The Torkel Saga 2059: Premature Death and Dying Too Young by Keith Torkelson MS, BS

Contents

Requirements
Results up Front - Count Summary
Define Dying Too Young
Statistically Normal Life
Statistical Cure for Mental Illness
Resolving Mental Illness by doing Normal Things
Features of Dying Too Young
What age is premature Death?
Dying Too Young in a War
Total Number of People that died in war?
Assignments for a Thanotologist
Tangent - Define Dying Old Men (DOMs)
Nature DBO = Death by Other - Impact
AD = Accidental Death
DBEN = Death by Exhaustion and/or Neglect
DEATH by Exhaustion and/or Neglect
Inappropriate Service
What does it mean to be inappropriately served?
Table – Those Who: Died Too Young (DTY) – KIA
Self-inflicted Death
Principles of Suicide prevention
Define Overtly Dead
Is Death a Power Greater Than Us?
MIA List
Images @ the End – Cemetery and MIA

Define Dying Too Young

Dying too young means losing a life prematurely, before reaching middle or old age, or before experiencing a statistically normal lifespan.

Key Aspects of the Concept

Untimely End:

It refers to passing away well before expected life milestones are met.

Unfulfilled Potential:

The phrase emphasizes the loss of future experiences, career goals, or family milestones.

Emotional Impact:

Such deaths often evoke a deep sense of tragedy, shock, and sorrow among family members and society.

Common Causes:

These premature losses frequently result from sudden accidents, severe illnesses, or unexpected violence rather than natural old age.

FYI – AI - If you'd like, I can provide: Statistics on average life expectancy. Information on how societies process untimely grief

Statistically Normal Life

A statistically normal life expectancy in the United States is 79.0 years overall, with 81.4 years for females and 76.5 years for males.

Key Statistical Life Metrics

Global Context:

Worldwide life expectancy at birth averages around 72 to 73 years, a major increase from about 31 years in 1900 due to better medicine and public health.

Maximum Lifespan:

While average life expectancy measures the mean age of survival, the maximum recorded human lifespan reaches up to 122 years.

Variability:

Geography, income, and education shift these numbers significantly; for instance, state averages in the U.S. can vary by nearly a decade depending on location.

Social Norms:

Beyond biology, statistical "normality" in human behavior and lifestyle shifts across generations as cultural and societal trends evolve.

Statistical Cure for Mental Illness

In medicine, mental illnesses are managed rather than statistically "cured," as most chronic psychiatric conditions focus on achieving remission rather than a permanent, zero-recurrence reversal.

Treatment and Remission Statistics

Adult Treatment Rates:

Approximately 52.1% of U.S. adults with any mental illness and 70.8% with a serious mental illness receive treatment annually, according to data from National Alliance on Mental Illness (NAMI).

Global Effective Treatment Gap:

Worldwide, an estimated 6.9% of people with mental health or substance-use disorders receive effective treatment, with a major barrier being lack of recognition that care is needed.

Remission vs. Cure:

Clinical definitions separate symptom remission (symptoms resolving temporarily or long-term) from a medical cure, because conditions like major depression, bipolar disorder, and schizophrenia carry a baseline risk of recurrence or relapse.

Annual Interventions:

Recent Centers for Disease Control and Prevention (CDC) Data Briefs show that roughly 19.3% of U.S. adults use prescription medication and 14.0% utilize counseling or therapy in any given 12-month period.

Resolving Mental Illness by doing Normal Things

Yes, engaging in standard, daily "normal things"—often referred to in medicine as lifestyle medicine or behavioral activation—is a powerful, scientifically proven way to manage and reduce symptoms of mental illness. While severe clinical conditions frequently require professional treatments like therapy or medication, everyday habits act as the foundation for chemical stability and neurological health in the brain.

Here is how routine, "normal" activities directly combat mental illness:

1. Physical Movement

The "Normal" Action:

Taking a daily 30-minute walk, cleaning the house, or taking the stairs.

The Biological Impact:

Exercise regulates neurotransmitters like serotonin and dopamine, which dictate mood and motivation. According to research shared by the American Psychiatric Association, routine movement is an effective primary or supporting treatment for depression, anxiety, and PTSD.

2. Social Connection

The "Normal" Action:

Having coffee with a friend, calling a family member, or volunteering.

The Biological Impact:

Human brains are wired for connection. Isolation tricks the brain into a state of chronic physiological stress. Interacting with others signals "safety" to the nervous system, lowering cortisol (stress hormone) levels and triggering the release of oxytocin.

3. Sleep Architecture

The "Normal" Action:

Going to bed and waking up at the exact same time every day.

The Biological Impact:

Sleep directly manages emotional resilience. Chronic sleep disruption impairs the prefrontal cortex, which handles emotional regulation. Sticking to a strict sleep schedule helps the brain process emotional trauma and daily anxiety effectively.

4. Behavioral Activation (Doing it anyway)

The "Normal" Action:

Getting out of bed, showering, making a meal, or participating in a hobby even when you don't feel like it.

The Biological Impact:

Mental illnesses like depression trick the brain into a cycle: Feel bad → isolate/stay in bed → feel worse. Doing normal tasks breaks this loop by forcing "opposite-to-emotion" behavior, proving to your brain that you can experience competence and control.

5. Nature and Environmental Shifts

The "Normal" Action:

Sitting under a tree, stepping into the sunlight first thing in the morning, or working out of a coffee shop.

The Biological Impact:

Sunlight regulates your circadian rhythm, which governs mood-lifting hormones. According to mental health insights from the NHS, environments with natural elements rapidly decrease blood pressure and nervous system hyper-arousal.

Features of Dying Too Young

Dying at a young age often involves a longer, more physically resistant dying process and complex emotional challenges compared to passing away at an advanced age.

Physical Features and the Dying Process

Stronger bodily reserves:

Younger individuals typically possess stronger hearts, lungs, and physical reserves, which can cause the body to sustain vital functions longer even during advanced organ failure.

Prolonged decline:

Because otherwise healthy organs resist shutting down, the active dying process can involve a more extended period of physical strain and symptoms.

Universal end-stage signs:

In the final stages, younger individuals experience similar physical signs of active dying as older adults, such as irregular breathing patterns (like Cheyne-Stokes respiration), cooling extremities, increased drowsiness, and difficulty swallowing.

Emotional and Psychological Features

Perception of injustice:

The death of a young person is widely viewed as tragic and untimely, which can lead to intense emotional resistance and grief from both the individual and their family.

Extended suffering:

The emotional toll often includes profound frustration and a prolonged sense of unfairness regarding unfulfilled life milestones.

Support focus:

Care for younger individuals nearing the end of life centers heavily on respecting personal autonomy, managing complex symptoms, and addressing heavy psychological distress.

FYI – AI - If you are looking for information on a specific condition, age group, or palliative care strategy, let me know so I can provide more tailored details.

What age is premature Death?

Premature death is generally defined as a death that occurs before the age of 75, though some health groups use age 65.

Age Standards

Age 75:

The Centers for Disease Control and Prevention (CDC) and America's Health Rankings use age 75 as the standard cutoff. This matches the average life expectancy in the United States.

Age 65:

Some researchers use age 65 to measure early or untimely deaths.

Life Expectancy:

Other studies compare the exact age of death to the expected life span of a specific group.

Common Causes

According to the National Cancer Institute, many early deaths come from preventable or treatable health issues:

Unintentional injuries (accidents)
Cancer
Heart disease
Suicide
Stroke

Note – For the purposes of this study we set the age of premature death at 70 years old or less.

Dying Too Young in a War

Older political leaders declare wars, but young soldiers bear the physical and emotional cost of fighting and dying on the battlefield.

Historical Sentiments and Quotes

Herbert Hoover:

Stated in a 1944 speech that "Older men declare war. But it is youth that must fight and die".

Popular Culture:

The 2004 film Troy popularized the line "War is old men talking and young men dying".

Rudyard Kipling:

Wrote in 1918, “If any question why we died, tell them, because our fathers lied”.

Why Young People Fight

Physical Fitness:

Military organizations generally recruit younger individuals because of their strength, quick reflexes, and endurance.

Generational Disconnect:

Decision-makers in government are typically older and remain safe from direct combat.

Total Number of People that died in war?

It is impossible to calculate a definitive total number of people who have died in all human wars throughout history due to missing ancient records, poor data collection, and unrecorded smaller conflicts.

However, broad historical estimates and data trackers provide a sense of the scale:

Historical Estimates

Recent Centuries:

According to Our World in Data, more than 37 million people have died fighting in wars since 1800. This number excludes many civilian casualties and war-related famines.

All-Time Estimates:

Some wide-ranging historical estimates suggest that anywhere from 35 million (for focused modern periods like 1816–2007) up to 1.5 billion to 2 billion people have died across all of human history when including indirect war-related famines, diseases, and ancient conflicts.

Deadliest Conflicts in History

World War II (1939–1945):

The deadliest military conflict in human history, resulting in an estimated 70 to 85 million total deaths (including 50–55 million civilians and 21–25 million military personnel from all causes, such as combat, disease, and famine).

World War I (1914–1918):

Resulted in an estimated 15 to 20 million deaths, split roughly evenly between military personnel and civilians, plus millions more missing or dead from disease.

Other Major Tolls:

Historical catastrophes like the List of wars by death toll estimate hundreds of thousands to millions of deaths in regional conflicts like the Taiping Rebellion, Mongol conquests, or the Second Sino-Japanese War.

FYI – AI - If you'd like, I can break down the numbers further for: A specific century or era

Specific major wars (like the American Civil War or WWI). Military vs. civilian casualty ratios.

Assignments for a Thanotologist

Thanatologists—professionals who study the psychological, social, and physical aspects of death, dying, and bereavement—take on dynamic assignments depending on their specific subspecialty. Their work spans clinical practice, academic research, community advocacy, and funeral operations.

Clinical & Bedside Care Assignments

Anticipatory Grief Counseling:

Working with patients who have received terminal diagnoses and their families to navigate emotional transitions before death occurs.

End-of-Life Legacy Planning:

Helping individuals author ethical wills, record oral histories, or curate memory books for their loved ones.

Vigil Accompaniment:

Providing a calm, non-medical presence at the bedside of actively dying patients—a common assignment for death doulas and hospice team members.

Symptom Comfort through Art:

Developing customized sensory interventions, such as utilizing bedside live music therapy, to reduce anxiety during the transition.

Grief Support & After-Loss Administration

Complicated Grief Therapy:

Facilitating therapeutic interventions for individuals experiencing traumatic, unexpected, or prolonged bereavement.

Support Group Facilitation:

Organizing and leading specialized community healing cohorts, such as groups tailored for grieving parents, veterans, or children.

Bereavement Care Assessment:

Evaluating surviving family members to identify individuals at high risk for clinical depression or physical health decline following a loss.

Post-Death Benefits Guidance:

Assisting families with immediate administrative tasks, including processing legal documents, navigating death benefits, and filing claims.

Funeral and Deathcare Operations

Custom Ceremony Curation:

Interviewing the bereaved to construct highly customized and culturally respectful funeral ceremonies and obituaries.

Restorative Arts & Preservation:

For thanatologists dual-certified as embalmers or thanatopractors, analyzing chemical and biological data to preserve and dress the deceased for open-casket viewings.

Academic, Research & Community Advocacy

Death Literacy Education:

Preparing and delivering community educational workshops, university curriculum, or open forums like "Death Cafés" to destigmatize mortality.

Sociological and Historical Research:

Conducting empirical field studies on how evolving social landscapes, virtual mourning trends, and diverse cultures shape modern perceptions of loss.

Medical Ethics Consulting:

Serving on hospital or corporate panels to advise on systemic protocols regarding euthanasia, physician-assisted care, or institutional living wills.

Tangent - Define Dying Old Men (DOMs)

For this study Dying Too Young (DTY) is dying before the age of 70. A dying old man is not defined by age rather by functionality, Quality of Life (QOL) and Life’s Satisfaction. We use various assessments to characterize DOMs. DOMs usually score lower than 70% or so with their Activities of Daily Living Basic 10 Item Screener. They have few Extended Activities of Daily Living such as literacy or working with computers. A common feature of DOMs is when they lose the ability to walk by themselves. If Buster can’t walk anymore he very likely will desire to be put-to-sleep (See POLST). Many DOMs tend to be angry and have few plans. An example of a dying old man was Al.

Table – Those Who: Died Too Young (DTY)
Nature DBO = Death by Other - Impact
PII = Personally Identifying Information

Last Reviewed: 20260924-TH:

Table – Those Who: Died Too Young (DTY)
AD = Accidental Death
PII = Personally Identifying Information

Table – Those Who: Died Too Young (DTY) - Sample
DBEN = Death by Exhaustion and/or Neglect

DEATH by Exhaustion and/or Neglect

Exploring an intense and heavy concept, whether for a creative writing project, a character backstory, or an educational research topic. Here is a breakdown of how exhaustion and neglect function as causes of death, focusing on the biological and physiological realities.

Death by Exhaustion (Inanition / Physical Collapse)

In medical and forensic terms, pure exhaustion rarely kills on its own; instead, it triggers a systemic failure of the body's vital organs.

Cardiac Arrest:

Extreme physical overexertion without rest places immense stress on the heart. The cardiovascular system eventually collapses, leading to fatal arrhythmias.

Organ Failure:

Prolonged lack of sleep or continuous physical labor prevents the body from repairing tissue. This causes a buildup of toxins, eventually leading to kidney or liver failure.

Immune Collapse:

Severe exhaustion completely decimates the immune system, making the body vulnerable to minor infections that quickly turn fatal (like sepsis).

Death by Neglect (Deprivation / Failure to Thrive)

Death by neglect is categorized by the withholding of basic human needs over a prolonged period.

Dehydration:

The fastest fatal element of neglect. Without water, the kidneys fail, blood volume drops, and hypovolemic shock or cardiac arrest occurs within days.

Malnutrition / Starvation:

The body begins consuming its own fat, then muscle tissue, and eventually its own organs to survive. Death usually occurs from heart failure when the heart muscle becomes too weak to pump blood.

Exposure:

Left in unsafe environments, the body succumbs to hypothermia (extreme cold) or hyperthermia (extreme heat), which rapidly shuts down the central nervous system.

The Combination:

The Feedback Loop

When exhaustion and neglect occur together, they accelerate one another. A neglected body lacks the calories and hydration needed to recover from physical exertion. Conversely, an exhausted body cannot seek out the resources it needs to survive, leading to a rapid downward spiral.

Inappropriate Service

The Wasteful and Inappropriate Service Reduction (WISeR) Model is a federal pilot program by the Centers for Medicare & Medicaid Services (CMS) designed to target low-value, costly medical services vulnerable to overuse, waste, fraud, and abuse.

How WISeR Works

Prior Authorization:

Healthcare providers must request prior approval from Medicare before giving patients certain targeted services.

Technology Use:

The program uses Artificial Intelligence (AI) and human clinical reviews to speed up and manage prior authorization decisions.

Timeline:

The pilot program launched on January 15, 2026, and is scheduled to run through December 31, 2031.

Locations:

It is mandatory only for Original Medicare beneficiaries in six states: New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington. Medicare Advantage plans are not included.

Targeted Services

The model requires prior authorization for about 17 specific low-value or frequently overused services, including:
Skin and tissue substitutes
Electrical nerve stimulators
Knee arthroscopy for knee osteoarthritis
Certain spine decompression and orthopedic pain management procedures, such as cervical fusion and steroid injections

What does it mean to be inappropriately served?

Being inappropriately served medically means receiving healthcare that is harmful, unethical, clinically unnecessary, or below professional standards. This concept usually falls into one of three major categories depending on the nature of the care:

1. Medically Unnecessary Care (Overtreatment)

This happens when a patient receives treatments, tests, or procedures that offer no reasonable benefit or where the risks outweigh the rewards.

Unwarranted Procedures:

Performing surgeries or diagnostic tests that have no clinical indication.

Overprescribing:

Providing medications, like unnecessary antibiotics for a viral infection, that can cause side effects without treating the cause.

Financial Drivers:

Administering services primarily to boost provider revenue or insurance billing rather than to help the patient.

2. Substandard Care (Improper Treatment or Omission)

This occurs when the care provided fails to meet accepted medical guidelines, commonly referred to as the standard of care.

Misdiagnosis:

Failing to correctly identify a condition, which delays appropriate therapy and allows an illness to worsen.

Medication Errors:

Administering the incorrect dosage or a drug that interacts dangerously with a patient's medical history.

Inadequate Monitoring:

Failing to watch a patient closely after a major procedure or surgery.

3. Unprofessional or Unethical Conduct

This involves a breach of the trust, boundaries, or dignity required in a patient-provider relationship.

Lack of Informed Consent:

Performing medical actions without fully explaining the risks, benefits, and alternatives to the patient.

Discrimination:

Providing unequal or biased care based on a patient's race, gender, age, or background.

Boundary Violations:

Behaving in a demeaning, offensive, or abusive manner during examinations.

Table – Those Who: Died Too Young (DTY) - KIA

SID = Self-Inflicted Death - Ledger

Self-inflicted Death

Self-inflicted death, or suicide, is defined as death caused by injuring oneself with the explicit intent to die.

Core Nature and Characteristics

Intent and Awareness:

Clinically and legally, suicide requires conscious or semi-conscious self-directed action coupled with an intention to end one's life. This distinguishes it from accidental injury or non-suicidal self-injury, where an individual may harm themselves without an underlying wish to die.

Psychological Pain:

Experts conceptualize the act not as a physical failure of the body, but as an overwhelming response to severe psychological distress, hopelessness, or a breakdown in coping mechanisms during a crisis.

Multifactorial Risk:

Roughly 90% of individuals who die by suicide experience an underlying mental health condition, such as major depression or substance use disorder, frequently compounded by acute environmental triggers like financial loss or relational distress.

Global Impact and Prevention

Statistics:

Over 720,000 people die by suicide globally each year, making it a leading cause of mortality across various age groups, particularly young adults.

Support and Intervention:

Suicidal behaviors are preventable through timely, evidence-based public health interventions, limiting access to lethal means, and providing mental health support.

If you or someone you know is struggling or in crisis, help is available. You can call or text 988 or chat at 988lifeline.org in the United States and Canada to reach the Suicide & Crisis Lifeline.

Principles of Suicide prevention

Suicide prevention relies on a public health approach that builds safe environments, teaches coping skills, restricts access to lethal means, and connects people in crisis to immediate help like calling or texting the 988 Suicide & Crisis Lifeline. If you or someone you know is struggling or in crisis, help is available. You can call or text 988 (available 24/7, free, and confidential in the United States and Canada).

Key Principles of Suicide Prevention

1. Create Safe and Healthy Environments

Build stable communities:

Promote strong social connections, stable housing, and financial security to reduce daily stress and isolation.

Foster supportive spaces:

Help schools, workplaces, and families create open, kind cultures where people feel safe talking about mental health.

2. Teach Coping and Problem-Solving Skills

Build resilience:

Teach children and adults how to handle strong emotions, solve conflicts, and manage life challenges.

Encourage help-seeking:

Teach people to recognize when they feel overwhelmed and make it easy to ask for help without shame.

3. Identify and Support People at Risk

Recognize warning signs:

Watch for signs of distress, such as talking about feeling hopeless, talking about wanting to die, withdrawing from friends, or giving away personal items.

Train gatekeepers:

Teach community members, teachers, and managers how to spot people at risk and safely connect them with professional care.

4. Reduce Access to Lethal Means

Secure dangerous items:

Put physical space between a person in crisis and things they could use to harm themselves.

Lock up dangerous objects:

Safely store firearms in gun safes with locks, and keep prescription medications locked away to prevent impulsive attempts.

5. Provide Effective Care and Treatment

Offer targeted treatments:

Use evidence-based therapies (such as specialized counseling that focuses directly on lowering suicide risk).

Follow up after a crisis:

Provide regular check-ins and medical support after a person goes through a mental health emergency or makes an attempt.

6. Support Survivors of Suicide Loss (Postvention)

Help families heal:

Offer bereavement counseling, support groups, and debriefing sessions for people who have lost a loved one to suicide.

Reduce future risk:

Providing support to survivors helps lower the higher risk of suicide that can happen after losing someone close to you.

Define Overtly Dead

"Overtly dead" describes a state of death that is completely obvious, unmistakable, and open for everyone to see, leaving no doubt that life has ended.

Meaning and Breakdown

Overtly:

Done or shown in an open, clear, and obvious way without any attempt to hide it.

Dead:

No longer alive; lifeless.

Combined:

It refers to a situation where signs of death (such as decapitation, rigor mortis, or decomposition) are immediately and unmistakably apparent. In medical or emergency contexts, it means a patient is visibly deceased without needing complex tests to confirm.

Is Death a Power Greater Than Us?

Death is a physical power that can end human life, but it is not greater than the enduring power of love, faith, or spiritual resurrection.

The Physical Power of Death

Ends the body:

Death has the absolute biological power to stop a physical life.

Universal reality:

Every living person faces the certainty of physical death.

Inescapable limit:

No human can permanently stop or reverse physical aging and dying on their own.

What Death Cannot Control

Cannot kill love:

Death takes a physical body, but it cannot erase the love or bonds built during life.