Although my military career preceded the Gulf War, I have nevertheless harbored a warm, fuzzy empathy with those veterans who claimed that they suffer the ravages of Gulf War Syndrome. After all, they are brethren in arms, despite a lack of contemporaneity. If they had indeed been afflicted with the effects of chemical or biological agents while in the theater of operations, then they warranted an official acknowledgment of their condition and some compensation from the federal government for a service-related disability. I was outraged by what I perceived to be our governments attempt to avoid any responsibility for the debility of these brave men, despite the emotional appeal of the victims and their families before the congressional committees, the compelling testimony of GWS experts, the heartrending articles in the newspapers, the expose on 60 Minutes. What meanspiritedness to deny deserving veterans just compensation for their pain and suffering. Why, that could have been me sitting in a wheelchair!
This was my position, until I read Michael Fumentos excellent piece in your March issue, "Gulf Lore Syndrome." My sympathetic mindset has been radically altered by his most convincing and insightful report. Fumento has pointedly rebutted or at least introduced a great measure of doubt into the existence of GWS. What began as a casual read turned out to be a learning experience. It would appear that GWS, like the AIDS tragedy, has become an emotional issue for political and media grandstanding rather than a medical condition that requires a medical solution.
I was impressed with Fumentos compassionate concern for the devastating effect that this media-generated hysteria has had on so many veterans. As he says, most of them have no expertise to distinguish real from suggested disease. They deserve better. I am a physician in practice for over 40 years, and people have no idea how seriously disability-seeking behavior can impact their lives. They have to play the disabled game. A veteran who is seeking new benefits or is receiving benefits as long as he/she remains disabled will often not look for a job, wont even help with the dishes or take out the garbage, and does not even have to be nice to his family. Such a person may think that he has or will have a pretty good deal, but ask his family and friends what they think of this new person whom they have to contend with.
The veterans organizations and many politicians are guilty of hurting many of the very people they allege to help by their suspicion of and opposition to the legitimate concerns of science.
Frank R. Williams, M.D.
Palo Alto, CA
It is so good to see in print a view contrary to the unreasonable and unreasoning flood in the general media. Sometimes I question my own reasoning when faced with such a deluge of contrary opinion. I was working at the Veterans Administration when we went through the last example of this epidemic hysteria, "Agent Orange." I remember one journal commenting on a civil suit that a veteran had filed. He stated that Agent Orange had caused his children to be born with polydactyly. He won his case even though the defense showed that this trait had occurred in the plaintiffs family for generations back.
As clinic doctors we participated in collecting data by surveying veterans. This survey had no context and could not provide any meaningful information, just a litany of complaints. Studies such as the New England Journal of Medicine article you cited were done and published in scientific journals, never to see the light of mass media. I fear we are about to throw a vast amount of money down this hole again and nothing will stop it.
Michael O. Montgomery, M.D.
Department of Anatomy & Cell Biology
I both write and edit for a political and policy newsletter (The Lone Star Report) and have worked in a press capacity for both elected officials and candidates. To someone who has had to deal with the absolute lack of journalistic standards (or even common sense) when it comes to scientific and environmental issues, your article is a breath of fresh air. It was just wonderful. How is it that the press can be so stupid when it comes to reporting on these issues? They are so quick to print, and so slow to check their facts. I have had to deal with this type of thing before, but your attempts to get at the truth here must have been mind- boggling.
Unfortunately, a whole industry has grown up around GWS. Truth hurts the bottom line, so myth and hysteria must be continued. Sure, the people involved truly believe there is a problem, but its still not provable. Many really believe in psychic hotlines, but they are still fakes. I used to think that this type of media goofiness was confined to late-night talk shows with UFO formats. But now its on the front page of the local paper.
James A. Cooley
I recently read the article on GWS in REASON. I am a lieutenant in the Marine Corps, and although I was not in the Gulf myself, I have friends who were. I also have the collateral duty of NBC (nuclear, biological, chemical) officer for my company. I would like permission to reproduce your article so that I may pass it around my unit in the interest of truth and understanding. In the military, rumors become gospel even faster than your research shows, and I think that your article would be useful in dispelling a few of these myths running rampant in the Corps.
Scott D. McDonald
I have spent part of my career as an epidemiologist and all of my career dealing with epidemiologically related issues. Your article showed an excellent grasp of the basic epidemiological principles which must be applied in order to understand any new disease or phenomenon. Unfortunately, most of these principles seem to be beyond almost all of the people writing about illness in Gulf War veterans. You have made a real contribution.
Jack Zusman, M.D.
I just finished reading "Gulf Lore Syndrome," and I could hardly wait to get to the keyboard to give you a big thumbs up! I have been proclaiming your exact words for years now. And I have been watching with increasing anger as the distortions have mounted in the press and have been fervently propagated by very visible members of Congress. I am a medical doctor who served proudly with my regular army artillery unit (I was on active duty – not a reservist), the 42nd Field Artillery Brigade, in the Gulf War. We were a VII Corps asset, meaning that we were assigned to and fired missions with several different divisions all across the battlefield during the war from the first days after the onset of the air war, including the 1st Cavalry, 1st Infantry, and 3rd Armored divisions. I was in the theater of operations from December 1990 through May 1991. I bet I personally covered 75 percent of the battlefield. In addition to preparing daily for the possibility of chemical or biological warfare, I took photographs. I have well over 2,500 photographs taken with my Nikon F3 during those months in the Gulf.
Since that time I have left active duty. I am currently in the third year of an Emergency Medicine Residency Training program at Vanderbilt University in Nashville, Tennessee. As part of this training I take care of patients at the V.A. hospital just behind the main University Medical Center. The classic case of GWS that I relate to my colleagues is that of a young former soldier (reservist) who told of a syndrome that consisted of a terrible rash, malaise, and low-grade fever, which recurred every few months and left him feeling washed out for a long time. I knew when I saw this young man with his malady and his mother at his side in the room that I would never be able to convince them that he had herpes and not some mysterious illness. Perhaps he had contracted it in the Gulf. I did treat genital pediculosis in our small headquarters battery without informing my commander. I also recovered boxes of untaken pyridostigmine bromide tablets after the war. Despite the warnings of possible nerve gas exposure, it seems that most of our soldiers just didnt like taking those little pills every eight hours for the short while we were supposed to take them. They made you pee.
I strongly believe that instead of doing our vets a favor, we are doing them a great disservice by allowing the propagation of these lies. I am a vet. I put my life out there on the front line with my fellow artillery redlegs (not at some hospital in the rear). I feel exceptionally strongly about this issue.
David W. Lawhorn, M.D.
Major, MC, USAR
Kudos to you. I am a Vietnam-era veteran and I want to congratulate you on your recent story "Gulf Lore Syndrome." I thought the story was brilliant. It was also an exercise in courage. Standing up to the national media and also to the delusional veterans – primarily victimized by the media – must be difficult. You may not win a Pulitzer Prize – in fact, you probably wont, because your story is politically incorrect. But your work is very admirable to this writer. Thank you.
Major, USAFR (Ret.)
I wanted to compliment you on your article analyzing the Gulf War Syndrome. Piece by piece, you take apart this problem and show it for what it is: media hysteria and psychosomatic illness. Your reasoned analysis is a breath of fresh air in a world that appears to have lost its ability to reason. Your placement of glowing vomit up front in your article was key. I would think anyone could understand this point. As a former chemistry professor turned lawyer, I found the lymphatic cancer point equally compelling, but to the ignorant, this will, I am afraid, appear to be hairsplitting. To see your skewering of 60 Minutes, I would have paid 10 times the cost of the magazine. More power to you. I await with interest Fumentos next piece.
Christopher J. Flann
I just read your article about Gulf War Syndrome, and Id like to thank you for your fine effort. An additional point may have helped to explain this particular craze. The public debate leading up to the Gulf War fed anticipation of far more casualties than there were. There followed a strange display – often approaching guilt – at the lopsidedness of the victory and the low Allied casualty rate. Im no psychologist, but it seems that if a whole nation braces itself for grievous injury and that injury fails to materialize, an imaginary injury could serve the need for drama and morality just as well. Perhaps this also helps explain why the pessimistic environmental predictions following the oil fires received such undue attention.
I have followed Fumentos work for some time, including his excellent book Science Under Siege. I just finished his article "Gulf Lore Syndrome." As a practicing plastic surgeon having just gone through silicone hysteria (I call it "media induced stress disorder"), I am struck by the similarities with GWS. In fact you could substitute the word silicone for GWS in your article and it would read remarkably accurately. The main difference is the lack of a contribution from the plaintiffs attorneys whose greed drove the implant crisis. I presume this is because the "bad guys" in GWS are government agencies and the Iraqis, who are harder to extort from. I plan to give copies of your article to other doctors who dont seem to see the fundamental assault on medicine, science, and reason that these episodes represent.
Scott L. Replogle, M.D.
Thank you very much for putting this nonsense into perspective. I am a Gulf War vet. I served as a Surgical Company commander, 1st Medical Battalion. My company deployed to Desert Shield in September 1990 and returned in March. There were over 200 men in the medical facility staff and we lived in the "field" the entire time. It was hard living: poor food, always dirty, too many flies, and too much uncertainty. I am very proud to say that the company performed its mission with determination and stamina. We saved many lives with our medical care because we were where they needed us, up front.
Those months in the desert were stressful, and every week I saw the effects of this stress on my men and myself. It was a great relief to return home to my family. Even being in the medical field, I never anticipated that post-traumatic stress disorder would affect me. It did. When the media started writing and broadcasting stories about Gulf War Syndrome, I was flooded with questions from my men. I tried to kill the myths and rumors as fast as I could, but they grew exponentially.
Your article has become a great myth killer for me. I too have heard Denise Nicholss bizarre tales and Brian Martins wild claims, and just stood back in total disbelief that they were getting air time on national news. All I wanted you to know is that I very much appreciate the hard work that went into your article. Thanks for clearing up so much.
Captain (S), MSC, USN
Naval Health Research Center
San Diego, CA
Michael Fumentos rambling, slanted "Gulf Lore Syndrome" was a disappointing discourse unworthy of REASON. Supposedly investigative articles such as this should look at all the facts, not only those the author wishes to bring out in order to shriek his opinion. More disconcerting, however, is the editors lack of insight in allowing this piece to be printed.
Fumento complains about Gulf War vets believing only what they want to hear, yet he does precisely the same thing by not examining all the data available and offering possible answers. Instead, he chose to use open-ended, amateurish claims such as, "It is no exaggeration to say that every ailment any Persian Gulf vet has ever gotten – or that anybody has ever gotten- – has been labeled a symptom of GWS." Such pedestrian assertions do nothing for this magazines reputation. Does he expect us to believe Gulf War vets are claiming that heart attacks and AIDS, to name but two ailments, are caused by GWS?
Fumentos toeing of the mainstream political line in accepting the governments suggestion that GWS symptoms are entirely psychosomatic is discouraging. He would have us believe that the hundreds of dead camels, sheep, and goats my unit walked through a few miles below the Kuwaiti border just days before the ground war started died, in fact, of psychosomatic illnesses. And he would have us believe that the two Marines wounded in action by an Iraqi mine filled with a blister agent in lane Red One on February 24, 1991, at 0656 were, in fact, not suffering from blisters and other injuries caused by the mine, but rather from psychosomatic illnesses.
Why would REASON allow a writer to ignore the independent medical studies (by such institutions as Duke and others) that found a combination of pyridostigmine bromide (the experimental nerve agent prophylaxis we were ordered to take without being told it was experimental), DEET, and permethrin caused symptoms in lab animals very similar to some of those most commonly reported in Fumentos nonexistent malady? Why does Fumento ignore the governments long and well-documented history of denying cover-ups like their early nuclear and chemical warfare and LSD experiments on their own soldiers, and the truth behind Agent Orange (or is that all in our minds, too)? Does he really believe the governments claim that every NBC (nuclear, biological, chemical) technician who detected chemical agents on the battlefield, and every piece of proven-effective chemical detection equipment that was calibrated by General Dynamics the day before the ground war kicked off, in every instance, was faulty? A 100 percent failure rate of men and equipment? Fumentos grant would better have been applied to a publication more prone to hype, political correctness, and one-sided reporting. I hope future articles by this biased and poorly supervised individual are more balanced and factual.
Thank you for exposing the poor job the news media has performed regarding the health claims of the Gulf War veterans. Four points for your consideration:
1. The medical bacteriology text I read regarding Mycoplasma fermentans states that "M. fermentans is a normal inhabitant of the genital tract." Therefore I do not understand the statement of the "man universally acknowledged as the leading expert on MF, Dr. Shyh-Ching Lo of the Armed Forces Institute of Pathology," that " Weve never found one Persian Gulf vet with the bacterium."
2. According to Science News (November 30, 1996, page 347), the May 1996 Journal of Toxicology and Environmental Health contains a study showing the nerve damage that happens to hens exposed to a combination of DEET, permethrin, and pyridostigmine bromide. (It leaves them "weak, breathless, and unable to fly.") All these chemicals were used widely by the troops in the Gulf War. In the same article, Science News reports that, according to Department of Defense spokesman Bryan Whitman, the DOD has conducted a similar study on rats, and "the chemicals were more toxic to rats when given together than individually. It is not known whether this holds for humans. Whitman says follow-up studies are underway."
3. By the time I got to this third point I had begun to wonder whether you were interested in seeking the truth in this mess or in merely winning the debate with the media. Why? Your use of the terms experimental and investigational. What are you logically trying to tell us when you write, "The drug itself comes from a class of pharmaceuticals that has been in use since 1864"? That it is not experimental? That it is not investigational? That it is safe? Methyl alcohol comes from a class that has been around for thousands of years, but I wouldnt drink it.
My Physicians Desk Reference gives a dosage range for pyridostigmine bromide of 60 to 1,500 milligrams per day for myasthenia gravis. As hard as you may try to minimize the amount taken by Gulf War troops with the phrase "three 30-milligram pills to be taken daily," it is still 90 milligrams, and so the troops were still taking more than what some myasthenia gravis patients take, not less.
Pyridostigmine bromide does have many serious side effects. Check a PDR. Now put those side effects together with an Israeli study, reported in Science News (December 14, 1996, page 375), showing how stress caused an increase of the neurological side effects of pyridostigmine bromide in their soldiers during the Gulf War, and you can see whence the hysteria might initially have come. The U.S. troops are stressed out because they might be gassed. They have trained for being gassed. They take pills to protect them if they are gassed. They start to get headaches, drowsiness, etc., as do 25 percent of their fellow soldiers, when they are in an area where they might be nerve gassed and are taking the pills. Even though the effects of pyridostigmine bromide alone are supposed to be of short duration, you can see where the troops might have gotten their initial dose of hysteria, cant you?
4. Dont be too hard on the media if they dont always believe the Pentagon. After all, some of them may be aware that the U.S. Army, in a germ warfare experiment, sprayed a bacterium, Serratia marcescens, over the San Francisco Bay area in the 1960s, making some people seriously ill. In that case, civilians, not soldiers, were guinea pigs. Over a year ago, I learned on Dateline NBC that the U.S. Army had also released a bacterium into the New York City subway system in 1966. I wrote two letters to Dateline NBC and one to my local NBC affiliate, KSBW, to find out the name of the bacterium, but so far none of my letters have been answered.
Dont throw your particular Gulf War baby out with the media bath water just yet. Keep on trying to cut through the crap and get to the truth.
"Gulf Lore Synrome" is one of the best articles I have read in REASON. But Id like to know: Do Gulf War vets show a higher incidence of psychosomatic symptoms than other vets of the same era, or than the public at large? It would seem that they should, since only this group would be affected by the psychological forces imposed by "Gulf Lore." But the information in your article seems a little confusing on this issue. For instance, at one point you discuss an Institute of Medicine investigation of three reports of GWS illness clusters. You state that "while the symptoms tended to be the same among the three groups, these were classic psychosomatic manifestations." At the same time you mention that the IOM studies "were not successful in demonstrating that these symptoms occurred at a higher rate among PGW [Persian Gulf War] veterans than among [other] PGW-era veterans."
Do you see my problem? This would suggest that psychosomatic symptoms are occurring at the same rate in both groups. If your suggestion is correct that the hype is causing Gulf War vets to get sick by suggesting that they should be sick, how could this be? This hype would not affect vets who had not been to the Gulf. Perhaps you can address this point in your response to the many angry letters you will get about your article. Again, congratulations on your excellent work.
I served proudly in the United States Army for over 10 years in elite military units, from the 101st & 82nd Airborne Division to the 2nd Infantry Division. If you think veterans are making up their illnesses, then you and your reporter are full of it, because we are trained to accept pain and drive on. However, illness which overcomes you within three days of arriving in a country following Scud missile explosions overhead only goes to show me and others that are sick that its not in our heads, but caused by some foreign agent or agents.
If Fumento is a medical writer, as he claims in both REASON and The Wall Street Journal, he should be doing adequate medical research and not relying upon the prepared statements and utterances of the government agencies he seems to favor, and whose opinions and inconsistent assertions are in question at the moment. He missed the recent University of Texas Southwestern Medical Center at Dallas study published in the mid-January issue of the Journal of the American Medical Association. He missed research done in Glasgow and Kuwait. He missed the 308 DOD Missing GulfLink Files. He missed reams of documents. Instead Fumento concentrated on presenting kooky aspects of a troubling and grim reality that no one yet has an answer to, and in the end could only substantiate his less-than-medical final assumption with the theory of a foreign medical historian, not even someone working on the problem in the field scientifically.
You are asking me as a reader to assume that this is reasoned thought? This is thinking? This is allowing oneself to live with the contradictions until more information is available? The tone of his piece had all the backroom bravado of the ugly fat kid figuring out how to get some attention. I am surprised at your editorial board for not doing – at least – basic fact checking. I did some of it for you and was even more surprised at what you missed. But maybe you thought the controversial nature of his stand would sell more copies of the magazine. Is that why you slapped it on the cover? All it did for me was cause me to never want to pick up your magazine again, and to tell as many people as would listen to do the same.
Michael Fumento replies: My head swelleth over with the praise. As to the criticisms, I was able to identify all of one (which not coincidentally was couched in the politest of terms) that actually helps clarify matters. Jack Tallent raises the basic question: Are Gulf War vets suffering illness at the same rate as both vets who didnt deploy and civilians, and, if so, how can this be reconciled with saying they have a higher rate of psychosomatic illness?
Let me provide the whole sentence from the Institute of Medicine report Tallent quotes. "Thus, although these outbreak studies were successful in demonstrating a common pattern of perceived health problems across a range of military units deployed to the Gulf, they were not successful in demonstrating that these symptoms occurred at a higher rate among PGW veterans than among [other] PGW-era veterans." What theyre saying is that the soldiers in the "outbreak" studies perceived themselves as being sicker, but theres no evidence that they actually were. The studies just took the soldiers word for it, and many of the complaints are things that cant be measured with medical instruments anyway, such as fatigue or muscle pain.
To some doctors, that means theres nothing there. To others, and to me, it means there is something there. That something is psychosomatic.
Lets restate the basic proposition. Yes, some Gulf War vets are sick. Since there are so many Gulf War vets, its fair to say that many Gulf War vets are sick. No, the Gulf War vets are no sicker than comparable non-deployed vets or civilians in areas that are thought to be nonpsychosomatic, including overall deaths, cancers, birth defects, and miscarriages. But several studies do indicate that Gulf War vets have more of what have traditionally been accepted as possibly psychosomatic illnesses – including muscle pain, fatigue, insomnia, joint pain, and the like – than other groups.
Whether they just think they have more illnesses isnt really a proper distinction. If a vet honestly says his joints ache, hes hurting. Thats why what I call Gulf Lore Syndrome is so vicious. Dannie Wolf, in the next letter, shows he doesnt understand this distinction. My article did not accuse any vets of "making up their illnesses." It said that all the vets who are sick either would have been sick regardless of their military service or are suffering from psychosomatic illness, which is real but stems from a persons own mind rather than being organic – from some outside physical cause.
After my article went to press, two new pieces of evidence came along indicating that the vets truly are suffering psychosomatic ills. Naturally, both were twisted by the press to make it seem as if they were organic. One was from the University of Texas Southwestern Medical Center in Dallas and appeared as a series of articles in the January 15 Journal of the American Medical Association. Janie Angus mentions this in her letter. The other was mentioned in the congressional testimony of Department of Veterans Affairs Under Secretary for Health Kenneth W. Kizer on January 21.
The Dallas study, not incidentally, was funded by Mr. Conspiracy Theory himself, H. Ross Perot, who is determined to show that GWS is real. It claimed to have found various neurological and other problems in Gulf War vets from a Seabee unit and correlated these with exposures to various chemicals, such as insecticides and the flea collars some of the men wore. The main problem with this study is that its based entirely on self-reports in terms of both illness and exposure.
As such, what the researchers found is exactly what you would expect to find if the main cause of GWS were psychosomatic illness and epidemic hysteria. That is, the soldiers reporting the most problems also reported the most exposure. Perfectly healthy soldiers would say, "No, Im absolutely sure we were never gassed." Those with aching joints and dizziness would say, to use the classic line quoted in one USA Today scare story, "I know in my heart I was gassed." Which is to say the soldier has absolutely no physical evidence that he was.
The material that Kizer provided had the same drawback. Again, it relied entirely on self- reports. Men who were closest to the munitions-dump blast at Khamisiyah and who have been told over and over and over again that they should be unhealthy – because, as we now know, the bunker contained nerve gas weapons – have a higher rate of complaints for certain illnesses. Of the 81 soldiers who were within a 50-mile radius of Khamisiyah, 28.4 percent reported various types of muscle and joint pains, compared with 18.4 percent of soldiers questioned who were outside that radius. These soldiers joints were not x-rayed, and they were not given other sophisticated medical tests. They were simply asked, and they answered.
Kizer desperately tried to make all this clear in his testimony. Yet The New York Times, in the lead paragraph of its story on the subject, translated this into, "For the first time, a federal agency acknowledged yesterday that there appears to be a direct link between the release of toxic chemicals in Iraq in 1991 and one of the many different symptoms that have come to be called gulf war syndrome." So it goes.
Bob Newman asks if I expect readers "to believe Gulf War vets are claiming that heart attacks and AIDS, to name but two ailments, are caused by GWS." At least two congressmen are on record as saying that heart attacks among Gulf War vets were quite possibly caused by the alleged syndrome. Any number of reporters have made the same claim. As I noted in the article, we have already seen herpes blamed on GWS. Can AIDS be far behind?
Now, before I go into any of the conspiracy theorists claims as to what is causing GWS, let me point out that, logically, to implicate something as a cause of a disorder, you must first establish that the disorder exists. None of these letter writers challenged the data – nor the five national panels of scientists who evaluated those data – that indicate that, but for a few psychosomatic symptoms, Gulf War vets are having exactly the amount of illness you would expect them to have. Trying to figure out the cause of GWS is as fruitful as trying to deduce who assassinated President Eisenhower and why they did so. These letter writers want us to ignore that whole section of the article and just go straight to their conspiracy theories. That said, here goes.
Regarding the alleged land mine explosion Newman refers to: This came out in the testimony of Maj. Randy Lee Hebert in December congressional hearings. Hebert has Lou Gehrigs disease that hes convinced is GWS. Never mind that 30,000 Americans who have never been near the Gulf are diagnosed with Lou Gehrigs disease each year. Hebert claims a chemical mine burned two Marines in his unit with blister agent. Maybe this happened; maybe not. But whats the point? Yes, we know chemical weapons were in the theater at the time. It also remains true that, as Gen. Norman Schwarzkopf told Congress recently, there is no evidence of a single soldier suffering at the time of the war from a chemical weapons attack – much less 60,000 to 80,000 of them.
The Duke study Newman mentions was also funded by (surprise!) Ross Perot. Funny thing, but where Perot money goes, proof of GWS seems to follow. The study was considered and rejected by both of the national panels that met after it was released, the Institute of Medicine and the Presidential Advisory Committee. It wasnt a hard decision. The poor chickens at Duke were given chemicals in amounts much larger than any that Gulf War vets received. Every day the animals were given four times the dosage of pyridostigmine bromide veterans were prescribed, and given it not for two weeks but for two months. They were given 10 times the DEET dosage that even a heavy bug repellent user would slather on. Finally, the chickens daily permethrin dose was 7 million times what a soldier would have absorbed each day from his uniform, which is where the troops exposure came from. All this experiment proved was what toxicologists have always known – that enough of anything will hurt you and even more will kill you. Little wonder that of the five birds exposed to all three of these chemicals, three keeled over and went to that great chicken bucket in the sky. Thats a symptom not of GWS but of acute poisoning.