Book Review
THE IRRITABLE HEART
The Medical Mystery of the Gulf War
http://www.nytimes.com/books/01/02/04/reviews/010204.04bendert.html
By Jeff Wheelwright.
427 pp. New York:
W. W. Norton & Company. $26.95.

Though the war in Kuwait ranks among the shorter of America's military ventures, it produced a conflict that has already gone on more than 10 times as long as Desert Shield and Desert Storm combined. The medical and political tangle is now entering its second contentious decade, with veterans and researchers at loggerheads over the nature and source of mysterious illnesses that have plagued thousands who served in the gulf. In an effort to clarify the science and history, Jeff Wheelwright now offers a book in some ways as perplexing as gulf war syndrome itself.

 The desert campaign was a war of contradictions. Astoundingly brief, staggeringly successful, dazzlingly high-tech, it nonetheless threatened to expose American and allied forces to primeval perils. Our smart missiles virtually stopped for traffic lights, our bombers could disappear from radar, but our ground troops faced an enemy apparently poised to unleash pestilence, poison and flame. Soldiers went about enveloped in both stifling protective suits and apocalyptic predictions. The Pentagon prepared body bags by the thousands while the troops took pills and injections that purported to protect them from invisible chemical and biological attack.

 In ''The Irritable Heart,'' Wheelwright powerfully conveys the menace of that bizarre battle zone. He was there as a journalist when Saddam Hussein turned Kuwait's oil wells and pipelines into weapons. He saw the hellish fields of flaming towers under banks of inky clouds. He inhaled the gritty, acrid air. He walked the beaches black and sodden with petroleum, heard the heavy plopping of the greasy surf, watched the doomed shorebirds floundering toward their deaths. He helps us feel the soldiers' fears of what might have been happening to their bodies.

 But the chemical, biological and ecological Armageddon never came, at least so far as Americans could discern, and the allied armies returned home in triumph. Soon, however, veterans began complaining of joint and muscle pain, headaches, dizziness, memory loss, insomnia, diarrhea, fatigue and difficult breathing. And soon after that the wrangling began. Weak and hurting, many veterans surmised that something encountered in the blasted landscape was now making them ill. But instead of being fairly promptly identified as a specific disease or reactions to a particular exposure, their disorders defeated science's standard methods of establishing the identity and etiology of illnesses. Competing theories emerged, including mysterious biological contagions and exposures to smoke, oil, depleted uranium or Iraqi nerve gas. No theory won a widespread medical consensus. Some people began to seek the culprit not in a specific physical insult but in the emotional stress of the desert war.

 Many suffering veterans, however, rejected any explanation not tied to Arabian exposures. Their nation, they insisted, owed them an explanation, compensation and a cure. Struggling with inconclusive science and aggrieved patients, federal bureaucracies proved neither agile nor sensitive. As conflicting studies multiplied and veterans' groups fixed on particular hypotheses, the debate became increasingly politicized. Charges of deceit and cover-up only added to the acrimony.

 As Wheelwright astutely observes, the answer probably lies not in one or another of the warring theories but in the realm that stretches between them, in the still largely uncharted borderland where the brain, the emotions, the immune system and the endocrine system intersect. In recent years several similar conditions have emerged from that same terrain. Fibromyalgia, multiple chemical sensitivity and chronic fatigue syndrome all involve clusters of diffuse but sometimes disabling symptoms that overlap with gulf war syndrome. These disorders also have defeated scientific attempts to identify definite organic causes. They too appear to involve not a specific bodily insult but a cascade of interrelated reactions. That such a condition should emerge from Desert Shield and Storm ought to be no surprise, Wheelwright notes. As far back as the Civil War, veterans have contracted mysterious, previously unknown ailments that in many ways resembled the symptoms that came home from the gulf. Each also afflicted large numbers. None yielded a clear-cut organic cause.

 Wheelwright came to his subtle and sophisticated conclusion through a great deal of highly intelligent research. But in writing a book to explain it, he seems to have fallen into the very trap of a forced choice between ''opposing frameworks'' that he spends hundreds of pages deploring. ''Basically there are two approaches to writing about a public health mystery: the personal and the scientific,'' he begins. ''The personal approach cultivates the narrative. . . . The scientific approach prunes the individual from the story and replaces him or her with medical analysis of the group.'' But the best medical writers recognize no such dichotomy. In the hands of the great epidemiologic explicators -- Berton Roueché, to cite just one -- suffering and science are aspects of the common humanity binding the sick and those struggling to help them.

 But having laid out this supposed conflict, Wheelwright proceeds to ''reconcile'' it by focusing his story on neither the patients nor the researchers but, astonishingly and self-indulgently, on himself. And then, perhaps to humanize material he considers forbidding, he adopts an irritatingly discursive tone. The reader has to tag along on countless interviews and hospital visits, listen to speculations about Wheelwright's own health and personal life, even watch him worry about his deadlines. The author intrudes everywhere. Introducing a Senate aide who played a crucial role in developing the chemical hypothesis, for example, Wheelwright informs us that, ''like me, Tuite was the oldest of six children. . . . He and I were given the names of our fathers and grandfathers, though I no longer used III after mine.''

 It's a shame that Wheelwright made the editorial choices he did. Scattered among the rambling, chatty accounts of his encounters with five sick veterans, the doctors treating them and a variety of researchers and experts are many illuminating ideas and much judiciously gathered information. In extensive source notes he provides crisp, focused discussions of issues that elsewhere appear fuzzy and diffuse. The writer who composed those notes, alas, could have produced a far clearer, more illuminating and altogether better book than this one.



Comments:

   The illnesses seen in GWS are hardly mysteries, fabricated mysteries perhaps to hide similar effects in the US population and also to protect the medical industry profits.

    The basic simple truth is that DU and all these other toxics damage cells and bioconcentrate in the lymphatic system and poison its immune protection cells and diseases are the result.    The major long term offenders are things like insoluble oxides of DU and other long retained toxins that linger in bone and fatty tissues.   The fluorides toxic effects are lead effects in poisoning the immune protection cells.

   There is no mystery to these ills, as they are well known processes ---BUT there is a full scale cover up of the toxic disease mechanisms and a Govt failing to take care of its Vets by providing proper diagnosis.    The Govt. is also pulling off a similar scam around its nuke weapons factories, again claiming mysterious ills.    All these ills trace back to one prime mechanism that has been very well known at national labs for decades.

   The term mystery illness is a fabricated hoax, as the diseases are quite real and there is a simple mechanism involved.