President Clinton's announcement of a new panel to oversee the Pentagon's investigations of Gulf War syndrome made it a hot Veterans' Day topic - even though nobody's quite sure just what Gulf War syndrome is. Some veterans report mundane illnesses, like gastrointestinal upset, muscle fatigue and problems with concentration that, as far as anyone knows, are no more common in veterans than in other people. Other veterans have alleged spectacular disabilities: one veteran reported daily bouts of glow-in-the-dark vomit. Despite Gulf War syndrome's uncertain existence, the government has panels, commissions and studies to investigate it. The investigations have failed to confirm the existence of the syndrome. Despite that, the president has called for further investigation.
Advocates of Gulf War syndrome argue that the government shouldn't repeat the Agent Orange experience. They say that the government bungled Agent Orange investigations for years but that "science" finally proved that veterans' claims of Agent Orange-caused deaths, diseases and birth defects were real.
The advocates interpret the science incorrectly. The Agent Orange saga was a clear case of politics' twisting science, and it indicates that Gulf War syndrome should be treated as a political issue and settled politically without dragging science into a debate in which it will be overruled and dismissed.
Like Gulf War syndrome, "Agent Orange diseases" began with veterans' reports. Veterans dying from cancers appeared on television and blamed Agent Orange; reporters tracked down veterans' children with birth defects and blamed Agent Orange. There was no evidence that the veterans had ever been exposed to Agent Orange, and cancers and birth defects occur everyday in people who were never exposed. Blaming was enough; it wasn't necessary to show any connection.
With the press on their side, the veterans pressed their claims before Congress. Congress decided that there was not enough evidence to decide whether Agent Orange was to blame; in 1979, it ordered studies of Vietnam veterans' health.
The Centers for Disease Control did the studies. CDC reported that mortality rates, disease rates and the frequency of birth defects in veterans' children were comparable for men who did and did not serve in Vietnam. CDC also found that few, if any, ground troops in Vietnam had been exposed to Agent Orange.
The Air Force's Operation Ranch Hand sprayed 90 percent of the Agent Orange used in Vietnam. There is no difference in the health of the Ranch Hands, the only veterans known to have been exposed, and that of other veterans who served in Southeast Asia at the same time and flew the same kinds of airplanes but were not exposed to Agent Orange.
Given the history of Agent Orange and the government's willingness to fund second-class science that points in a politically desired direction, can anyone imagine politicians' telling veterans and the votes they represent that Gulf War syndrome doesn't exist?
The plans for the studies of Vietnam veterans' health were approved by government and non-government scientists. The studies were carried out at private hospitals and research centers of the highest reputations. The results were reviewed by expert advisory panels and published in the open medical and scientific literature after the customary peer review. The studies were well designed, well conducted and well reviewed.
The results didn't satisfy the people who "knew" that Agent Orange was the culprit. Led by Rep. Ted Weiss (D-N.Y.), they shouted "coverup," without ever specifying errors in the studies or results. Congress turned to the Institute of Medicine, an operating arm of the National Academy of Sciences, for a review of the scientific literature on the consequences of Agent Orange exposure.
The IOM found "sufficient" or "limited/suggestive" evidence to link eight diseases, including lung and prostate cancer, with exposure to Agent Orange. Those diseases are not found at elevated levels in heavily exposed chemical plant workers, in veterans of Operation Ranch Hand or in Vietnam veterans generally. Even the Environmental Protection Agency, always eager to find connections between chemicals and health, has not endorsed IOM's interpretations.
No matter. On Memorial Day, a year and a half ago, President Clinton announced that the government would pay compensation to any Vietnam veteran who developed any of the diseases on IOM's list. There's every reason to expect that the list of compensable diseases will increase as IOM continues its literature search.
In one important way, Agent Orange diseases differ from Gulf War syndrome. Agent Orange was a single identified potential cause of disease. There is no single potential cause of Gulf War syndrome. It could be anything. Smoke from oil fires, chemicals from flea collars and in anti-nerve gas agents, vapors from kerosene heaters and low concentrations of nerve gas that may have been released in an explosion have all been suggested. The yet-to-be-defined syndrome is equally elusive. It can be anything anyone says it is.
Gulf War syndrome is an unspecified disease in search of an unidentified cause. The search isn't scientific. It's political. The Pentagon awarded $3 million to a researcher who claimed that he had identified three syndromes associated with service in the Gulf War. When his proposal for additional funding failed to garner scientific approval, he went to members of Congress and Mrs. Clinton to plead his case. A Pentagon spokesman said the researcher "has a fairly attractive following." It's not the first time that mediocre science has been funded because it has a fairly attractive following.
Given the history of Agent Orange and the government's willingness to fund second-class science that points in a politically desired direction, can anyone imagine politicians' telling veterans and the votes they represent that Gulf War syndrome doesn't exist? Of course not.
Congress should bring down the curtain on the charade that science will guide the decision to compensate veterans. If it decides to compensate veterans for diseases that they and their champions associate with the Gulf War, it should concede its motivations: compassion for veterans, gratitude for their service or simple congressional vote grubbing. It's too late for Veterans Day this year, but Memorial Day is only six months away.