In 1967, Tom Simpson collapsed on the 13th stage of the Tour de France. The superb British cyclist had won considerable fame in his short life, and was expected to join the greats of the sport. The autopsy showed small amounts of amphetamine and methamphetamine, a combination that killed him climbing up stony Mt. Ventoux.
It also marked one of the first of the many doping scandals that bedevil professional sports yet. Lance Armstrong stands accused of hair-raising sessions of group intravenous drug and blood infusions in hotel bedrooms, while professional baseball has asterisks attached to many of its greatest performances.
Each month new drugs are devised in kitchen labs and garages to beat the standard testing protocols. Athletes take them. Sometimes they win their meets, sometimes they die. But winning athletes are often separated by the smallest of performance measures, and the tiniest change can lead to great fortune as well as immense fame.
Why do some internet gamers, who often play in total obscurity, keep playing until they die?
Recently a 24 year old gamer outside Beijing died after gaming in the same room for 86 straight hours. He had spent about $1,500 paying for games the month before, an enormous sum for a Chinese worker. In 2005 Seungseob Lee played 50 hours straight in Taegu, South Korea before collapsing with heart failure. Other young gamers have died in similar circumstances. Many have written about why internet games are so addictive. The reasons include:
1. A completely immersive environment. The game morphs into their world.
2. Social interaction. Major stories of addictive behavior generally come from multiplayer games, where gamers feel great responsibility for their own and their peers' success.
3. A better reality. The results are clear -- you win, you lose, you gain rewards. Success can be instantaneous, leading to more rewards and an encroaching sense of power, unusual in a time of economic uncertainty and personal chaos.
4. Multi sensory impact. The games include great level shifts in noise, vertiginous angles and stunning visuals, requiring constant attention and decision making. In the game life and death whoosh by in fractions of a second.
5. No closure. Games can go on and on; generally there is no final measure of success that cannot later be exceeded.
6. Competition. Humans are competitive animals, and games provide instant, continual, repetitive feedback that plays to some of our cortex's deepest sensitivities and responsiveness. In games you can become an actor in a drama determining the future on a mythic or cosmic scale.
And then there's sleep.
The Strange Effects of Sleep Deprivation
Internet games require machines. Machines do not renew themselves. They're not organisms. They stay on as long as the electricity stays on. Animals are different. While migrating, some birds can fly 24 hours a day, day after day. Yet animals cannot exist without rest.
That includes humans. Rest is how terrestrial life regenerates itself. Sleep deprive any animal in a laboratory and it eventually dies.
Deaths in internet gamers generally involve long bouts of gaming without sleep. Though the final, fatal gaming event may last two or three days, often the players have been playing addictively for weeks or months. Therein may lie another kind of attraction for long-period gamers. In most people -- kept up all night against their will -- sleep deprivation makes them depressed, anxious, and irritable. It's a different story with depressives -- and many young people. For them sleep deprivation may provoke a brief, high mood. Often depressives get a dramatic improvement in mood -- which disappears with even a brief nap. Young people like to stay up late. Some enjoy enthralling performances or social gatherings. Yet not a few also feel a brief euphoria after long hours awake.
Practitioners of strict meditation programs also can experience the strange euphoria that attends some bouts of sleep deprivation. With many hours of enforced meditation -- as in Japanese Zen temples -- practitioners find that lack of sleep may provoke a sense of great well-being. When meditators go days without sleep and food, they often see visions.
Gamers already experience visions playing -- right in front of them. In multiplayer games they may stay up many hours to keep playing with colleagues in different time zones and countries. Sometimes they experience the timelessness of flow experiences. They don't notice the clock. They don't notice themselves. They become one with the game. And they want to keep that feeling going. Here energy beverages play a role. Legal stimulants are abundant -- just a few feet away at the Internet café's kiosk. And stimulants can give you a sense that you don't need to sleep -- or eat.
Your Family's Health and Internet Games
Fortunately, deaths from gaming remain rare. Many times the worst results come not to the gamers but their charges -- like the South Korean couple whose infant died last year while they kept playing infant rearing games in another internet café.
The real dangers may arise when adolescents and young adults become socially isolated. The dangers will come through a combination of sleeplessness, lack of food, and stimulatory medications. Heart failure generally does not happen to physically healthy teenagers and 20-somethings. Yet the euphoria of sleep deprivation can be enhanced by energy beverages. And energy beverages, particularly those with high doses of caffeine, can cause arrythmias in perfectly normal hearts.
The heart is far more than a pump -- it is an exquisitely timed and tuned electrical system. Stimulants can disrupt that system for the briefest periods and cause sudden death. Tom Simpson died of stimulants at the Tour de France. Now, legally available stimulants may cause extreme, unexpected side effects to youthful gamers -- fatal ones.
Gamers need reminding that rest is more than regeneration. It's required to live.
Follow Matthew Edlund, M.D. on Twitter: www.twitter.com/therestdoctor