- The Washington Times - Tuesday, February 27, 2001

"The Irritable Heart" is a strange, compelling book. Stylistically, it shouldn't work. It's too contrived, too much back-and-forthing, too many comments addressed directly to the reader. Even the author's self-deprecations on matters such as avoiding Vietnam or stepping on a dud land mine in the Gulf seem calculated. But it does work.
Jeff Wheelwright is a former science editor of Life Magazine and author of "Degrees of Disaster," about the Exxon Valdez. He went to the Persian Gulf as the war began to cover the ecological aspects. He's a hard-nosed type, with little patience for bad science, politicized hysteria or self-serving agendas.
In his study of Persian Gulf Syndrome (PGS), he encountered all three aplenty.
A few months after the war, veterans (mostly older reservists) began complaining of a constellation of symptoms: extreme fatigue, palpitating hearts, diffuse pain, loss of memory and motor skills. No one doubted that these people had something wrong with them. But no one was sure quite what, and if or how it was related to their Gulf experiences. After nearly a decade of controversy, and armed with a grant from the Sloan Foundation and extreme personal persistence, Mr. Wheelwright set out to investigate.
"The Irritable Heart" (we'll explain the title later) is narrative nonfiction, combining long-word portraits of several veterans and investigators, scientific and policy analysis and personal observations. Normally, this would be a Part I/Part II book, the personal and the technical. Mr. Wheelwright, holding that the two can't be separated in real life, mixes them in the book. It gets annoying. But the meta-themes seem clear enough.
When the complaints began coming in, and the issue started getting political, the first responses involved finding out what this was like, i.e., what pre-existing paradigms might explain PGS. The most obvious: Vietnam. America was determined that Desert Storm vets would not be treated like their older brothers and sisters. The American people wanted medical complaints taken seriously … and many were willing to charge and/or believe that, if they weren't or seemed not to be, only high-level indifference, coverups and worse could explain it.
Vietnam provided two other paradigms for initial grappling with PGS. One was chemical, the Agent Orange controversy, involving veterans who claimed health damage and damaged children from exposure to the pesticide and one of its nastier ingredients, dioxin. What might Gulf veterans have been exposed to that would cause PGS? Iraqi chemical weapons, whether used by Saddam or released during postwar destruction? Breathing all that oil and smoke? The shots and pills that they took while in the Gulf? No one could nail it down.
The other paradigm was Post-Traumatic-Stress-Disorder. But PTSD symptoms flashbacks, startle reactions, anger, etc., were totally unlike PGS. And PTSD required, by definition, some sort of traumatic stressor. Many of the Gulf vets (the number may now be around 100,000 with some sort of problem) had never seen combat; one of Mr. Wheelwright's informants didn't even get there until the war was over.
If Vietnam didn't fit, perhaps America might. As the century waned, strange new diseases, diffuse and vague, were cropping up. Chronic Fatigue Syndrome, Multiple Chemical Sensitivity, Sick Building Syndrome. Unlike traditional ailments, they couldn't be explained by single causes, whether germs or exposure to other malevolent substances. Could PGS be caused by some sort of "cocktail" of low-level exposures: a little sarin, a bit of oil smoke, maybe a local parasite, maybe throw in a few more items. Again, no one could nail it down. There seemed to be no direct correlation between where a vet was and when, and the symptoms. And even more puzzling, if one in seven vets might have it, why not the other six?
At the moment, and despite all the charges and denials and studies, no one knows. Mr. Wheelwright, however, has his own theory. He calls it "chemicals in the brain." His argument is that veterans who were subjected to prior physical, mental, and sexual abuse, especially in childhood, are simply more susceptible, physiologically and psychologically, to pain and debilitating conditions later in life. He notes also that in the Civil War, thousands of soldiers were diagnosed with the same set of symptoms. Doctors then called it"irritable heart" or "soldier's heart."
The 20th century, with its tunnel-vision emphasis on the psychology of shell shock (World War I), combat fatigue (World War II), and PTSD (Vietnam), has totally lost sight of this far more complex mind-body interplay.
Can he be right? It's an old cliche that those who are troubled going into war often come out the same way. Symptoms and syndromes may vary with the times; the basic problems remain. This is not to say that any stigma should attach to PGS, or that suffering veterans should not be treated fully and humanely. But perhaps it is to say that war's destruction takes many forms, and that the catalogue of suffering always has room for one entry more.

Philip Gold is a senior fellow of the Discovery Institute in Seattle and president of Aretea, a cultural affairs center.

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