Having stood down the fifth-largest military in the world, the men and women who served our country in the Persian Gulf are being told their fate will be forever linked to that line they guarded in the sand. For they are at risk of suffering one of the most insidious afflictions of the late twentieth century — Gulf War Syndrome.
Or so theyve been told by over 500 newspaper and magazine stories, and a slew of television shows ranging from 20/20 to Nightline to 60 Minutes. No fewer than three respected mens magazines have featured the story, with such titles as GQs "Cover-Up: U.S. Victims of the Gulf War." What vets havent been told is the source of their fear may lie a bit closer to home than the windswept deserts of the Middle East.
That which is called Gulf War Syndrome comprises ailments diagnosed in some of the almost 700,000 men and women assigned to the Gulf region in 1990 and 1991. More than 50,000 vets have now signed on to the Persian Gulf Registry. While some of these vets say they are perfectly healthy and simply want to be monitored, the majority have joined the registry because they believe they may be suffering from the alleged syndrome.
According to Rep. Lane Evans (D-Ill.), "The commonality of experiences that (Gulf War veterans) have faced seem to be fairly convincing that they are suffering serious problems . . ." Likewise, CNN titled one of its interview segments "Gulf War Veterans Complain of Common Symptoms."
Yet their symptoms are anything but similar. They include, among others: aching muscles, aching joints, abdominal pain, facial pain, chest pain, blood clots, flushing, night sweats, blurry vision, photosensitivity, jaundice, bruising, shaking, vomiting, fevers, sinus growths, irritability, fatigue, swollen lymph nodes, weight loss, weight gain, loss of appetite, heartburn, nausea, bad breath, hair loss, graying hair, rashes, sore throat, heart disease, diverticulitis and other intestinal disorders, kidney stones, a growth in the eye, tingling and itching sensations, sore gums, cough, cancer, diarrhea with and without bleeding, constipation, testicular pain, epididymitis, unspecified swelling, memory loss, dizziness, inability to concentrate, choking sensation, depression, lightheadedness, hot and cold flashes, labored breathing, sneezing, sensitive teeth and other dental problems, neurological disorders, nasal congestion, bronchitis, leg cramps, twitching, hemorrhoids, thyroid problems, welts, rectal and vaginal bleeding, colon polyps, increased urination, a "bulging disk" in the neck, hypertension, blood in urine, insomnia, headaches, and "a foot fungus that will not go away."
The symptom list reads like the index of a medical self-help book. Veterans have even blamed the syndrome for their having contracted malaria, herpes, and tuberculosis, diseases heretofore thought to have been spread by mosquitoes, sexual intercourse, and coughing. Many symptoms are highly subjective, such as "lumps under the skin" or "thick saliva." Readers or viewers of news reports dont know this, however, because whenever they see or hear a list of symptoms its rarely more than about five items long, implying the syndrome spectrum is fairly small.
Yet the definition of the syndrome has been widened even beyond Gulf vets to include their wives and children. In addition to suffering most of the illnesses of their husbands, these women also claim to suffer yeast infections, menstrual cramps, and irregular periods, while the childrens attributed ills include earaches and rashes, among others. Some wives and girlfriends of vets have even complained that their mens semen burned their skin, rather like the blood of the creatures in the Alien films.
If the definition of this syndrome is murky, the cause is hardly more clear. Theories as to the specific cause or causes of the illnesses have ranged from the use of depleted uranium in American shells to fumes from burning oil fires. A 1994 Centers for Disease Control (CDC) study found that while firefighters did have increased exposure to certain toxics from the burning wells, personnel in nearby Kuwait City had essentially the same exposure as persons living in the United States. Yet few American soldiers were even as close as Kuwait City. Likewise, a National Institutes of Health report issued in April 1994 made short order of the uranium theory, noting among other things that the use of the material was highly localized.
At a hearing on May 6, 1994, Sen. John D. Rockefeller IV (D-W.Va.), then-chairman of the Senate Veterans Affairs Committee, implicated the drug Pyridostigmine bromide, which had been given Gulf troops as "pretreatment" for nerve agent poisoning. But a National Institutes of Health (NIH) report released on June 22, 1994, noted this drug has been used by some patients for decades — in doses of up to 6,000 milligrams a day — with "no significant long-term effects. By contrast, the troops received a mere thirty milligrams for up to three weeks."
Nonetheless, Rockefeller continues to hammer at Pyridostigmine bromide as being the syndromes most likely cause, which says something about the even less likely causes. On a December Nightline broadcast focusing on the offspring of Gulf War vets, Rockefeller went on to claim that the drug causes birth defects in Gulf vet offspring. But no birth defects have been associated with women who used the drug before or during pregnancy, much less with the more tenuous exposure of the male.
The most chilling theory, and the one to which the media has given the most credence, was suggested by the USA Today headline, "Trail of Symptoms Suggests Chem-arms." Chemical weapons were the focus of a 160-page report from the Senate Banking Committee. Don Riegle (D-Mich.), then-chairman of the committee, had been among the minority who voted against the resolution authorizing President George Bush to take military action against Iraq — as were four of the most vocal congressmen on the issue of Gulf War Syndrome.
The Riegle report includes testimony from a number of vets who appear convinced that they were exposed to chemical weapons and believe they are now suffering as a result. The media reported statements such as the one by a fellow who told USA Today, "I know in my heart I was gassed."
But chemical weapons experts such as Dr. George Koelle, professor emeritus at the University of Pennsylvania and a former chemical warfare specialist for the military during World War II, have pointed out that if the men were really exposed to such weapons, they would darned well know it. Koelle says, "None (of the Gulf War vets) exhibit symptoms characteristic of either blistering agents like mustard or organo-phosphates, those types of agents which would be primarily in use."
Koelles experience with chemical warfare victims from World War I indicates that, as he put it, "Blistering agents or mustard leave very little in the way of residual effects. Acute effects, yes, even fatal ones, but lasting effects are not characteristic." He recalls that during the Second World War he tried recruiting into a study chemical-weapons victims who were still suffering from the attack but couldnt find any. Further, he notes, this was the case with soldiers who had suffered massive acute exposure, much less soldiers who by their own statements could not have received a high dosage.
He is also aghast that chemical weapons could be blamed, as they are in the Banking Committee report, for illnesses in family members of exposed persons; only a contagion could accomplish this, he notes.
In a 60 Minutes segment on Gulf War Syndrome broadcast on March 12, reporter Ed Bradley, who six years earlier began the Alar apple scare, suggested that the veterans symptoms could have been the result of poisoning by sarin. Sarin is a nerve agent the Germans developed before World War II but never deployed. Eight days later, the world was horrified to find out what the real symptoms of sarin poisoning are when terrorists planted the gas aboard several Tokyo subway cars. Passengers fainted, vomited, and went into convulsions. Over 5,000 needed immediate hospitalization, and eight died within hours.
This is what chemical weapons do; they incapacitate an enemy. Conversely, vets who have now become convinced they suffered gas attacks in the Gulf say that at the time they had symptoms no more serious than tingling on the back of the neck or dry mouth or perhaps a burning sensation in the lungs. In contrast with the thousands of Japanese subway riders, no U.S. soldier in the Gulf was ever hospitalized or incapacitated by any unseen weapon.
Admitting as much was Dr. Charles Jackson of the Tuskegee VA Medical Center in Huntsville, Alabama. Jackson brought great publicity to the issue of Gulf War Syndrome in 1993 by using the syndrome, and exposure to chemical-biological warfare, as a diagnosis for numerous ailing members of a Naval Reserve Seabee unit. "But suppose theyd developed something that was insidious so they didnt need to incapacitate in the field," he told USA Today, "something that would get you when you got home." For a guy as wily as Saddam Hussein has proved to be, inventing a chemical weapon that didnt even begin working until years after the war was lost would be pretty stupid indeed.
Neither the NIH report, nor another produced by the Department of Defense in June — by a task force chaired by Nobel prize winner Dr. Joshua Lederberg of Rockefeller University — was able to pinpoint a specific cause for the mysterious syndrome. A third report, released in December by the Defense Departments Comprehensive Clinical Evaluation Program, declared, "There is no clinical evidence for a single or unique agent causing a Gulf War Syndrome." Rather, it said, "unexplained illnesses reported by Persian Gulf veterans are not a single disease or apparent syndrome, but rather multiple illnesses with overlapping symptoms and causes."
An Institute of Medicine report released in January criticized the governments efforts to study the problem and reach scientific conclusions. It then made the seemingly bizarre recommendation that Vice President Al Gore be in charge of coordinating the Gulf War Syndrome research effort. Gore has no scientific or medical background. But even the Institute of Medicine panel said it couldnt find evidence to support the argument that chemical weapons and medicine dispensed to vets were the chief causes of the syndrome.
The Experts Agree
If these various reports could find no syndrome, how to explain all those sick men, with their sick wives and sick children?
Lost in the rush to find the most quotable or pathetic victim is the notion that everybody occasionally becomes ill. Says Edward Young, former chief of staff at the Houston VA Medical Center, one of the three centers set up to investigate ailments among Gulf War vets, "Were talking about people who have multiple complaints. And if you go out on the street in any city in this country, youll find people who have exactly the same things, and theyve never been to the Gulf."
An early Army study of seventy-nine Indiana reservists who served in the Gulf and complained of a variety of symptoms found "no objective evidence for an outbreak of disease." It said, "Problems and symptoms like those found here would be expected to occur throughout the Reserve forces which deployed."
One advocacy group that opposed the Gulf War deployment, the Military Family Support Network of Fort Bragg, North Carolina, has attributed both miscarriages and birth defects to exposures in the Gulf. But a combined study of pregnancies at several bases found the miscarriages of Gulf vets wives to be at the same level as that population had before deployment to the Gulf. This was about half the civilian rate.
Yet in a December 1994 Nightline broadcast focusing on the children of Gulf War vets, the shows reporter made the alarming claim, "In Waynesville, Mississippi, thirteen of fifteen babies born to returning members of a National Guard Unit were reported to have severe and often rare health problems."
Reported, yes — but without substantiation. The Mississippi Department of Health investigated the alleged cluster and found that of fifty-four births to returning Guardsmen in that state, there were three major defects, with two to four expected in a group that size. They also found four minor defects, with three to five expected. There were no more premature or low birth-weight children than would be expected.
A larger study of 620 pregnancies at Robins Air Force Base in Georgia also found defects and miscarriages among Gulf vets children to be at or below normal levels. In the Persian Gulf Registry of veterans, the reported rates of miscarriage are below that of the general population.
The Real Cause
The thing unspoken in the Gulf syndrome allegations is that somehow the vets, their wives, and their offspring are supposed to be immune to illness. If they are not, then the illness must be from exposure to something in the Gulf. The fallacy employed is the one universally used to show causation where none is otherwise apparent. It is the bulwark of scare-of-the-weekism, as in "My wife began using a cellular phone and then developed a brain tumor, therefore the phone caused the tumor."
Does all this mean that, for all categories of illness, Gulf vets, their wives, and offspring have no more problems than other people? Not at all. Gulf veterans show extraordinarily high rates of post-traumatic stress, and they also suffer disproportionately from drug and alcohol dependency.
But with a few exceptions, the vast number of symptoms attributed to Gulf War Syndrome can be brought on by stress. While the Allies ultimately won a quick, lopsided victory, the soldiers had no idea that would be the case. What they did know was that, in facing Saddam Husseins Iraq, they were threatened by horrible weapons which no American had faced since World War I.
A further stressor for many was the quick transformation from civilian to combatant— as was the case with reservists and National Guardsmen. The Indiana reservist study concluded that, to the extent there were abnormalities, they appeared to be related to the stress of being ripped quickly out of civilian life and being sent to a war zone, and then a few months later being thrust back into civilian life. This may explain why reservists and National Guardsmen are far more likely to complain of Gulf War-related ills than are active duty soldiers.
Massive illness brought on by stress among veterans is nothing new. Stephen E. Straus, of the National Institute of Allergies and Infectious Diseases, told Science News, "There is a spectrum of this illness that is seen with all military adventures." Civil War veterans had undiagnosable symptoms, including fatigue, breathlessness, and gastrointestinal symptoms.
In World War I, some 60,000 British troops were found to suffer from a mysterious "effort syndrome," a problem that recurred in World War II. Similar phenomena have been called variously "soldiers heart," "neurasthenia," "combat fatigue," "shell shock," or the Vietnam-era "post-traumatic stress disorder." But a major difference between then and now is that now there is a mass media to publicize the claims.
Indeed, the closest Gulf War Syndrome comes to having a prime cause may be the American media. The study of the seventy-nine Indiana reservists found that many of the symptoms appeared to arise in response to reports of other people being sick. "When we have media reports of a particular symptom that hasnt been reported before," said Army spokeswoman Virginia Stephanakis, "suddenly by God well get plenty of those."
Hillary Clinton surely understands the power of the media in this regard. Since her health-care reform setback, she has adopted Gulf War Syndrome as a personal cause and pledged to do whatever she could to bring more attention to the plight of the ailing Gulf vets. The Washington Post reported that the first lady "has become the Clinton administration point-person on the Gulf War Syndrome issue."
In March, her husband announced he was forming a special panel of physicians, scientists, veterans, and unspecified "others" to investigate the mystery ailment. Even the mainstream media found the presidents announcement a bit much, with several newspapers referring to Clintons act, combined with an effort to prevent trimming the Veterans Affairs budget, as a move "to outflank his GOP rivals on veterans issues."
There are plenty of veterans issues at play. Under the enacted legislation, veterans can receive anywhere from $89 to $1,823 a month, depending on the extent of their alleged disabilities. To qualify, they must have been symptomatic at least six months and be found to suffer fatigue, skin problems, headaches, muscle pains, joint pains, nerve disorders, neuropsychological problems, respiratory problems, sleep disturbances, stomach problems, heart problems, and menstrual disorders that began during or within two years after the war and lasted at least six months.
Other vets may simply have succumbed to the lure of litigation. Some 2,000 of them have joined a $1 billion lawsuit against both American and foreign companies, alleging that these companies gave Iraq the chemicals needed to produce the weapons that they claim caused their illnesses.
Hysteria, But No Laughing Matter
Theres no reason to think, however, that most of those vets who say they are sick from exposure in the Gulf are not sincere. Indeed, most may be truly sick. As Dr. Dimitrios Trichopoulos, the head of the Department of Epidemiology at the Harvard School of Public Health, explains it, when many people hear they should be ill, they become ill — the flip side, as it were, of the placebo effect. "If you keep telling people they should be sick, of course they believe it," Trichopoulos says.
Phantom epidemics in which many people fall ill upon hearing they may have been exposed to something harmful are not uncommon. Two years ago, more than 2,000 children in and around Cairo fell suddenly ill in an epidemic of fainting that some blamed on chemical and biological agents. The "epidemic" proved to be only psychological.
In 1986, reports of hundreds of girls in the Israeli-occupied West Bank hospitalized with symptoms of nausea, dizziness, headaches, abdominal pains, and fatigue sparked an international incident. At least one newspaper blamed the maladies on nerve gas; others pointed to a pesticide. Ultimately, medical investigators found nothing to blame for the epidemic other than mass hysteria. U.S. schools are also occasionally swept by such hysterias.
The illnesses attributed to Gulf War Syndrome also seem to have a peculiar way of targeting Americans. Although there are some ill Canadian, British, and Australian troops, as of last year no more than a few dozen of the 42,000 British troops who served in the war reported any kind of mysterious illness. The British Surgeon General has denied that any "medical condition exists that is peculiar to those who served in the Gulf conflict."
Brian McMahon, who was Trichopolouss predecessor as head of the Department of Epidemiology at the Harvard School of Public Health and is now professor emeritus at the school, says, "Weve been through this before. We saw this broad array of symptoms with PCBs in Michigan. When you get such an array with the only thing in common being exposure," he said, youre seeing psychosomatic illness. "People are looking at clouds and trying to see faces instead of looking at data," he said.
Still, some veterans — and their terrified wives — are truly suffering. Stress-related illness is "a devastating problem with physical consequences," says Dr. Barry Rumack, a toxicology expert and clinical professor at the University of Colorado School of Medicine. "Its just not anything chemical."
"Ah, any minute now Ill have the cure for Gulf War Syndrome!"
Naval Reserve Seabee Nick Roberts is one of the Seabees diagnosed under the auspices of Dr. Charles Jackson. Roberts suffers from lymphoma, a cancer of the lymph glands. In November 1993, he told a congressional panel that of the thirty-three members in his military reserve unit, ten have been diagnosed with the same illness. He also held up a list of what he said were 173 cancer-stricken Gulf veterans. The media promptly reported his testimony.
Yet a Persian Gulf Registry update five months later showed only eight lymphomas out of all Gulf vets in America, with thirty-eight cancers of all types. This cancer rate was about fifty percent below that of the comparison non-Gulf veterans, although the control group was not scientifically matched.
Lymphomas are thought to usually develop decades after their instigation (although with AIDS patients who have suffered almost a complete collapse of their immune system, this can be shortened to a few years). What may be the most celebrated case of Gulf War Syndrome — and the only one with death widely attributed to it — is that of lymphoma victim Michael Adcock. But Army spokeswoman Stephanakis said Adcock had just arrived in Saudi Arabia when he was diagnosed with his first symptom. "He (Adcock) had rectal bleeding six days after arriving and the family blamed it on the Gulf," she said skeptically.
"Beyond a shadow of a doubt, I believe Michael died of multiple chemical exposure," Adcocks mother told the Washington Times in May 1993. She cited exposure to oil well fires, paint used to insulate vehicles from chemical weapons exposure, and lead in the diesel fuel used in lanterns and heaters as probable causes for her sons lymphoma.
Six months later, in congressional testimony, she was convinced the cause was a chemical weapon released in a Scud missile explosion — which authorities said was actually a sonic boom — the day before her sons rectal bleeding began.
No reporter or congressman dared suggest it was more probable that Adcocks cancer was merely one of the almost 50,000 lymphomas diagnosed that year. No one dared consider the possibility that Mrs. Adcocks statements were one womans sad effort to cope with the unexpected loss of a child. Surely much of why the coverage of Gulf War Syndrome has been so lopsidedly unskeptical is that to do otherwise is to be branded a rotten human being, not unlike those who, a decade earlier, questioned what proved to be the outrageous estimates of missing and kidnapped children.
The Real Cover-Up
Just ask the Houston VA centers Edward Young. In an interview with the Birmingham Daily News, he said he had seen enough alleged victims of the disease to be convinced there wasnt one. "It really rankles me when people stand up and call it Persian Gulf Syndrome," said a clearly frustrated Young. "To honor this thing with some name is ridiculous."
Although he later asked that his comments not be printed, the American Legion, the chief lobbying group for the syndrome, got wind of them and complained to the VA, which unceremoniously yanked Young from his position. The VA cited his lack of compassion.
The CBS program Eye to Eye with Connie Chung originally expressed great interest in doing a show debunking the alleged syndrome, or at least telling both sides of the story. Producer Mary Raffalli collected a great deal of information on the subject and said the show would definitely be done. But it wasnt — according to Susan Zirinski, a CBS producer, the program at the time was understaffed and the piece seemed time-sensitive, although she now concedes it was not.
Some syndrome proponents, however, are willing to concede that science is not on their side. Last year, after Congress passed legislation providing compensation without a clear definition of the ailment, Veterans Affairs Secretary Jesse Brown admitted, "This legislation is revolutionary. We have never before provided payment for something were not even certain exists." Jay Rockefeller, asked if there was a definite connection between Gulf War service and defective offspring, said, "If you were to ask as a human being, I would have to say absolutely. If you were to ask me as a scientist, I would have to say we cannot yet prove there is a link."
Seen any non-human scientists lately? Rockefeller was saying the problem with scientists is they insist on using science to draw conclusions. And the science here, as he admits in his own way, does not support his position.
Nor will it ever, which may be what those "others" to be appointed to President Clintons panel are all about. As Mary R. Stout, then-national president of Vietnam Veterans of America, once testified before a congressional panel:
I guess, to sum up all of what this means to us and what it means to . . . veterans, is that if we must now presume that the scientific community cannot be trusted—and in some cases obviously — we are assuming that — a political decision must be made on this issue to provide compensation to veterans.
The year was 1990 and the issue wasnt Gulf War Syndrome but the defoliant Agent Orange, and the vets in question were from Vietnam. Study after study found that, other than stress, there was no difference in levels of illness between soldiers who could have been exposed to the herbicide and those who were not, and that many convinced theyd been exposed clearly hadnt been. The scientific community thus became untrustworthy and was overridden by the political "community." The case of the Gulf War Syndrome is currently following a similar course.
Where does this leave the vets? Dr. Russell Tarver, who led the Mississippi National Guard birth-defect investigation, strayed from his data during an interview just long enough to offer an opinion. "I think its unconscionable to frighten people out of reproducing unless you have some good data to support that contention," he said. "I think youre committing a crime against those veterans."