Veterans' Burning Questions

by Howard Fienberg
January 14, 2003

According to a recent article in the Chicago Sun-Times, "researchers have identified a new malady among veterans of the first Gulf War: burning semen syndrome." Direct exposure to their semen can cause "burning, pain and swelling" in intimate areas. The syndrome is only one of dozens of ailments and "syndromes" which have supposedly befallen some Gulf War veterans, collapsed under a single heading: Gulf War syndrome (GWS). The most recent figures indicate that the U.S. government has spent over $115 million researching GWS, not necessarily including the Army funding of this most recent study of burning semen. So what is this expensive syndrome and what caused it?

GWS symptoms range from the mundane to the bizarre. Sufferers have claimed symptoms from insomnia, nausea and aching joints to lupus and Lou Gehrig's disease. Dozens of culprits have been named, including vaccinations, biochemical warfare, oil fires, and depleted uranium munitions. Some have called it an infectious disease, others a genetic impairment.

As you might guess, people have been thoroughly (and quite rightly) confused as to the precise nature of GWS. The possibilities seem limitless. Veterans and non-veterans alike have learned to fear the syndrome, despite the fact that few know anything tangible about it. But lack of concrete knowledge has not stopped a decade-long flood of speculation, rumor, alarm, and charges. The media and governments of Canada, the U.S., France and Britain have all at various times claimed to understand the disease, often relying on the self-reports of the same fearful veterans. Without a doubt, the veterans are experts at determining how they feel, but few have medical training and laymen not uncommonly make mistakes. It is all too easy to confuse symptoms (pain, headaches, fatigue) with a disease syndrome and rush to judgment on what caused the condition.

It is still unclear on what these symptoms can be blamed. But almost every scientific, epidemiologic and medical study has found no evidence of an all-encompassing syndrome. These have included studies by the military, the Centers for Disease Control and Prevention, the National Institutes of Health, the Rand Corporation, the National Academy of Sciences, and innumerable prestigious universities, usually published in prestigious and reputable journals. The U.S. Presidential Advisory Committee on Gulf War Veterans' Illnesses, whose mandate was extended in 1996 because the U.S. government refused to accept the verdict that the PAC could find no evidence of GWS, returned the same conclusion a year later.

Evidence demonstrates that some Gulf War veterans are ill. That's all. This does not mean that some of these vets are not sick, nor that they are all suffering from psychologically based illness, though some of them may be (and even they are still sick). But their illnesses match those afflicting ordinary individuals over time - and usually at a lower rate.

Veterans and their advocates can not only misunderstand symptoms, they can also mis-diagnose what may have caused them. For instance, some people fall prey to the post hoc fallacy, confusing correlation with causation. Just because one event occurred after another event does not mean it is a result of that event. Careful study has demonstrated that some veterans carried illnesses before they ever set foot in the Gulf.

A striking example is American Army Reservist Michael Adcock, the first death widely attributed to GWS. He died in 1992 of lymphoma. His family blamed it on his Gulf War service and testified to that effect before Congress. In reality, he started to show symptoms of lymphoma six days after deployment to the Gulf. That practically excludes a Gulf War link, since lymphoma usually takes more than ten years to develop.

Scrutiny reveals other peculiarly faulty diagnoses. For instance, Denise Nichols testified before Congress that her daughter was one of two she knew who had developed congenital cataracts after their parents had returned from the Gulf. Congenital means "from birth" - both daughters being born before the war. She missed the meaning, and hence, so did Congress and the media at large.

Media coverage of GWS over the last decade has been remarkably inconsistent and incoherent and, as a consequence, may have helped spread the purported disease. A 1998 study in Psychosomatic Medicine pinpointed stress and anxiety disorders as a prime cause of GWS. A study earlier that year, in the American Journal of Epidemiology, found a correlation between large increases in veterans' reporting of symptoms to periods of intense media coverage of possible chemical weapons exposure. In this respect in particular, veterans fears seem more than a little misplaced, since the estimate of the number of soldiers potentially exposed to chemical weapons has fallen dramatically, from 100,000 to 10,000, to hardly any.

Every twist and turn in the GWS drama has led to more research funding for ever more disreputable scientific investigations. The choices of which projects to fund have been frequently snatched out of the hands of their usual scientific bodies and put at the mercy of passing political necessities. Government officials must understand that it would be cheaper in the long run to simply provide full medical care for all veterans than to continue to fund such research and open the government to a potential future of blockbuster lawsuits (as may be happening with its treatment of Vietnam veterans and their possible exposure to Agent Orange). In fact, full veteran medical care may provide a further incentive to join the armed services, helping the military attract better and brighter soldiers confident that, no matter what happens, their employers will look after their welfare.

The U.S. government has no business wasting all this time and money on dubious research investigations. We have looked under the rug a hundred times over and have found no evidence of an elephant hiding there. Rather then embarking on another endless hunting expedition, perhaps it is time to consider that there is no elephant. Our efforts are best focused on treating sick veterans, not toying with them.

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