Credibility Gulf: the military's battle over whether to protect its image or its troops.

• Author: Waldman, Amy
• Position: Gulf War syndrome - Includes related article on research on pesticide interactions

IN SEPTEMBER, BILL CLINTON ENDED A WAR the U.S. military had been fighting for more than two decades--against its own soldiers. He I signed legislation agreeing to compensate veterans for the health problems and birth defects believed to have been caused by the military's use of dioxin-containing Agent Orange during the Vietnam War. In one fell signature, Clinton ended an acrid standoff between veterans and the Pentagon, which had first denied the use of dioxin, then resisted releasing its spraying patterns, then insisted that no one could prove that Agent Orange caused spine bifida.

Technically, the Pentagon was right: Even today, the mechanism by which dioxin does its damage in the human body isn't known. Of course, until just a few months ago no one knew how cigarette smoking caused lung cancer either--knowing how isn't the same as knowing if. Regardless, the Pentagon's stonewalling had long ago pushed the issue from the logic of the lab into the emotion of the political arena. Definitive scientific proof or not, Clinton was calling a truce.

So when the Presidential Advisory Committee on Gulf War Veterans' Illnesses recently released a draft report concluding that there is no Gulf War "syndrome," no single disease traceable to the Persian Gulf War causing the variety of symptoms that veterans have experienced--but also stating that DOD's investigation has "lacked vigor, fallen short on investigative grounds, and stretched credibility"--you could see the handwriting on the wall. Once again, wartime experience had spawned thousands of sick veterans, who came home not with bullet wounds or shrapnel in their flesh, but with initially invisible symptoms that could stem from physiological or psychological causes. And once again, the Pentagon had attributed it all to stress, resisted investigation, and withheld crucial information. Now the issue is gathering political momentum (with the Agent Orange debacle fresh in politicians' minds), and you can be sure that eventually Congress will pass, and the president will sign, legislation to compensate sick veterans, even if no one can prove that their Gulf experience caused the illnesses. Sen. Jay Rockefeller (DW.Va.), who has butted heads with the Pentagon repeatedly on Gulf War syndrome, says that regardless of whether the ailments are attributable to stress or, as he believes is more likely, physiological causes, "We can't just walk away. We have a hell of an obligation"

The time frame for resolution will likely be much more compressed than for Agent Orange, because now policymakers and the public are wont to suspect the worst. "The Department of Defense is engaged in probably one of the most serious cover-ups in the history of military affairs," says Paul Sullivan, a Gulf veteran and founder of the National Gulf War Research Center. "The cover-up continues," Rep. Christopher Shays huffed in a September House hearing The allegations by two former CIA analysts that the CIA has withheld evidence of numerous exposures during the Gulf War have only added to the suspicions.

But the focus on sinister conspiracies obscures what may be a more persuasive explanation for DOD's response, first to Agent Orange, and now to Gulf War syndrome: If there is such a thing as institutional stubbornness, the Pentagon has it. All bureaucracies react to something that could cost them face much the way a sea anemone touched by a finger does--they close up and seal off. But DOD is particularly prone to such reactions, which makes the science worth studying in the story of Gulf War syndrome behavioral as much as biological.

More than most bureaucracies, the military faces very public tests of its effectiveness. Since it failed one of those tests in Vietnam, exposing itself to years of abuse, humiliation, and low public esteem, the Pentagon has been especially defensive, and eager for redemption--which the Persian Gulf War provided. It dispatched the military's Vietnam complex, sending institutional pride to new heights. It was the mythical "perfect war" Then along comes not only a nasty set of illnesses, but a plethora of investigators muddying the myth by churning up questionable decisions, vulnerabilities, and just plain mistakes on the military's part.

The apparent stonewalling seems to have been an attempt to paper over bungling or negligence that would tarnish the Gulf victory, as well as the careers and reputations of those associated with it. This same phenomenon surfaced in the investigation of the terrorist bombing at Khobar Towers in Saudi Arabia. A report by a retired Army general concluded that many of the casualties were preventable: Commanders had failed to take basic anti-terrorist precautions, despite ample warning, and Pentagon policymakers had been lax in their intelligence gathering The report also insinuated that the commanders and Pentagon officials had been less than honest about both the precautions they took and their estimates of the size of the bomb (they claimed it was 20,000 pounds, which meant any precautions would have been inadequate; the report concluded it was only 5,000). The inclination was to prioritize protecting the institution over protecting the troops.

Military leaders and their troops have a relationship fraught with authoritarianism, paternalism, and, from the soldiers' point of view, a great deal of faith--because they must entrust their well-being to their superiors. Whatever the etiology of Gulf War syndrome, it has strained that already fragile relationship, exposing the gulf between troops on the ground and the decisionmakers who often determine their fates.

A Priori Assumptions

Imagine a reporter who goes into a story with a hypothesis, then either discounts or tries to discredit any evidence--no matter how compelling--that contradicts that hypothesis. Now you have a pretty good idea of how the Pentagon approached Gulf War illnesses.

Its working hypothesis was that the symptoms would ultimately prove to be traceable to some known disease or to the ordinary stresses of wartime service. 'When you send a large number of healthy young people to a very stressful environment," Dr. Stephen Joseph, assistant secretary of defense for health affairs, said this April, "surprise, surprise! Some proportion of them come home with a variety of illnesses."

The corollary to that hypothesis was a denial that factors unique to the Gulf War could be causing the health problems. So from the start, the Pentagon took a hard line on Gulf War illnesses, insinuating that they were purely stress-related, or all in veterans' heads. Doctors at Veterans Affairs' hospitals took their cues from DOD. To be fair, the military's toughness comes partly from the fact that a fit force is essential to mission performance, and tolerating unexplained sicknesses opens the door to malingering, fakery, even cowardice. But the military's resistance seems particularly vehement when to acknowledge such sicknesses could reflect negatively on its own performance.

The most plausible suspect for the reported illnesses was exposure to chemical and biological weapons in the Gulf, yet that was the possibility the Pentagon most adamantly resisted. Edwin Dorn, undersecretary of defense, said in sworn Senate testimony on May 25,1994: "There were no confirmed detections of any chemical or biological agents at any time during the entire conflict." Assistant Secretary Joseph testified before the House Veteran Affairs Committee on March 9,1995: "There is no persuasive evidence of such exposure, even after much scrutiny." On "60 Minutes" in 1995, John Deutch, then deputy defense secretary, said troops had never been exposed to chemical agents "in any widespread way"

As early as 1993, an investigation by the Senate Banking Committee had challenged such assertions, suggesting that the United States' own actions may have exposed its troops to low levels of chemical weapons when allied forces bombed Iraqi munitions facilities during the war and detonated Iraqi weapons immediately afterward. The Pentagon--led by John Deutch, now director of the CIA--summarily rejected the possibility. James Tuite III, the lead investigator on the Banking Committee report says, "The U.S. government policy that has existed since we wrote the first...