No, seriously. I don’t have any idea what this phrase actually means in medical terms. There’s a piece in the New York Times about how there’s a concern about Internet addiction in South Korea, and it brings up, once again, how young men are allegedly dying from “exhaustion” as they’re doing round-the-clock binges of World of Warcraft. Or Starcraft. Or Cyworld, or whatever it is they might enjoy playing.
I remember doing a quick literature search a little while ago, and I couldn’t find anything on the term — or, the underlying causes thereof. That is to say, “dying from exhaustion” is a little bit like saying “dying from a fever”. You don’t actually die *from* the fever, but the thing that is causing the fever and overwhelming infection.
Is it the sleep deprivation itself? Doubt it. There are many medical students and residents right now which might be up for 30+ hours in a row, and I myself have been up for almost 40. No reports of sudden death amongst us yet for those reasons.
Is it renal failure? Perhaps because they’re not drinking, which leads to dehydration? Also unlikely, as long as their thirst centers are intact, they’ll reach for something that should stave this off. As long as this isn’t a diuretic (something which makes you pee, and therefore dehydrated even more) this shouldn’t happen as well (well, see update below).
Is it a pulmonary embolus? Long hours of being stationary … somewhat analogus to being on a long-haul flight … that could be a risk factor for a clot. But even then, in otherwise healthy young males, this chance of this happening is highly unlikely. Its conceivable that some of them might have underlying and as-yet diagnosed predispositions to clotting, however.
Is it a sudden fatal arrhythmia? Perhaps triggered by the stress of sleep deprivation? Perhaps some of them had Brugada syndrome and didn’t know it — a cardiac disorder that afflicts young asian males, where they are prone to electrical disturbances of the heart which are lethal. If you survive this, congratulations — you get a combination implantable pacemaker and defibrillator.
Update: One conceivable way is through dehydration –> hypernatremia (imbalance of too much sodium) –> seizure –> death // or, renal failure –> hyperkalemia (too much potassium) –> cardiac arrest. See Mark’s comment below, where a Korean gentleman didn’t eat or drink for a few days.
If anyone has any other ideas, I’d love to hear from you. We’ve been hearing this phrase for so long now, as a cause of death being applied to Internet addicts. Its kind of vague — like saying they died of a cardiac arrest (everyone technically dies of a cardiac arrest eventually) without stating the underlying cause.
{ The tin-foil-hatted amongst us, however, might say that no one *actually* died, or that the death *wasn’t* because someone was sitting at an Internet Cafe; rather, these kinds of stories are disseminated with vague-but-seemingly-plausible-causes-of-death from centralized governments who wish to crack down on this less-than-desirable/productive behaviour }
November 18th, 2007 at 2:26 pm | Permalink
[...] sounds like a web worker I know. Fortunately, no one has ever died from exhaustion due to making too many VoIP calls in one [...]
November 18th, 2007 at 5:27 pm | Permalink
there’s always that Japanese word karoshi - death by overwork - which is claiming numerous lives around the world now… china has another word for the same phenomena.
i saw a presentation somewhere and one example was a woman in her 20’s in Japan, a graphic designer, who they just heaped so much pressure on that she had no work-life balance. She died of some sort of a stress induced bleeding episode in her brain.
of course deep vein thrombosis might be an issue. The trick is to put the coke machine on the floor below just to save lives :)
November 18th, 2007 at 6:02 pm | Permalink
Hi Steven,
I’ve heard about Karoshi — and great point about it. In a relatively old journal article (http://www.workhealth.org/whatsnew/lpkarosh.html) that I found, there was this statement near the end, however:
… which would lead one to think that there hasn’t yet been shown to be a firm medical reason for this phenomenon.
Furthermore,
All fairly interesting, suggesting that there may be underlying causes that might, under situations of prolonged stress, cause that cause to flare up and when this happens, being ignored.
How all this applies to otherwise young and healthy males who haven’t been over-stressed for years … not quite sure.
Anyway, great idea, Steve. If I find anything else definitive or current I will let you know . ;)
November 19th, 2007 at 5:13 am | Permalink
GameSpot ran an article with a quote from the hospital where that guy died.
“He was so concentrated on his game that he forgot to eat and sleep. He died of heart failure brought on by exhaustion and dehydration,” said Park Young Woo, a Taegu Fatima Hospital psychiatrist.
http://www.gamespot.com/news/6132357.html
November 19th, 2007 at 7:32 am | Permalink
Hi Mark,
Thanks for pointing that out. Couple things.
First of all — and I have great respect for psychiatrists, for what they do — I wouldn’t trust a psychiatrist to necessarily make a diagnosis of heart failure, any more than I’m sure they’d like me to make a diagnosis of borderline personality disorder.
Secondly, if he didn’t drink for 5 straight days, it was probably dehydration that did him in, as it probably led to an imbalance in his sodium and potassium. Its possible if his potassium was too high (probably complicated by renal failure if he was dehydrated) then he could have had a cardiac arrest because of this; alternatively, he could have seized if his sodium levels were too high, aspirated (choked) and died that way as well.
“Heart failure”, which is a failure of the heart to pump, however, isn’t something that usually develops over the course of a few days. However, if he did have an underlying cardiac condition leading to an undiagnosed cardiomyopathy — i.e. heart failure — then all of the above would have made it worse, and in that case, it could have been a situation that contributed to it.
Thanks for letting me know about the article, though.
November 24th, 2007 at 1:03 am | Permalink
Mmm point taken. It is, regardless, taught widely as an OH&S issue in many university business schools so I probably wouldn’t negate it. The trouble is how do you measure these things in the wild.
Historically we have been slow to accept many illnesses - ie. shellshock and post traumatic stress - until many years down the track. I guess I’d just say common sense should prevail that if anyone, not just IT or managerial personell, works 16 hour days and 7 days per week something will eventually give. If we push past our barriers and at the same time lead sedentary lives that is a dangerous mix.
I’m not sure its a totally black and white subject with one side being either right or wrong in this. Plus there is the complexity we all have genetic and current health dispositions that affect how we cope with that stress.
The key is work - life balance I guess. And avoid sitting at WOW for 5 days straight forgetting that we’re not an animated character lol.
I do find it an interesting topic though :)
I ran into the concept last summer at a Uni Business School unit in Organisational Behaviour - I can’t recall off the top of my head where the online videos relating to the issue were though.
I really can’t conceive how a gamer can forget to drink for 5 days though. That’s lame.
November 24th, 2007 at 12:41 pm | Permalink
Oh, don’t get me wrong — I think that there are consequences to working long hours for years at a time.
I think that there is, however, a very different phenomenon to gamers who “drop dead” after long gaming sessions.
First of all, because what they’re doing has a generally pleasurable goal (perhaps what psychiatrists call “egosyntonic”), and secondly, because many gamers haven’t been consistently doing this kind of behaviour, without end, for extended — and I mean years — amount of time.
Its this kind of phenomenon that I’m querying the pathophysiology of … and not drinking for 5 straight days might be one way you might “do” it, I think. ;)
November 25th, 2007 at 3:48 pm | Permalink
Yes I agree entirely - its a phenomena I don’t understand at all. I’m of the informal opinion that they are somewhat unhinged mentally to do so - much like school mass murderers and some base jumpers lol.
It would be a hard one to study in the wild though because ultimately you probably couldn’t pick the “danger gamer” from the “extreme fringe gamer”. I’ve been a bit of a gamer in the past and wonder how WOW is actually a game anyway? Isn’t it kind of like pseudo-life? I’d have enjoyed it before I reached 10 perhaps. Definately would never forget to drink.
I hope the phenomena doesn’t increase. Maybe there are some who see a WOW player dying of extreme gaming and somehow puts them on a pedestal of awe to be emulated. Maybe these guys are trying to push their physical limits. After all, they must feel thirsty and hungry and sleepy and be denying their body signals.
Yes an interesting subject you’ve raised. I’d never really thought of it in that way.
March 19th, 2008 at 7:47 pm | Permalink
if he didn’t eat and didn’t drink to the point of dying becuase of it. wouldn’t he have had trouble playing the game correctly from being lightheaded or something like that. I skip on emeal and I get a headache and my eyesight gets worse. surely after a couple day without food, he would not have the dexterity or the right mind to play, hell even holding his head up should presumably become impossible.