Is it "Saddams Revenge?"
More than two years after the end of the Gulf War, newspapers and the airwaves are filled with stories about veterans of Desert Storm falling ill with a variety of perplexing illnesses. No fewer than 11 television programs such as Nightline have focused on it. This, in turn, has prompted congressional leaders to hold several hearings in which they blasted military authorities.
"The Pentagon just doesnt get it," said Veterans Affairs Committee chairman Lane Evans, D- Ill., at the hearing he sponsored. "Thousands of veterans are suffering without knowing what ails them."
But some authorities who have gone unnoticed — or at least unquoted — by the media are skeptical and see it as but one more example of a media-created and politically-charged "scare of the week."
Dr. Barry Rumack, a toxicology expert who is a clinical professor at the University of Colorado School of Medicine and director emeritus of the Rocky Mountain Poison Center in Denver, said, "I wouldnt call this a syndrome at all, because to me a syndrome a disease and Ive seen no evidence of that."
Rumack, who is also a retired major in the Army Reserve, added, "There is no relationship between events purported to have occurred there, actual or potential, and these illnesses."
That which is called Gulf War Syndrome comprises a number of ailments that have been diagnosed in some of the 657,000 men and women assigned to the Gulf region in 1990 and 1991. Among the symptoms attributed to the syndrome are aching muscles, irritability, fatigue, thick saliva, weight loss, weight gain, hair loss, sore gums, diarrhea, nausea, swelling, memory loss, labored breathing, and headaches.
Much of the attention has been focused on a single unit, the reserve 24th Naval Construction Battalion stationed at Columbus, GA, and the doctor in charge of investigating their complaints, Charles Jackson of the Tuskegee VA Medical Center in Huntsville, AL.
At one time Jackson was using Gulf War Syndrome and exposure to chemical-biological warfare as a diagnosis. He has since backed away from it, though presumably under pressure. Jackson has said of the alleged syndrome it is, "One of the great mysteries of the century. And I dont exaggerate."
Theories as to the specific cause or causes of the illness have ranged from the use of depleted uranium in American shells to fumes from burning oil fires, but by far most of the attention has focused on the most exotic possibility — Iraqi use of chemical agents. USA Today went so far as to headline an article, "Trail of Symptoms Suggests Chem-arms."
But toxicology experts say they these symptoms suggest just the opposite. Neither Americans nor their allies reported suffering from chemical weapons at the time of the conflict, although some of Jacksons patients are now saying that in retrospect they suffered a burning sensation in their lungs after a Scud missile attack.
Jackson admitted as much, yet told USA Today, "But suppose theyd developed something that was insidious so they didnt need to incapacitate in the field," he told the newspaper, "something that would get you when you got home."
But Rumack said, "Obviously Dr. Jackson has no experience with chemical agents or chemical warfare agents. I think U.S. intelligence is extremely aware of everything in Iraqs arsenal."
Further, said Rumack, "The whole reason chemical weapons were developed was to incapacitate enemy troops so one could take the land they were occupying." In other words, immediately.
The Defense Department has stated there is no evidence that Americans were exposed to enemy chemical agents. A spokesman said at a news conference that Czechoslovakian chemical agent detection teams had found evidence of low-level chemical agents which it attributed to allied bombing of an Iraqi chemical weapons facility in northern Iraq. But Northern Iraq is on the other side of the country from Allied troops and was downwind that day, according to the Pentagon.
The spokesman added that U.S. forces used about 13,000 chemical agent detectors during the war and that none showed any harmful concentrations.
According to Rep. Evans, "The commonality of experiences that (Gulf War veterans) have faced seem to be fairly convincing that they are suffering serious problems . . ." But experts note that they have very little commonality at all. Rather, the list of symptoms is both huge and diverse, quite the opposite of what one would expect if they had a single cause. Indeed, the net has been cast so wide as to include even medical problems of soldiers spouses. One soldier speaking at a congressional hearing described how his wife is "beginning to suffer pains in her joints."
"Weve looked very carefully for common exposures," said Virginia Stephanakis of the Army Surgeon Generals office, "and we cant find them of any sort. The soldiers were in different places in Saudi at different times and doing different jobs."
An early Army study of 79 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."
The report said that to the extent there were any abnormalities, they appeared to be related to the stress of being ripped quickly out of civilian life and being sent to a war zone, then a few months later being thrust right back into civilian life. "The only common denominator," of Gulf War Syndrome said Stephanakis, "is the complaints are overwhelmingly in Reserve and (National) Guard troops."
A wider, on-going Army study has compared 5,300 Gulf War veterans with 5,300 veterans who had served elsewhere during the same period. So far it has found that on the whole there has been no difference in illnesses.
The only exceptions it found were that twice as many Gulf veterans showed symptoms of post-traumatic stress, and about 15% more showed signs of alcohol dependence.
The report on the 79 reservists also 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 Stephanakis, "suddenly by god well get plenty of those."
According to Dr. Dimitrios Trichopolous, the head of the Department of Epidemiology at the Harvard School of Public Health, to tell people that something is making them ill is often to induce illness, just as placebos are often effective at convincing sick people that they are becoming well and thereby actually making them well.
"If you keep telling people they should be sick, of course they believe it," said Trichopolous.
Phantom epidemics in which massive numbers of people fall ill upon hearing of other people being sick are well-documented.
Earlier this year more than 2,000 children in and around Cairo, Egypt fell suddenly ill in an epidemic of fainting which some blamed on chemical and biological agents. But researchers from the government and the World Health Organization found no poisons of any sort associated with the victims and declared the problem was psychological rather than physiological.
Eight years earlier, 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 while others blamed a pesticide. Ultimately, medical investigators found nothing to blame for the epidemic other than mass hysteria.
Interestingly, the syndrome symptoms dont seem to have been reported among the hundreds of thousands of other nations troops who served in the Gulf during the war. It appears to be strictly an American phenomenon. Some might argue that this is because for some reason only American soldiers have been exposed to the chemical agent causing the illness, but it could just as well be argued that its because only Americans soldiers have been exposed to the idea that they have reason to fear for their health.
While he doesnt believe that veterans are suffering from anything they were exposed to in the Gulf, Rumack says that this doesnt mean they dont deserve sympathy or help. Stress-related illnesses, said Rumack, are "a devastating problem with physical consequences, its just not anything chemical."
Some of the illnesses which have been related to the Gulf are clearly both serious, even life-threatening, and not the result of stress.
One veteran, helicopter pilot Mike Land, testified before the House committee that he was diagnosed with non-Hodgkins lymphoma after he came back from the Gulf. Another told the story of her son who developed cancer of the heart, lungs, spleen, kidney and brain and died 11 months after he came home from Saudi Arabia.
But assuming these ailments to be related to anything in the Gulf is a huge leap, say authorities. "If you take any population (this large) and look at it for normal rates of disease, there will be a certain number who will develop brain tumors, leukemia, adult onset diabetes. You can expect to find any condition among 700,000 people," said Rumack. "You have to be able to demonstrate that it is different from (the) background (rate)."
The scattered press reports, he notes, do not do that.
Mike Land, for example, is 29. While cancer is relatively rare at that age, it is hardly unheard of. According to the National Center for Health Statistics, over 1000 men a year die of cancer between the ages of 25 and 29 in this country.
Further, said Stephanakis, "Lymphoma has an intermediary stage (the time between the promotion of cancer and its development) of many years and it would be almost impossible for these to be related. If theyre looking for a specific cause of these lymphomas, they should be looking for something they were exposed to 10 or 15 years ago."
In one case, Stephanakis said a soldier who ultimately died of lymphoma had just arrived in Saudi Arabia when he was diagnosed. "He had rectal bleeding six days after arriving and the family blamed it on the Gulf," she said incredulously.
Some veterans and one advocacy group which opposed the Gulf War deployment, the Military Family Support Network of Ft. Bragg, N.C., have also attributed both miscarriages and birth defects in their offspring to exposures in the Gulf.
But again, miscarriages and birth defects among Gulf War veterans must be compared to the background rate. Various studies reported in medical journals have determined that the rate of miscarriage among recognized pregnancies (those where the mother knew she was pregnant) is about 12% to 15%, while at least 2% to 3% of babies in this country exit the womb with some sort of major malformation.
Thus, if just 10% of female Gulf War veterans or their wives had a recognizable pregnancy in the last 10 years, one would expect 7,884 to 9,855 miscarriages by chance alone. Of those remaining babies born alive, 1117 to 1675 would be expected to be born with at least one major birth defect.
Stephanakis said that a study of pregnancies at the Armys largest installations both before and after the war, "was the same — about 8% of all pregnancies. Thats half the national average," she said.
Speaking of the syndrome as a whole, Stephanakis said, "I think were going to find that each case is unique" and unrelated to any given cause. But, she added, "its complicated by politics."
"You have to look at the political side," she said, "and note that its a constituent issue and they would be loathe to turn aside constituents."