From the Seattle Post-Intelligencer Reporter, 1/17/01
A decade later, America's 'easy war' lingers on
Cause of illnesses that have struck thousands of Gulf War vets may never be known
By David Fisher

In 1990, before his reserve Army hospital unit was called up to go to the Gulf War, David Zielke of Tacoma was a machinist with a good salary and a young family.

Today, at age 41, he suffers from memory loss, fatigue and uncontrollable muscle twitches. His nerves are jumpy, the result of post-traumatic stress. He hasn't worked in 19 months.

In 1990, Evelyn Hazen of Walla Walla was a healthy Army Reserve nurse who went active long before her unit was called. She never left the country, but she treated troops who were sent home before the shooting started in earnest.

Today, at age 58, she is too disabled to work, haunted by fatigue, memory loss and a host of physical problems.

In 1990, before the war started, Denise Nichols taught college nursing courses.

Today, the 50-year-old former Air Force Reserve major says her memory and her health are so bad she could be dangerous in a hospital setting. So she spends her days lobbying for help for herself and the other victims of unexplained Gulf War illnesses.

The day it ended, the Gulf War -- at 47 days the shortest in American history -- was hailed as an easy victory.

Casualties were light -- only 148 Americans were killed. The mass-scale chemical and biological attacks that had been most feared did not occur. An aggressive dictator had apparently been stopped.

Ten years later, however, vets and their families are still grappling with the war's aftermath.

But no one can say for sure just how many suffer from the mysterious collection of maladies known as Gulf War illness.

Since 1992, about 117,000 of the Gulf War's more than 500,000 veterans have come in for voluntary health evaluations, according to Pentagon reports.

Eighty-seven percent complained of diagnosable health problems; about 21,000 suffer from symptoms that can't be explained or accurately diagnosed.

Sufferers report symptoms that can include chronic fatigue, skin rashes, headaches, muscle and joint pain, memory problems, shortness of breath, sleep disturbances, vomiting, diarrhea and chest pains.

Thousands of Gulf War troops were exposed to a stew of potential irritants or toxic agents, including vaccines for anthrax, plague, pertussis, tetanus, cholera, hepatitis A and B, polio, yellow fever and typhoid.

An estimated 110,000 were exposed to the nerve agents sarin or cyclosarin when allied forces blasted an Iraqi weapons bunker after the war, and thousands more were exposed to the fallout from oil well fires.

More than 250,000 apparently took tablets laced with pyridostigmine bromide, an enzyme that inhibits neural transmitters, to block the potential effects of an attack with the nerve agent Soman.

Some -- anywhere from a tiny handful to more than 450,000, depending on whose numbers you believe -- were exposed to radiation from depleted uranium, a substance used in armor-piercing weapons.

Yet, despite $155 million in research and more than 190 separate research projects, no one has been able to pinpoint a cause for Gulf War maladies, or even to define a single set of symptoms that define the illness.

"We're certainly not giving up hope," said Austin Camacho, a spokesman for the Office of the Special Assistant to the Secretary of Defense for Gulf War Illnesses.

"That research is still continuing and ongoing," Camacho said. "But more and more, there is a feeling that it may be beyond science to find the cause for all of these illnesses."

A presidential oversight commission's latest attempt at a comprehensive report discounted each of the potential physical causes of Gulf War illnesses, either because exposures were not consistently found among large groups of sufferers, or because more research needs to be done to establish links.

Instead, the commission headed by former U.S. Sen. Warren Rudman leaned heavily on the physical aftershocks of wartime stress as a potential explanatory factor.

That explanation was not without precedent.

Research done in the mid-1990s found that the veterans of every American conflict since the Civil War have complained of similar symptoms, including fatigue, shortness of breath, sleep disorders and memory problems.

But the oversight committee's report did nothing to calm the Pentagon's critics, such as Nichols, the woman who had taught college nursing courses.

Nichols, now vice chairwoman of the National Gulf War and Vietnam Veterans Coalition, said she has been diagnosed with hyper coagulation of the blood, and traces of depleted uranium have been found in her urine.

Gulf veterans, she said, have suffered unexplained spleen ruptures and heart attacks, as well as cancers that have occurred at unusually young ages.

She, too, thinks it's unlikely that only one cause will be found to explain every malady, but stress seems inadequate to explain such serious disorders.

"Sure, stress is not good for the body," Nichols said. "But this was the shortest war in history."

Other critics labeled the report an attempt to avert liability.

"It would be very costly for the government to have to take the full responsibility for this, like they did in other wars," said former Congressman Jack Metcalf, R-Langley, who pressed the Pentagon for four years to consider the possibility that an agent in anthrax vaccines might have caused some Gulf disorders.

The research seems promising, if so far inconclusive.

Researchers at Tulane University have found traces of squalene, a biochemical agent that might have been present in anthrax vaccines, in the blood of some veterans, but Food and Drug Administration officials claim there is "no clear pattern" to link the chemical to adverse reactions.

At the University of Texas Southwest Medical Center at Dallas, researchers theorize that brain damage might have been caused by a combination of nerve gas, anti-nerve gas agents and a chemical pest repellent, but their study has been criticized for its small sample -- only 30 veterans from one battalion.

Meanwhile, researchers at the University of Texas M.D. Anderson Cancer Center in Houston say they may have found a link between Gulf War symptoms and Mycoplasma fermentans, an infection that can be battled with the antibiotic doxycycline.

Tests are under way with the antibiotic in a handful of Veterans Administration medical clinics, including Seattle's.

Despite its short duration, the Gulf War was stressful in a life-changing way, Zielke said.

Troops were pulled out of private life and drilled to expect massive chemical, biological and terrorist attacks once they hit the desert.

Zielke, a security specialist in a hospital unit, was dispatched to a deserted settlement 40 miles north of Riyadh, Saudi Arabia.

Once the shooting started, 31 Iraqi Scud missiles were blasted out of the sky by Patriot missiles near the village.

Troops on the ground had no idea what was in the Scuds, Zielke said -- each time the alarms sounded, they scurried for chemical-protection suits that left them covered with fine charcoal dust.

One explosion knocked his cot 3 feet away from the tent wall, while he madly scrambled for his chemical suit. Shredded missile fragments frequently landed around the camp.

Sometimes the blasts would come one a night. Sometimes two. Sometimes not at all.

The anticipation of attack and death hung in the air like the sand, a constant irritant.

But the war, he said, was nothing to what came later.

A sinus infection he caught in 1991 is still with him. Memory loss, periodic muscle spasms, joint pain, irritated eyes, fatigue and unpredictable emotional reactions have been constant companions.

The first Veterans Administration doctor he saw at American Lake "put his hand on my shoulder and told me I was a parasite on society," Zielke said.

That much, at least, has gotten better.

Congress required the VA several years ago to treat Gulf War veterans with undiagnosable illnesses as though their illnesses stemmed from the war, even if no connections can be established.

Pentagon officials are still encouraging the 500,000 or so Gulf veterans who have not been checked to get a health assessment from their local VA clinics.

Zielke doesn't hold out much hope for himself.

Yet, he thinks it's worth keeping the pressure on for more and better research, or the face of the next war may look a lot like the last.

"What I hope is that they learn what happened to us, so in the next go-around, once it happens, they can treat them quicker," he said. "They can't help us. They don't know enough about the nervous system to fix us."