick up and intensify signals from within, or even make them up. A phenomenon called “phantom limb pain” sometimes occurs after an amputation when the brain, faced with a sudden complete loss of incoming signals from the lost body part, begins to generate the same signals as if the part were still there. I once treated a bass player after a drunken patron at a New York jazz club took exception to his music and shot his hand off. The musician said that for months afterward, whenever he heard a bass being well played, he felt his missing hand “come alive with pain.”

If the brain doesn’t get enough excitement, it will create its own. A lot of electrochemistry is generated by emotion and memory. The signals they send are powerful and highly organized. The visual cortex, the area of the brain that monitors input from the eyes, will light up on a brain scan almost identically in a person who is imagining a scene as in a person who is actually seeing it. Usually the false image is less intense because it’s mixed with outside signals the brain is receiving at the same time, but if those signals are absent, there’s no competition, and emotion and memory have free reign to conjure up any image they want. In the case of Norman Baker, mindlessly splicing rope under a hot sun on a long voyage with an all-male crew, it’s easy to
understand why he saw a pretty waitress offering him a drink. His hallucination was all the more vivid because he wanted so much to believe it. It was only by using his highest capacities of reasoning and discipline that he was able to overpower the intense signal and make the image disappear—to his great disappointment.

Norman Baker set himself adrift intentionally, and so did Frenchman Alain Bombard, a voluntary castaway who in 1951 crossed the Atlantic in a rubber raft without supplies of food or water. He set out from the Canary Islands and drank nothing but seawater during his first seven days adrift. Once he began catching fish, he ate and drank them, alternating the fluid he extracted with small amounts of seawater. He landed in Barbados sixty-five days later, proving dramatically that man could live off the sea indefinitely.

Nonetheless, Bombard had help. Besides the simple fishing gear that most life rafts carry, he had books and musical scores, the morale value of which would be hard to calculate. He brought other possessions too: a comprehensive knowledge of sea life and the confidence that it could and would sustain him. And he had one additional asset that castaways rarely have: the resolve of someone who has chosen his course voluntarily and has something to prove to the world.

Unlike Bombard or Baker, most people who find themselves adrift at sea have no prior intention of starting an adventure. Someone who sets off in a life raft with the determination to cross the Atlantic—and read some good books—enters the ocean with a very different mindset than someone expecting a 20-mile island-hopping ferry ride in the Seychelles—an archipelago in the Indian Ocean 1,000 miles off the coast of Africa. The ferry was the
Mary-Jeanne,
an old scow powered by a car engine that, shortly after it set off, got stuck in low gear, consuming a lot of fuel and making very little headway. The boat ran out of gas in sight of the destination. The crew dropped anchor and waited for help. That night there was a storm, the anchor chain broke, and the boat drifted out to sea. The ten passengers and crew, mentally prepared only for a two-hour boat ride, faced what would become a seventy-four-day ordeal.

Expecting an early rescue, they quickly used up their meager supplies of food and water, then passively waited thirteen days before trying to catch a fish. After one attempt with a bent wire and one attempt with a makeshift harpoon, they gave up. Periodic rain quenched their thirst, but they were dying of hunger.

Hungry
means that not enough fuel is being distributed by the blood. Blood transports fuel in the form of a sugar called glucose, a simple carbohydrate that enters cells easily and burns quickly (this is why eating sugar gives you a quick burst of energy). Blood resupplies its load of glucose constantly by tapping into the liver and muscles for their stores of glycogen, a slightly more complex carbohydrate readily converted to glucose as needed. Glycogen reserves are normally maintained at about a three-day inventory, with regular restocking from outside sources through a process called eating. When food delivery stops and carbohydrate supplies start running low, the blood goes back to its main warehouse—fat cells. Fat does not burn as cleanly as carbohydrates. It leaves behind a residue of acetone, excreted in urine and exhaled in breath, making starving people smell like nail polish remover.

With the steady mobilization of fats in tandem with carbohydrates, and no incoming food to replace the dwindling fuel supply, the body takes steps to decrease the rate of power consumption. It turns down its idling speed, or basal metabolic rate, and shuts down nonessential functions. The result is like a brownout. There is a slowing down of reaction time, decreased production of standby cells that repair wounds and fight infections, and diminished formation of “superfluous” chemicals such as sex hormones, since reproduction is not exactly a priority during starvation. This conservation of energy takes place within about two weeks, which explains why dieters often find it increasingly difficult to lose weight after a promising start.

The continuing energy crisis leads to the exploration and development of alternate energy sources. The body has vast reserves of protein, which comprises over one-third of body weight, though none of it is stored as fuel. Proteins provide structure and function to every system of the body, including muscles, bones, liver, and kidneys. They
can be burned as fuel, yielding about as much energy as carbohydrates, but it’s a lot like burning your house down to keep warm.

Although burning protein is a sign of the body’s desperation, it is nonetheless done in an orderly manner. Taken together, muscles are the largest organ in the body, and they are made largely of protein. They account for twice as much body weight as fat. Because fat burns twice as efficiently, however, muscles represent about the same amount of potential energy as fat. Muscle is the first protein to be sacrificed, because it is abundant and the loss of even a lot of it will not have an immediate impact on survival; weakened muscles can still function. More critical are the much smaller quantities of protein that make up tissues in the liver, brain, heart, and kidneys.

So the starving body maintains a rigid hierarchy when it accesses its own fuel sources. After carbohydrates start to run out, it taps fat supplies, then muscle reserves, until all that remains are the proteins in the critical organs and a tiny amount of fat essential both as a key ingredient in hormones and as electrical insulation for nerve and brain cell transmissions. At this point, body weight has been reduced by 50 percent. The body is eating itself alive.

After thirty-six days at sea, the passengers and crew of the
Mary-Jeanne
were living in decomposing bodies. Their only external supply of nutrients had been a few birds and some flying fish, which were quickly devoured when they landed on the deck. At one point they had gone eighteen days with no food at all. On the thirty-sixth day they sighted land, drifting close enough to see houses and trees before a shift in current carried them back to an empty horizon. The passengers lost hope and with it, the last remnants of their strength. Their bodies were no longer able to “defend” their essential fat and protein. And once those are consumed, body systems go haywire; chaos and death ensue.

So it was for those on board the
Mary-Jeanne.
Passengers started to die. The bodies thrown overboard were eaten by sharks. Still, it never occurred to the survivors to try fishing again, even if it meant using human body parts as bait. They were starving to death with food all around them because they were mentally unprepared for their hardship
and were unable to generate any will to survive. On the seventy-fourth day, the boat was finally spotted by an Italian tanker, and two living corpses were rescued.

Perhaps more passengers would have survived the ordeal had their options not been limited by one of the strongest of cultural taboos: cannibalism. Although they were starving, their civilized upbringing had created within them an artificial barrier so powerful and unquestioned that it was able to block their access to a readily available source of nutrition. They viewed their dead shipmates as departed souls but not also as food. An inbred horror of cannibalism works against the individual but favors the survival of the group by preventing its members from becoming targets for each other. Yet the revulsion is not universal. In most societies, only the most deviant members would eat another human, but there are others in which, at least until recent times, the practice was accepted. Some even revered it as a way to capture a victim’s soul. Whether for the spirit or for the nutrition, there is no biological reason why one human cannot eat another. Indeed, the meal would be more balanced than turtle or fish. Unlike seafood, humans contain carbohydrates, and because the muscle has a much higher fat content, the meat would provide more energy. Our liver, heart, and kidneys are especially nutritious and would supply essential vitamins. Given that the protein intake would already be in human form, it could be utilized efficiently; there would be no need to rearrange many of the amino acid building blocks. Dressed out like an animal, a human can yield as much as 60 pounds of meat—about twice as much as a sea turtle. However, only the most hardened survivor would find all of it to be edible. Everyone else would have to remove the head, hands, feet, and genitals—in other words, all the most obvious signs of human identity. I am often reminded how personally we identify with that anatomy when I see medical and nursing students studying gross anatomy or watching surgery. Many will faint or ask to leave the room when those body parts are being dissected or repaired. Conversely, they are the parts a crazed warrior would be most
likely to remove from his vanquished enemy as a sign of complete victory.

For a starving castaway, cutting up and eating a dead human body is not an act of perversion. It is a demonstration that a taboo imposed by civilization no longer prevails; it yielded to extreme stress and hunger. Such was the case in the Andes in 1972 when a plane crash turned a Uruguayan rugby team into a group of desperate survivors surrounded by frozen corpses. They were stranded for two months in barren, frozen terrain with no source of food outside their wrecked airplane. The players, after much soul-searching, brought themselves to eat their former teammates, remaining strong enough to make forays to lower elevations, which eventually led to their discovery and rescue. They were saved because they had committed an act of self-preservation consistent with the prohibition against suicide set forth by the Christian Bible with which they had been raised.

Breaking a taboo is dangerous because the proscribed behavior is then no longer enforced by fear, only by ethics. Once broken, an individual might be tempted to bring down other cultural restraints in order to minimize guilt over his irreversible transgression. Concepts such as fairness and morality, which reside in the cerebral cortex, can easily be deactivated by self-serving rationalizations. As ethical standards drop, the cortex exerts less control over primitive urges, and the human being will steadily fall more under the command of his most primal instincts.

This degradation was evident in the behavior of some members of the Donner Party, settlers in an 1847 wagon train bound for California but marooned by an early winter in an icy mountain pass of the Sierra Nevadas. The first settlers to die were properly buried. Later, however, as the food ran out, they were dug up and eaten. When the situation became even more desperate, those who died were roasted and eaten immediately. The acts seemed to unleash primal behavior in some of the members, who soon found themselves able to kill and eat the weakest among them, reasoning that they wouldn’t survive anyway. Applying their own moral distinctions, they then found it acceptable to kill any of the Indians traveling with them, since they were of an
inferior race. One man may have resorted to killing and eating a woman settler, although none had the idea of killing members of his own family, a taboo that runs so deep it was God’s ultimate test for Abraham.

Even in those societies where killing and eating a human is countenanced, it is never done casually. The practice is generally accompanied by ritual and solemnity—whether the victim is providing strength for a triumphant warrior, magic powers for a medicine man, or nourishment for a starving sailor. The tradition of cannibalism once traveled the high seas in the mind of every mariner on every voyage. When a crewman signed on, he entered a culture in which rare and dire circumstances might make cannibalism an acceptable survival technique. All knew that a shipwreck could turn a crew into a group of hungry humans eyeing each other as food. The rules were unwritten but clear, and following them made the deed seem less savage. A dying sailor would be sacrificed first. There was no point in having him consume precious supplies, and the longer he lingered the more he would dry out, making him less nutritious and harder to chew. It was believed that drinking the blood while it still flowed would quench thirst. Actually, this isn’t true, since a dying sailor’s blood would most likely have an even higher salt content than that of his slightly healthier shipmates. The macabre soup would have a desiccating effect similar to seawater.