FRONTLINE
Show #1607
Air date: January 20, 1998
The Last Battle of the Gulf War
Written, produced and directed by Jon Palfreman

1st VETERAN: [at hearing] Are you going to allow us to die slowly of some unknown disease? We need - as a nation, as a people - to make a statement to the world.

2nd VETERAN: I get angry at people for no reason. And I want to just twist Washington's head right off.

NARRATOR: America's veterans are angry. America's veterans are sick.

KIM HEBERT: When Randy left for the war, he was just in perfect condition, until he came back from the Gulf.

NARRATOR: Did something happen in the Gulf War that made the vets sick? The idea has excited the media.

TED KOPPEL, ABC News: ["Nightline"] Tonight, Gulf War Syndrome, the battle between soldiers and-

ED BRADLEY, CBS News: ["60 Minutes"] -mysterious illness that has come to be known as Gulf War Syndrome-

NARRATOR: The possibility has enraged some members of Congress.

Rep. CHRISTOPHER SHAYS, (R), CT: [at hearing] You didn't listen to the veterans. Nobody was listening to the veterans.

NARRATOR: But many scientists worry that emotion has overwhelmed scientific reality.

Dr. STEPHEN JOSEPH, Assistant Secretary of Defense, Health Affairs 1994-1997: What could be more sensational than this- you know, "U.S. soldiers gassed in the Gulf" or "Mystery illness strikes down American military after the war"? But it's pretty clear there is no magic bullet. There is no mystery illness. There was no "Gulf War illness."

NARRATOR: Seven years after the ceasefire, the battle rages over "Gulf War Syndrome."

In 1991, American troops returned from a stunning victory. The Iraqi forces had been decimated at a cost of only 146 American lives. Yet within a few months there were signs that all was not well with the troops. Some members of an Army reserve unit in Indianapolis based at Ft. Benjamin Harrison began complaining of strange symptoms. One was Sergeant Jim Simpson.

Sgt. JIM SIMPSON, 123rd Army Reserve: I started having problems with concentration and that's when I noticed the fatigue really setting in. At times, it was very hard to focus. I felt nauseous. I didn't- didn't really want to eat.

GLENDA SIMPSON: He was just exhausted constantly. He could never get enough rest. His motivation was deteriorating. He couldn't remember what was being told to him. There would constantly be arguments and fights in the house with me and the kids and him because we'd say, "Well, we told you," and he wouldn't remember.

Sgt. JIM SIMPSON: And it was about some time in November I ran into a soldier from the battalion that said I looked terrible. And she started asking me a lot of questions- "Have you been having problems with headaches, blurry vision? And have you had some rashes, extreme fatigue?" Then she informed me that there were a lot of other people were having the same problems.

NEWS ANCHOR: [Channel 18 News, Lafayette, Indiana, March 19, 1992] Good evening. Soldiers from three Indiana-based Army reserve units that served in the Persian Gulf are reporting health problems that could be related to the Gulf region.

REPORTER: 123rd ARCOM command surgeon Norman Teer says none of the illnesses are life-threatening.

Dr. NORMAN TEER: We haven't been able to rule out anything, so we're not trying to rule out, so we're just trying to make sure that get into the right channel and get the right tests done on them.

NARRATOR: Dr. Norman Teer examined dozens of reservists, but he was completely baffled.

Dr. NORMAN TEER: We got a variety of symptoms that did not fit any one disease entity and it made it kind of confusing to us. They complained of fatigue, problems sleeping, memory loss, bleeding gums, losing hair, rashes, gastrointestinal problems, joint pain. So there were so many symptoms, we couldn't attach it to any particular disease entity at that time.

NARRATOR: So Teer called the Pentagon, which sent a special medical team to investigate.

Dr. NORMAN TEER: It consisted of an epidemiologist, environmental specialist, a dental pathologist, a psychiatrist and a medical technician that they brought with them. And that particular weekend, we know up to about 80 some people that we examined. And they took specimens of blood, urine, medical histories from all the specialists, took that back to see if they could make a determination.

NARRATOR: The tests found nothing. The Pentagon report stated there was "no organic disease" and concluded that most symptoms were likely the result of stress. But the problem was not confined to Indianapolis. Members of a reserve Naval construction unit in Alabama and Georgia - the Seabees - were also ill. One was Larry Perry.

LARRY PERRY, Seabees: It's like something you never had before. Like when you have the flu, you don't hurt anywhere in particular, you just feel miserable all over. And that's pretty much the way it runs. You get the severe headaches and when you get two or three symptoms together, you're in the bed. You just can't go- you can't- you can't function. There's times when I couldn't find my way home. I've attempted to go back to work about eight times. I wound up in the hospital with exhaustion. I can last about two weeks.

NARRATOR: Perry made contact with other Seabees who had served in the Gulf and who were feeling ill, like Sterling Sims, Lester Hallman, John Gonzales and affected worst of all, their friend, Gene Trucks, who is confined to a chair.

STERLING SIMS, Seabees: Old man, how you doing?

GENE TRUCKS, Seabees: Hi.

STERLING SIMS: You put on some weight yourself.

GENE TRUCKS: I have.

NARRATOR: They felt their symptoms were due to Iraqi chemical weapons. They were stationed at the Saudi port of Al Jubayl when a loud explosion awakened them one night.

STERLING SIMS: When I got out of the tent, there was a mist in the air. My eyes had been burning, my throat was burning, my nose was running, my skin was on fire.

JOHN GONZALES, Seabees: My eyes started watering and I could not- I could not breathe from- by no means and I was just about- just about losing it.

LESTER HALLMAN, Seabees: It was a yellow, powder-type substance that settled over the flat surfaces of the compound. You could see it on the tents, on the vehicle. Anything that had a flat surface of any description, you could see it the next morning.

NARRATOR: Had chemical weapons been used at Al Jubayl? The Department of Defense said there was no evidence they were used there or anywhere else. A Navy medical team was sent in to examine the Seabees. Their investigation, like the Army's in Indianapolis, found nothing and concluded stress was a likely explanation.

Unlike active duty troops who had full medical coverage, many veterans depended on the Veterans Administration. To get medical help they had to negotiate a bureaucratic maze and prove their sickness was connected to their service in the Gulf. With an unrecognized disease and no idea what caused it, many were turned away.

MATT PUGLISI, Director of Gulf War Illnesses, American Legion: Service connection for V.A. used to be a pretty simple thing way back when. You were shot, you stepped on a mine, you were run over by a tank or some other awful thing that occurred in combat and you had a clear injury that you went to the battalion aid station with. You were treated. It was in your medical records and then you could be compensated. When you're talking about chemical exposure or investigational drugs that were taken, and no records were made in your medical records, that's something altogether different.

1st VETERAN: [at meeting] The doctors that we have in the VA hospitals now, are students.

NARRATOR: As veterans shared stories, their anger at the V.A. and the DoD grew.

1st VETERAN: [at meeting] Well, what the hell. If I- if I knew what was wrong with me, why the hell would I come here?

2nd VETERAN: We want you to hear our problems, what we feel those problems were in the Gulf.

NARRATOR: In desperation, they took their story to the media.

DAVE PARKS, "The Birmingham News": Sterling Sims called me up out of the blue one afternoon and said, "Listen, I'm a Gulf War veteran. You want a story?" I said, "Yeah." He said, "You got enough guts to print it?" And I said, "Well, it depends on what it is." He said, "Well", he said, "I'll give you a heck of a story."

NARRATOR: Dave Parks would write dozens of articles on what became known as "Gulf War Syndrome." Journalists everywhere jumped on the story. It was a compelling tale, a story of sick vets, of a mystery disease perhaps caused by something exotic in the Gulf.

LYNN SHERR, ABC News: ["20/20"] How many of you have had symptoms of aching joints?

ED BRADLEY, CBS News: ["60 Minutes"] How many of you get tired very easily? How many of you have joint pain?

NARRATOR: Vets also told their story to Congress.

BRIAN MARTIN, Veteran: [at hearing] I have experienced swollen and burning feet, swollen knuckles, loss of strength in my right hand, problems with my heartbeat, shortness of breath.

1st VETERAN: Joint and muscular pain, testicular pain, myofacial pains-

2nd VETERAN: I can't sleep. I can't drive.

NARRATOR: The vets' stories had a similar theme.

3rd VETERAN: [at hearing] Do we all have to die first before you believe us?

NARRATOR: Before the war they were fine. After it they were sick. The diseases varied enormously. One of the most striking was that of Marine Major Randy Hebert. Hebert was diagnosed with Lou Gehrig's disease.

Rep. CHRISTOPHER SHAYS: [at hearing] Your testimony will be read by your dad, is that correct?

NARRATOR: He believes his condition is due to the Gulf. He is a shadow of his former self.

KIM HEBERT: When Randy left for the war he was very active, a health nut. He was that poster-board Marine until he came back from the war and just slowly deteriorated from there.

NARRATOR: Did all these illnesses constitute a "Gulf War Syndrome" and, if so, what was the cause?

KIM HEBERT: We believe Randy's illness is due to the chemical poisoning that he received while in the Gulf War.

NARRATOR: Stung by the criticism, the V.A. began treating more Gulf War vets and the Pentagon appointed Dr. Stephen Joseph, a seasoned public health physician who'd worked in New York at the height of the AIDS epidemic, to lead its medical investigation of Gulf War Syndrome.

Dr. STEPHEN JOSEPH, Assistant Secretary of Defense, Health Affairs 1994-1997: In many ways, it was a classical public health problem because there was a scientific dilemma, a medical dilemma. Here were people with symptoms that had all been in the same place at the same time.

The important thing, from the public health and the medical point of view, is what are they ill with? What symptoms do they have? Can you cluster those symptoms into groups that lead you to look for a single cause?

NARRATOR: Working with the V.A., Joseph invited any Gulf War veteran who was feeling ill to register and undertake a full exam. Panels of scientists were asked to review everything known about any toxin vets might have been exposed to in the Gulf, from tropical infections to chemical weapons. Millions of dollars were authorized to support a series of epidemiological studies to see whether Gulf War servicemen were being hospitalized at a higher rate than normal, to find out if they were dying at a higher rate than expected.

In all, four blue-ribbon panels were set up, including the Defense Science Board, the Institute of Medicine and a special panel created by the president, the Presidential Advisory Committee, the "PAC." Chaired by Dr. Joyce Lashof, former dean of public health at U.C. Berkeley, it had an all-star cast of scientists, physicians, ethicists and Gulf War veterans. Designed to be as free as possible of political influence, its mandate was to get to the bottom of the science and report on what was really happening to the vets.

Meanwhile, the scope of Gulf War Syndrome was spreading. Some families now reported wives and children were becoming ill.

GLENDA SIMPSON: I have noticed joint aches and pains like he experiences. I'm starting to struggle with my memory. And the fatigue, I'm getting it, and the exhaustion, the pure "I just can't function anymore. I have to go lay down."

Sgt. JIM SIMPSON: I started hearing about other soldiers that had these illnesses, and their kids coming down with strange things, and I started getting a little nervous about certain contacts with my kids. And we're getting to the point where we're paranoid of, "No, I drank out of that glass. You leave this glass alone. Don't drink out of my glass."

NARRATOR: But for other vets the news was even worse.

Sgt. PAUL HANSON, Ft. Bragg, N.C.: [to child] What's up buddy? How're you doing?

NARRATOR: They believed that Gulf War Syndrome had caused birth defects in babies born after the war.

CONNIE HANSON: When Jayce was born, he was born with no upper or lower arm bone and his wrists connect at his shoulders. Before he had his legs amputated, his legs were bent and twisted up, like if you can imagine sitting Indian style. Paul and I had never seen a child like Jayce before.

Sgt. PAUL HANSON: It was a shock. I was real hurt and I immediately- I wondered, "Man, what in the world happened?" You know, I'm not a scientist. I'm not somebody who can figure out stuff like that, but I believe it was the chemicals. There were oil well fires constantly. We took pills that we had no idea what type of effect they were going to have on our systems. There are so many contributing factors that could have caused him to be born that way.

CONNIE HANSON: As Jayce approaches the different obstacles in life, the pain's going to come out. And that hurts me probably as much as it hurts him because you hate not to see your children succeed in simple things in life- just to be able to catch a ball!

NARRATOR: In November, 1995, "Life" magazine put the Hansons on their cover. But if the media and Congress had accepted there was a true Gulf War Syndrome, the scientific community was far from convinced. By 1996, the DoD had examined 20,000 Gulf War vets, one of the largest clinical investigations ever undertaken. The results were shocking.

Dr. STEPHEN JOSEPH, Assistant Secretary of Defense, Health Affairs 1994-1997: We found that there was no single unifying hypothesis that could explain the symptoms of large numbers of people. There was no magic bullet. There was no mystery illness. There was no "Gulf War illness."

NARRATOR: Joseph had found lots of common illnesses, but no new mystery disease, no unique "Gulf War Syndrome."

Dr. STEPHEN JOSEPH: In some cases, they were illnesses that people would have had whether they went to the Gulf or not. In some cases, they were injuries that were a result of being in the Gulf. If you have a chronic arthritis of the hip from an injury that you got jumping off the mechanized vehicle, that's related to your service in the Gulf very directly. Then there was a small group who had symptoms that really couldn't be understood or put into a current diagnostic framework- headaches, fatigue, depression, muscle soreness, joint pains, et cetera.

NARRATOR: Did these symptoms have anything to do with the Gulf? That depended, Joseph said, on how many vets were sick out of the estimated 700,000 service men and women who went there.

Dr. STEPHEN JOSEPH: It's not surprising that four or five years after the event, you have 40,000 or 50,000 people out of 700,000 who are ill. If you looked at a small or medium-sized American city on any given day and said to over half a million people, "How many of you in the last four or five years have been ill for some period of time or haven't felt well or have had symptoms of any kind?" you would have a number probably much larger than that.

CONGRESSMAN: [at hearing] I might say, Dr. Joseph, is there a yes or no answer to the question? Is there a "Persian Gulf syndrome" or illness?

Dr. STEPHEN JOSEPH: Yes, there is an answer and the answer is no, if by that you mean-

NARRATOR: As Joseph delivered the stunning conclusion in his characteristic blunt style, he met with skepticism and mistrust. Vets now pinned their hopes on the Presidential Advisory Committee, the PAC, chaired by Dr. Joyce Lashof. The PAC decided to hold hearings all around the country to find out first-hand about the veterans' problems.

1st VETERAN: [at hearing] Listen to the veterans who were there, veterans who answered the call and are concerned about their health and the health of their family. Don't turn your back on us.

1st VETERAN'S WIFE: A few months later we were given the devastating news that the-

JOYCE LASHOF, M.D. Chair, Presidential Advisory Committee (PAC): It was extremely important to the work of our committee that we really understand how the veterans were feeling and what the issues were to them.

2nd VETERAN: [at hearing] I'm tired and I get so darned depressed.

Dr. JOYCE LASHOF: It was very difficult to sit and listen to the vets describe their problems.

2nd VETERAN'S WIFE: [at hearing] I lost my husband and I have a deformed child.

Dr. JOYCE LASHOF: Many of them are heartbreaking.

FATHER OF VETERAN: [at hearing] This cancer crucified him. It just crucified him.

NARRATOR: Tragic and compelling though the stories were, the PAC couldn't find any scientific evidence to support the idea that acute and dramatic conditions like cancers were connected with the Gulf War.

Dr. JOYCE LASHOF: The problem you have is, when a group of people come back from a particular experience and various ones find that they're ill, and they weren't ill before they went, they naturally blame it on having gone to the Gulf. Well, someone else could have come down with that exact same illness who didn't go to the Gulf.

3rd VETERAN: [at hearing] Family members, wives, that are now sick-

Dr. JOYCE LASHOF: We heard veterans describe their diagnosis that we know happened to the general population. I mean, amyotrophic lateral sclerosis is a disease that happens to people.

JON PALFREMAN: That's Lou Gehrig's disease.

Dr. JOYCE LASHOF: Lou Gehrig's disease. And there is a veteran who has that. He feels it's due to his service in the Gulf. We don't know the cause of Lou Gehrig's disease, but we know it happens to lots of people who didn't go to the Gulf. It was heart-rending to sit and listen to the woman with a child with a congenital defect. She feels it's due to service in the Gulf . I think it's completely understandable, but it's just not valid. Birth defects are very common. About 3 percent of births have some type of congenital defect. The initial studies we have show no greater frequency of birth defects among those children born to veterans who were in the Gulf, either women veterans or men.

NARRATOR: The first thorough epidemiological studies began to appear in the medical journals, studies comparing troops who served in the Gulf with troops who didn't. The results were reassuring. Gulf War vets were not dying from disease at a higher rate than expected, although more had died in car accidents, something that has been found after other wars.

Gulf War vets weren't being hospitalized at a higher rate than military servicemen who didn't go to the Gulf. And a large study showed that babies being born to Gulf War vets had no higher rate of birth defects. [www.pbs.org: Read the results of the studies] The PAC had discovered only a handful of cases where there was no doubt the disease was Gulf-related.

PHILIP LANDRIGAN, M.D., Epidemiologist (PAC): There were a few cases of acute disease in the vets that were quite clearly associated with service in the Gulf. There have been some 30 or 40 cases of the parasitic disease Leishmaniasis. There had been a few cases of malaria. But I think they're different from the chronic sort of illness that seven years post-service continues to plague some number of the veterans.

NARRATOR: Essentially, the PAC agreed with Dr. Joseph: There was no unique Gulf War Syndrome. There were unexplained symptoms like migraine, joint pain and insomnia. For the scientists, there was still the issue of whether these common symptoms could have been caused by something in the Gulf. But the media continued to act as if there was a Gulf War Syndrome, pursuing theory after theory about its cause.

NBC NEWS CORRESPONDENT: ["Dateline"] Mixed in with the smoke pouring from those burning Iraqi tanks was a toxic radioactive dust released when those highly effective-

NARRATOR: "Dateline" speculated that radioactive debris from the uranium shell casings used to pierce Iraqi tanks might be the cause of Gulf War Syndrome.

Dr. PHILIP LANDRIGAN: I don't think so. The number of vets who have been documented to have fragments of depleted uranium is, at most, a couple of hundred and, using strict criteria, fewer than that. It just doesn't account numerically for the thousands of people who complain of symptoms.

NARRATOR: 20/20 wondered about the oil fires that Saddam Hussein had set-
LYNN SHERR, ABC News: ["20/20"] -those fires in the oil wells that were burning our of control for so long to increased health risks.

NARRATOR: Scientists now agree that the heat drove most of the fumes high up into the atmosphere, away from the troops on the ground.

JOYCE LASHOF, M.D., Chair, Presidential Advisory Committee (PAC)Surprisingly enough, the data from the air monitoring which was done shows that the air was no dirtier than an average American city which, you know, sounds illogical to us when we saw all the pictures of the oil wells and the fires.

ED BRADLEY, CBS News: ["60 Minutes"] Every eight hours during the war, hundreds of thousands of American soldiers stopped what they were doing to take a pill, pyridostigmine bromide, or P.B.

NARRATOR: 60 Minutes wondered if side effects from P.B., a drug given to protect against the nerve gas soman, might be the cause of Gulf War Syndrome. It had, after all, never been given to large numbers of troops. But it's not new. People like Janet Wagner have been taking it for decades, in doses 20 times larger than that used by the troops, for the neurological disease myasthenia gravis. The FDA regards it as a perfectly safe drug and Janet, like most users, hasn't experienced any of the chronic side effects that Gulf War veterans have reported.

Dr. JOYCE LASHOF: The doses, as compared to treatment doses, were quite small, so that, as a cause of any long-term illness, was considered very unlikely.

NARRATOR: Nightline brought up another possibility: pesticides.

JOHN McWETHY, ABC News: ["Nightline"] -causes could be heavy use of pesticides to protect soldiers from such deadly insects as scorpions.

Dr. PHILIP LANDRIGAN: Pesticides are certainly toxic chemicals and we've seen cases of neurotoxicity in people like park rangers in the Everglades who slathered themselves with DEET every day for a whole season. But I just can't imagine that thousands of people had the kinds of heavy exposure to pesticides that would be required to produce the overall pattern of illness that we're seeing here.

NARRATOR: Dan Rather suggested vaccines.

DAN RATHER, CBS News: ["CBS Evening News"] The veterans may be suffering side effects from experimental vaccines.

Dr. JOYCE LASHOF: The majority of the immunizations which they received are standard immunizations that we've been using in civilian life and in military life for a long time. The two that cause concern were those that were more unusual and not part of the standard immunization routine and that would be anthrax and botulinum toxin.

NARRATOR: But the panel could find little evidence that these vaccines caused the chronic symptoms.

Dr. JOYCE LASHOF: There is no reason to believe that the vaccines could cause any problem, nor that they could be a vehicle for transmitting any other organism, as has been postulated. These are safe vaccines.

NARRATOR: But the media's favorite theory by far was that chemical weapons might be to blame. Since the war, the DoD had repeatedly denied that U.S. troops had been exposed to chemical agents. But many vets were skeptical of these denials because during the war hundreds of chemical alarms had gone off.

BERNARD ROSTKER, Ph.D., DoD Special Assistant, Gulf War Illnesses: There are many chemicals that will set off a chemical alarm. Insect repellent will set off a chemical alarm. Diesel fuel exhaust will set off the chemical alarm. The fact that an alarm went off in no way is definitive that you've been exposed to chemicals.

NARRATOR: But the PAC detected a logical flaw in this argument.

Dr. JOYCE LASHOF: DoD said all these other things like oils and petroleum, waxes, all of them could cause alarms to go off, there's no way you can say that it was due to a chemical warfare agent. And that's correct. But there's also no way you can say that it wasn't due to it. All you can say is "It could have been, it could not have been".

NARRATOR: But still the PAC had medical reasons for doubting that Saddam had used chemical weapons. Their effects on humans are hard to miss. When a religious cult released the nerve agent sarin into a Tokyo subway in 1994, the effects were immediate, dramatic and followed a classic pattern known to physicians since World War II: constriction of the pupils, tearing of the eyes, respiratory and neurological symptoms, paralysis and death.

Since no such acute effects were seen anywhere in the Gulf, what were the chances that sarin or any other chemical weapons were used by Saddam?

Dr. JOYCE LASHOF: If there had been an offensive release, there would have been acute health effects. There's no way you could have shot off a warhead full of chemicals and released it into a battlefield situation and not have had illness. So I think everyone was satisfied that there was no offensive use of chemical agents really designed to kill people. But could there have been some release of low level? We felt that was worth exploring.

NARRATOR: While there was no scientific evidence that low levels of nerve agent could cause delayed chronic effects like those seen in the vets, the PAC recommended more animal research be done. But their report in early 1996 was clear and agreed with the other scientific panels. There was no unique Gulf War Syndrome and the symptoms, like fatigue and joint pain, were not likely the result of the risk factors publicized in the media, including chemical weapons. There was one factor, however, the PAC thought very likely to have contributed to the vets' symptoms: stress.

Dr. JOYCE LASHOF: Stress has profound physiological effects on the human body. Stress can contribute to the development of cardiac symptomatology and even heart attacks. Stress impacts on diabetes. It's not the primary cause, but it has an effect on the disease and how the body is handling the disease and how severe the disease is. So stress has profound effects. And they're not imaginary, they're real.

NARRATOR: The vets were not impressed.

LESTER HALLMAN, Seabees: Bunch of bull. If you go back and look at these blue-ribbon panels, they are government-sponsored and government employees, for the most part. Need I say more?

STERLING SIMS, Seabees: Do we look like we're stressed out? It's just another delaying tactic, is all the world it is.

DENISE NICHOLS: [at hearing] This is not stress. The stress is what the government has-

NARRATOR: Anger mounted.

DENISE NICHOLS: [at hearing] -done to us for seven years.

FATHER OF VETERAN: I know what my son died of. He died of cancer. I want to know what killed him. And it wasn't stress.

VETERAN: It's not in your head. This illness is real. What's happening to me is real. It's destroying my life. It's destroying my body. And as every day goes by-

NARRATOR: So great was the anger that threatening phone calls were made to the PAC. The panel continued its work protected by federal agents, their conclusions unchanged. One reason they felt so sure of their conclusions was because of the work of this man. Captain Craig Hyams, an infectious disease specialist and Gulf War vet, wondered whether anything like Gulf War Syndrome had happened before.

Capt. CRAIG HYAMS, M.D., U.S. Naval Medical Research Institute: It took over a year, actually, to find all of the articles written by the physicians at the time. Starting with the Civil War, we had a war-related health problem known as "irritable heart" or Da Costa Syndrome and it presented similarly to the illnesses that we're seeing now amongst Gulf War veterans. The veterans complained of fatigue and shortness of breath and headache and problems with sleeping and problems concentrating and remembering. At the beginning of the First World War, there was a major problem when the British had to evacuate soldiers from the front in France because of a condition known as "effort syndrome" and, again, this condition presented with fatigue and headache, shortness of breathe and problems remembering and concentrating. In fact, after all the major wars the veterans have had the sort of physical complaints that we're seeing amongst Gulf War veterans.

NARRATOR: And the cause? Many military doctors had thought stress was the likely explanation.

Capt. CRAIG HYAMS: If you read the medical literature, with all major wars the troops suffer from psychological problems after the wars. Anyone who's been traumatized, their life has been threatened, is going to have some problems afterwards.

NARRATOR: Are Gulf War vets like Simpson simply going through what previous generations of soldiers have gone through? [www.pbs.org: More on illnesses in previous wars] While few were traumatized by the violence of the Gulf War, they endured the stress of a long build-up in a harsh desert environment, fearful of what Saddam might do with his army and chemical weapons. And many have had trouble adjusting back to civilian life. Still, they found the stress theory repellent.

Sgt. JIM SIMPSON: Yeah, it was an insult. It was a downright insult. Wouldn't you feel stressed if you lost your job and you were suddenly unable to do certain things that you used to do on a regular basis?

Dr. STEPHEN JOSEPH, Assistant Secretary of Defense, Health Affairs 1994-1997: Why? Why is it so difficult to accept the message that when you put young Americans or anyone in a situation that is uncomfortable, dangerous and uncertain, that a number of those people come back from that situation with a combination of physical symptoms and psychological symptoms? I think we all know that. We look at ourselves in the mirror, every one of us knows that and understands that in our own life. When you wake up in the morning and don't feel well and don't want to go to work because you have something unpleasant that's going to happen to you at work that day, you understand this combination of physical symptoms, whether it's sleeplessness or depression or pains in your joints or pains in your stomach and what's going on in your psyche.

NARRATOR: Vets who had placed their hopes in the PAC were disappointed. So were some their advocates in congress.

Rep. CHRISTOPHER SHAYS: The President's commission were quick to accept that this was basically more of a mental problem than a physical problem. I find that pretty outrageous.

NARRATOR: Congressman Shays, who had spent years investigating Gulf War Syndrome, found stress an unsatisfactory answer.

Rep. CHRISTOPHER SHAYS: Gulf War Syndrome is not one cause, not one illness. It's many causes, many illnesses.

JON PALFREMAN: So it doesn't rule out yet, in your view, the idea this could be an infectious disease that affects family members?

Rep. CHRISTOPHER SHAYS: Oh, it doesn't rule out that at all. No, I think it can be infectious. In some cases, I think it is.

JON PALFREMAN: It doesn't rule out that it can cause birth defects in children?

Rep. CHRISTOPHER SHAYS: Doesn't rule out that it can cause birth defects. I believe it can.

Rep. BERNARD SANDERS, (I), VT: There is no question in my mind - none, zero - that tens and tens of thousands of our soldiers are suffering from a wide range of illnesses, which I believe are attributable to their service in the Gulf.

JON PALFREMAN: But does this go beyond symptomatology to include things like Lou Gehrig's disease and cancers?

Rep. BERNARD SANDERS: Could it? The answer, again- you're- I'm not a physician and I'm certainly not an expert on that illness. Do I think it is possible? Yes, I think it is possible.

Dr. STEPHEN JOSEPH, Assistant Secretary of Defense, Health Affairs 1994-1997: People have a great resistance to hearing what they don't want to hear. It was not a palatable message to some of the members of the media, to some members of the veterans' groups and, regrettably, to some members of the Congress to accept what the information- what the scientific data showed, which is that there was a wide variety of symptoms, there was no single or unique mystery illness and, most importantly, that stress- that psychological stressors were very intimately and importantly related to the physical symptoms. This was a disagreeable message and people did not want to hear it.

NARRATOR: Vets had craved answers to explain why they were ill. But all the scientific panels had failed to find a Gulf War Syndrome. The story seemed to be at an end. Then something happened that would change everything.

ED BRADLEY, CBS News: ["60 Minutes"] After denying it for years, little by little the Pentagon is now admitting to something American soldiers who fought in the Gulf War have been claiming for years, that they could very well have been exposed to deadly nerve gas.

NARRATOR: In June, 1996, the Pentagon admitted it had made a big mistake. Shortly after the ground war ended, U.S. troops had blown up an Iraqi ammunition dump called Khamisiyah and in the process had blown up some rockets filled with the nerve agent sarin. The Pentagon, which had resolutely denied any chemical weapons exposure, now found itself under attack from all sides.

Rep. BERNARD SANDERS: [at hearing] I think the key question that all of us want to know is that how come it took the Pentagon five years to acknowledge that?

NARRATOR: Dr. Stephen Joseph, the DoD's main medical spokesman on Gulf War illness, was accused of being part of the conspiracy.

ED BRADLEY, CBS News: ["60 Minutes"] If you knew the information since 1991, why did the Department of Defense spend so much time-

WOMAN ON ELEVATOR: Can we please get off, please?

Dr. STEPHEN JOSEPH: Excuse me.

WOMAN: Thank you.

Rep. CHRISTOPHER SHAYS: [at hearing] My question to you is when did you know there was a chemical weapon in any of these bunkers?

Dr. STEPHEN JOSEPH: When did I know that there was a chemical weapon in the bunkers?

Rep. CHRISTOPHER SHAYS: Yes.

Dr. STEPHEN JOSEPH: Several days before the press conference.

Rep. CHRISTOPHER SHAYS: How many days before?

Dr. STEPHEN JOSEPH: I can't tell you exactly.

Rep. CHRISTOPHER SHAYS: No, no, no. You can. This-

Dr. STEPHEN JOSEPH: It would be an understatement to say that I was surprised. It would be an understatement to say that I was embarrassed for the department and for ourselves. I mean, this- the Khamisiyah issue just destroyed any credibility the department had. It threw everything into further uncertainty and, of course, total loss of public credibility.

NARRATOR: The heroes of the Gulf War were hauled before Congress to answer charges of a cover-up.

Gen. NORMAN SCHWARZKOPF, U.S. Army (Ret.): [at hearing] Certain people have charged that I and my commanders knowingly placed our troops at risk to chemical weapons while we sought protection for ourselves. Such a statement is a blatant lie.

Gen. COLIN POWELL, U.S. Army (Ret.): I don't think there is a conspiracy going on. I think there's a lot of- a lot of confusion with respect to what intelligence information did or did not exist.

NARRATOR: Everyone wanted to know what happened. Khamisiyah was a large Iraqi ammunition storage depot that allied troops blew up in March, 1991, shortly after the war ended. Days before the demolition, at least three intelligence leads raised the possibility that the site might contain chemical weapons. But the Pentagon says they were lost in the fog of war. So thinking it was a conventional weapons site, the Army blew it up and moved on. There were no confirmed chemical detections and no medical symptoms reported. The site was forgotten.

A few months later, in October of '91, Khamisiyah was visited by a United Nations inspection team. They found parts of the site heavily contaminated with sarin. They also found an empty U.S. Army explosives crate. Since whoever destroyed the site might have been exposed to sarin, the U.N. passed on its findings to U.S. authorities. The Pentagon investigated, but dismissed the possibility that U.S. troops had been involved. Now, five years later, Congress wanted to know why.

Rep. CHRISTOPHER SHAYS: Oh, it's clearly a cover-up. I mean, I have no reluctance in saying that. I might have earlier on, but after 11 hearings, everything that we've learned we've had to pull out of DoD.

NARRATOR: The Pentagon claimed it was all an innocent mistake.

Dr. BERNARD ROSTKER, Ph.D., DoD Special Assistant, Gulf War Illnesses: There was no cover-up. No one who was at Khamisiyah had any indication, any inkling that they were dealing with chemical weapons, either during the period they were rigging the site for demolition or after it blew up.

[www.pbs.org: More on the cover-up question]

NARRATOR: Khamisiyah was a devastating blow for the Pentagon. In an effort to restore credibility, it embarked on an extraordinary mission: to reconstruct the Gulf War, to investigate each and every potential Khamisiyah. The Pentagon took their show on the road to special town meetings at which the new spokesman, Bernard Rostker, tried to reassure vets that they were now being taken seriously. But far from reassuring the vets, Rostker attracted a newly energized anger.

1st VETERAN: [at meeting] -you guys doing anything about it.

2nd VETERAN: Wait a minute. Wait a minute. Wait a minute! Okay, I gave- I gave you an opportunity. Let me finish speaking.

Dr. BERNARD ROSTKER: I'll let you finish, but I take great exception to that.

2nd VETERAN: You should be ashamed to call yourself a veteran. You know what-

NARRATOR: The news went from bad to worse. Complex computer models of the Khamisiyah release showed that over four days, a plume of very low levels of sarin gas passed over nearly 100,000 American troops. The media, led by The New York Times, portrayed the Khamisiyah revelations as if they were evidence that the cause of Gulf War Syndrome had now been found: chemical weapons.

ED BRADLEY, CBS News: ["60 Minutes"] And if Pentagon officials lied about Khamisiyah, are there other Khamisiyahs?

JOYCE LASHOF, M.D., Chair, Presidential Advisory Committee (PAC): I don't reach conclusions without scientific data. I'll wait for the scientific data. That's my training. That's my job.

NARRATOR: The PAC was as angry with the DoD as anyone else, but Dr. Lashof was also worried that the careful scientific work of her committee was being obliterated by the media frenzy over Khamisiyah. Medically, she said, Khamisiyah made no difference.

JOYCE LASHOF, M.D., Chair, Presidential Advisory Committee (PAC): The problem we had throughout was trying to separate the issue of exposure to chemicals and illness due to chemicals. I continually have people come up to me and say, "I read in The New York Times that chemicals are the cause of it." I say, "No, no, no. That's not what we in the committee have found." We are concerned about the issue of exposure because we think the veterans have a right to know and we make an issue of that. And we've made an issue of the DoD for not doing a good job of exposure. But that is not to say that we believe that those exposures are the actual cause of illness.

NARRATOR: In reality, Khamisiyah had changed the politics, not the science. There was still no evidence that very low levels of chemical weapons could cause delayed chronic symptoms like fatigue.

And there was another problem. The vast majority of the troops in the plume are not ill. And most of the troops who went to the Gulf, including thousands of vets who were ill, like the Seabees at Al Jubayl, were not in the plume. But most of the media failed to point this out to their readers.
In this charged media climate, vets like the Seabees were not inclined to believe the official DoD report that they had not been exposed to chemical weapons at Al Jubayl, that the loud noise was a sonic boom and the yellow mist chemicals from a nearby fertilizer plant.

LESTER HALLMAN, Seabees: They knew what happened over there, but they would have egg on their face, as the old saying goes, if they admitted it.

NARRATOR: Vets seemed more fearful than ever.

LEGIONNAIRE: [to Matt Puglisi] We weren't too happy about that Scud missile.

NARRATOR: American Legion spokesman Matt Puglisi, himself a Gulf War vet, had made great efforts to get vets to pay attention to the emerging scientific studies. Now he saw things falling apart.

MATT PUGLISI, Director of Gulf War Illnesses, American Legion: [at meeting] The media is very, very interested in the risk factors-
There were a lot of reckless statements being made about these illnesses that took on a life of their own. They're not helpful to the veterans. They frighten those who are in good health and they frighten those who suffer from poor health, as well. If you look at The New York Times, which has some of the best medical reporters in the nation, it hasn't been allowing them- it hasn't encouraged their medical reporters to cover this issue. Why not? They've been covering it from a political angle with their Pentagon reporter. Doesn't help the nation understand what's really important about Gulf War illnesses, what are the medical complexities of this. This is not a political story. This is a medical story. Gulf War veterans went to the Gulf and came back and some of them suffer from poor health. Let medical doctors try to answer that.

NARRATOR: We wanted to ask The New York Times why they hadn't assigned their medical reporters to cover this story and to answer the charge that they had created the impression of a connection between Khamisiyah and Gulf War Syndrome. But editor Andy Rosenthal, after agreeing to an interview, canceled at the last minute, saying, "I never wanted to do the interview anyway."

Dr. STEPHEN JOSEPH, Assistant Secretary of Defense, Health Affairs 1994-1997: I think the media in general did a very poor job of covering what the medical facts and what the scientific realities were.

NARRATOR: Joseph had been incensed by Life's 1995 cover story on the Hansons.

Dr. STEPHEN JOSEPH: The Life magazine piece was both a charade and very cynically done. We talked to the people at Life magazine, told them what the scientific data showed, that there was no evidence for congenital defects. They went ahead and published in the most sensationalistic way anyway. I think they did a great disservice to- not only to the people who served in the Gulf, but to their families. I think they scared a lot of people.

MATT PUGLISI, Director of Gulf War Illnesses, American Legion: In one health survey that's been conducted, a majority of male Gulf War veterans responded that they've delayed having children because of reports of excess birth defects in the Gulf War veterans population. That's a tremendous change in behavior.

NARRATOR: When asked to respond to these charges, Life magazine said they stand by their story. [www.pbs.org: More on the media coverage]

Rep. BERNARD SANDERS: [at hearing] Answers to questions about troop exposure to chemical agents and their connection to the Persian Gulf War Syndrome are long overdue.

NARRATOR: Like the media, Congress, too, had been reenergized by the Khamisiyah revelations. Congressman Bernard Sanders got 86 of his colleagues to sign a letter asking the Presidential Advisory Committee to change its conclusion that stress was the likely cause of the vets' illness.

He wanted the PAC to consider the work of other scientists who'd come to different conclusions, like Garth and Nancy Nicolson, who believed Gulf War Syndrome was caused by a insidious biological weapon; or Robert Haley, a Texas epidemiologist funded by Ross Perot, who had studied the Seabees and concluded that vets who thought they had been exposed to mixtures of chemicals displayed subtle neurological changes; and Mohamed Abou-Donia, who injected a combination of very large quantities of pesticides and pyridostigmine bromide into chickens and showed that their brains were affected, evidence, he argued, that a combination of chemicals might be the cause of Gulf War Syndrome.

The PAC had already considered and rejected each of these studies.JOYCE LASHOF, M.D., Chair, Presidential Advisory Committee (PAC): One of the studies, for instance, in chickens, of Abou-Donia, in which he gave very large doses of DEET and pyridostigmine bromide, is not duplicative of the type of situation we saw among the veterans. If he really wanted to duplicate what we saw in the Gulf, he would have given them in lower doses, not have caused symptoms, and then have stopped them and then waited several months and then sacrificed them to see if there was anything there.

JON PALFREMAN: I asked them about many of the studies of the people in your letter. And I think it's pretty clear that they've considered them. They don't actually think very much of them.

Rep. BERNARD SANDERS: Fine. They don't think very much of them, but go out to the veterans' community and go out to the people who are suffering and speak to them. But let me turn the tables and say to all of these scientists who tell us that nobody else is doing serious work out there, what have they discovered after six years? What is their understanding? Oh, it's an incurable problem? There is no cause to the problem? That's not a particularly good answer.

Dr. STEPHEN JOSEPH: Well, one could say Congress has had 175 years to sort out some of their problems and they haven't gotten- I mean, that's a ridiculous argument. Hard problems are hard. You can't make them easier by plucking solutions out of the air.

NARRATOR: In the wake of Khamisiyah, the government has allocated millions of dollars of research to investigate each and every theory, but many vets are tired of waiting. They have sought out the handful of scientists who believe in Gulf War Syndrome and claim they can cure it. One of these scientists is Garth Nicolson. Nicolson believes the vets' symptoms are caused by an organism called a mycoplasma that Saddam had modified with genes from the AIDS virus.

According to Nicolson, Saddam then delivered this biological weapon in Scud missiles. But critics ridiculed his theory. What would be the purpose of a weapon that didn't kill the enemy, but caused chronic symptoms years later?

GARTH NICOLSON, The Institute for Molecular Medicine, Ph.D.: Saddam said he would send the war back to the United States and I think this is how it was done.

JON PALFREMAN: But wouldn't he have rather won the war?

NANCY NICOLSON, The Institute for Molecular Medicine,Ph.D.: It's a question of what you mean by "winning." See, you can- to him it was probably, in his mindset, just a battle, but sending home a deadly illness like this, the aftermath is- in a way, he- he has won.

NARRATOR: The best proof of his theory, Nicolson argued, was that by using very large doses of certain antibiotics to kill the mycoplasma he had been able to cure many Gulf War veterans. One vet that Nicolson approached was Randy Hebert.

KIM HEBERT: We received a call from Dr. Nicolson right after we testified up in Washington. He had seen Randy on CNN. And we were very interested in trying because he was the only one that had given us any type of hope. You've just got to put faith in someone that positive.

NARRATOR: Initially Randy seemed better, but after a few weeks he had a setback. Nicolson also tested Kim Hebert for mycoplasma and diagnosed her with Gulf War Syndrome, as well.

KIM HEBERT: Dr. Nicolson really believes that my signs, as far as migraines and vision going bad and- is a sign of the mycoplasmas. But I think all my signs are due to stress. You know, our household is not normal anymore. I mean, we just went from a healthy relationship to, you know, your husband being sick. And it turns your whole house upside down when Daddy's not well.

JON PALFREMAN: Can you cure Lou Gehrig's disease with antibiotics?

Dr. JOYCE LASHOF: No. If we had a cure for Lou Gehrig's disease, especially with antibiotics, we wouldn't have any deaths from Lou Gehrig's disease. No one can cure Lou Gehrig's disease today.

NARRATOR: The PAC disbanded last November and Joyce Lashof is back teaching at Berkeley, frustrated that the panel's conclusions got so little attention from Congress and the media. Joseph left the DoD medical department and is now in private practice. He is philosophical about what happened.

Dr. STEPHEN JOSEPH: The veterans, they were hurting and they wanted answers that were most acceptable to them. They wanted medical labels and psychological stress was a message that was not and is not today palatable to the vets. They don't want to hear that. I think part of the blame rests on those who continue to whip up the issue. I mean, I think there were certainly those in the media, there were pseudo scientists, there were individual members of Congress who just would dredge up the most fantastic hypotheses and explanations without a shred of acceptable scientific and medical evidence.

Eventually, this will all sort out. Eventually, those self-interested loud voices of sensationalism will pass away. Eventually, people will look back at this three years, five years from now and say "What did we learn from this?"

ANNOUNCER: Examine more of this report on Gulf War Syndrome at FRONTLINE online. Read the scientists' conclusions on the major theories on causes. Take a closer look at Khamisiyah. Was there a cover-up? And check out Gulf veterans' health compared with other veterans- and much more at FRONTLINE online at www.pbs.org.

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LAST BATTLE OF THE GULF WAR
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Next time on FRONTLINE: old age. We all face it. Most of us dread it.

SPEAKER: What is the definition of "retirement" and what does it mean to you?

MAN AT MEETING: Death.

SPEAKER: Death? Did he say "death"?

MARIAN MARZYNSKI: Now I am approaching 60 and wonder what is the American dream for the old?

ANNOUNCER: Filmmaker Marian Marzynski takes us on a poignant journey exploring the many faces of old age.

MAN IN CLASSROOM: How many geezers do we have out there?

ANNOUNCER: My Retirement Dreams next time on FRONTLINE.

Now it's time for your letters. Our program on captive whales and dolphins left many viewers unsatisfied. Here's a sample.

MARK MACHADO: [Swansea, MA] Dear FRONTLINE: I find it distasteful that your organization would downplay the role of important marine mammal research at the expense of a few captive animals. Furthermore, the business of theme parks is an absolute and necessary component in advancing these studies.

DAVID KRAUS: [Lincoln, MA] The views presented were not balanced and the positive side of keeping wild animals in captivity to educate and inspire the public were ignored in favor of a purely emotional attachment to one animal.

RUTH MUSGRAVE: [Bakersfield, CA] I was disappointed that you, like the rest of the media, took the subjective, pop-biology road. You gave legitimacy to those whale-huggers based on their ability to cry on cue or create their own publicity. Millions and millions of dollars were raised to save one whale, who is now better cared for than most of our children and senior citizens. This should scare you. It does me.

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