STARLIGHT
Contents of articles are the sole opinions of authors and do not necessarily reflect the policy or opinions of the Defence Medical Association of Canada.
Copyright - Permission to reproduce in any form, only by consent of the editior in writing.
Le contenu de ces repr�sente l'opinion de leur auteur et ne repr�sent pas n�cessairement les politiques et les opinions de l'Association m�dicale de la D�fense du Canada
Copyright ' La reproduction de tout article sous quelque forme que ce soit est sujette au consentement de l'�diteur par �crit.
Lieutenant-Colonel Ken Scott, a Fellow of the Royal College of Physicians of Canada, Head of Medical Services at the Canadian Forces Support Unit Ottawa's Health Care Centre at the National Defence Medical Centre and head of a special Gulf War Clinic set up to investigate every complaint by a veteran of the Gulf War, recently spoke to the Eastern Ontario Branch on his findings on Gulf War Syndrome.
There have been any number of reports in the press, both in the US and in Canada of government apathy in providing care for veterans of the Persian Gulf War. These veterans are reported to be suffering from a wide range of ailments directly related to their service in that conflict. The ailments are attributed to their exposure to harmful environmental conditions, such as the smoke from burning oil fields or to chemical agents that may have been used by the enemy. Other claims are made that the use of vaccine and other prophylactic drugs are the cause of these illnesses. The lack of interest, as reported by the press, borders on medical negligence on the part of physicians, who cannot diagnose or refuse to recognize glaring medical conditions that are so obvious to the lay person. To name but a few, these include chronic fatigue, joint pain, memory loss, congenital abnormalities in newborn children of veterans, increased dependency on drugs and medication, increased rate of hospitalization, and an increase in the death rate. Veterans have been denied access to restaurants, their spouses and children have become ill, even their pets have become unwell. Their children have been refused access to schools for fear of transmitting their illnesses to other students. Quite an indictment and who would not agree that the press had every right to take this hard line on the blatant disregard of the governments and the medical profession.
Lieutenant-Colonel Ken Scott, who is deeply involved in both the care of Gulf War veterans and in researching the root causes of their problems cited Dr. William Osler's skepticism regarding reports in the press:
"If you read anything in a newspaper that you know to be true, begin to doubt it at once."
The Gulf War veterans clinic maintains a registry of patients who have come directly to the clinic or have been referred by their attending physician with a complaint that might conceivably be related to their service in the Gulf. He also sees patients who have served on other special duty deployments and who have similar complaints. Of the 4,500 Canadians who served in the coalition forces, on Canadian ships, with the Land Forces, with the Air Force, and with the Field Hospital, 213 (about 4%) have reported to the clinic for investigation. Following an exhaustive day-long assessment, the patient is referred to specialists for further investigation of any areas that may have produced questionable results in the initial assessment. A long-term follow up is then instituted. Dr. Scott calculates that he has personally devoted over 2,000 clinical hours to these patients. To date, his clinic has recorded 200 different diagnoses, the most common of which can be related to post-traumatic stress disorder. LCol Scott referred to a clinical study that made a historically connection with similar disorders found in veterans of the American Civil War when it was called DaCosta syndrome, in veterans of The Great War of 1914-1918 when it was called "soldier's heart" and in WWII when it was called "combat stress." There is a greater incidence, he said, of of stress disorder in veterans of the Somalia deployment than of Gulf War veterans.
Colonel Scott reported on the numerous studies that have been conducted in the U.S. and on a comprehensive study that is underway in Canada. The Canadian study, being conducted by Goss-Gilroy, is due for publication in the Spring. The conclusions reached by of all of these studies is that
THERE IS NO GULF WAR SYNDROME!
Dr. Scott discussed each of the claims made by the press and others, including congenital deformations, increased drug dependency, increased hospitalization and mortality. Extensive studies, carried out in the U.S. compared the study group with a comparable group in the civilian population, revealed incidents of morbidity and mortality to be just about the same. The one exception was mortality by motor vehicle accident, which seemed to be higher in Gulf War veterans. The question of suicide in these cases was raised, but was not substantiated because of the number of incidents in which there were passengers in the vehicle; suicides generally do not include other family members and friends in suicide attempts. Therefore, it was concluded that those returning from this type of military duty were more prone to take high risks.
Possible exposure to airborne pollutants or to biochemical agents as a possible cause of illness was examined closely. The small percentage of the troops reporting ill affects (about 4%), their even distribution and the widely dispersed areas of duty make this most unlikely. Not all coalition troops were exposed to the same environment, yet the incidents of illness are evenly distributed, even for those who served on ships.
LCol Scott is not minimizing the complaints these patients report, but he does question the focus of the investigations. He quotes from Dr. William Kissick's views on illness:
"Any individual can be diseased without being ill and any individual can be ill without being diseased."
and further,
"A healthy individual can be defined as someone who has been inadequately investigated."
He is convinced that a proportion of all troops exposed to life-threatening hazards for an extended period will react in a similar fashion. Dr. Scott wonders if there is not something that could be done before such exposure to either identify those most susceptible to stress disorders or if training could be instituted to prevent its occurrence.
LCol Scott reported that US colleagues are most impressed with the work being done in Canada with Gulf War veterans. He said that he would be prepared to make the investigation into these conditions and research to find a way of preventing it a long-term commitment. Dr. Scott has been speaking widely across Canada and in the US on the Canadian experience with veterans of special duty deployment such as Rwanda, Somalia, the Golan and the Persian Gulf. He has worked closely with American colleagues on their studies of what has become known in the popular press as "Gulf War Syndrome" and is keenly interested kn sharing his findings with concerned government and veterans groups. Gulf War veterans with any of these complaints can book an appointment for care with the Ottawa Post-Deployment Referral Centre by phone at (613) 945-8062 Extension 3676.
The above report, prepared by Major(ret'd) Charles King, was published in
the Eastern Ontario Branch News of February 1998.