A doctor who has worked with some of the most malnourished children in the world had trouble keeping himself composed while looking at photos of Alex Radita.

Dr. Michael Seear, an expert in malnutrition and its effects on the human body, testified at the first-degree murder trial of Emil and Rodica Radita in Calgary. They are accused in the neglect and starvation death of their 15-year-old son.

Seear treated Alex when he was hospitalized while living in British Columbia. The first time was in 2000 when the boy was diagnosed with diabetes and again in 2003 when he nearly died of complications from untreated diabetes.

"We tiptoed around this boy … I thought there was a fair chance he would die," said Seear of Alex's 2003 hospital stay.

A decade later, Alex weighed 37 pounds when he died of starvation and neglect inside his Calgary home.

Alex would have died within a day had he not been taken to hospital in October 2003, according to Seear. He testified that he had never seen malnutrition to that extent in Canada.

Emil and Rodica Radita are charged with first-degree murder. (CBC) While looking at the photos of Alex from his 2003 hospital admission, Seear paused at times, sighed and muttered expressions of disbelief.

"You can see the misery in this poor child's eyes," said Seear. "This was a case of neglect and child abuse."

But doctors got Alex healthy again, and the boy was placed with a foster mother for a year before being returned to his parents.

The family eventually moved to Alberta in 2009. Alex was never taken to see a doctor after that.

'He's trying to put on a brave face'

Evidence from the family's time in British Columbia — including from Seear — has yet to be ruled admissible by Court of Queen's Bench Justice Karen Horner.

Seear was asked to analyze Alex's condition in photos taken at his final birthday party on Jan. 29, 2013, which was three months before the boy's death.

Alex Radita needed medical attention months before his death, a diabetes expert testified at his parents' first-degree murder trial. This photo was taken at his 15th birthday party, three months before his death. (Court exhibit)

Alex is already "severely malnourished" and "approaching the final stages of malnutrition," according to Seear.

"He's trying to put on a brave face," said Seear. "This is not a happy child.

"He's … very, very miserable."

It would have taken at least two months for Alex to get to the state he was in. He was so malnourished that his body was already consuming its muscle, said Seear.

'Utter neglect'

Photographs taken of Alex in the hours after paramedics found the boy's body were also examined by the doctor.

"There are only tendons and bones," he said. "There is nothing left."

It would have taken months for Alex to reach the state he was found in, according to Seear.

On top of the boy's condition, the state of his "filthy" bedroom caused Seear concerns too.

"To call this neglect, you need a new word," said Seear. "This is utter neglect with this emaciated corpse in the middle of it."

Under cross-examination, Seear told Rodica's lawyer Andrea Serink that he had used some "loose language" when discussing Alex's case with Det. Matt Demarino when he said Rodica Radita "did not seem sane."

"I did not feel that the mother was in her right mind," said Seear. "They seemed very unusual."

Seear said he didn't believe Rodica could care for Alex.