Nora Eisenberg, AlterNet
Monthly Archives: March 2009
The Most Pervasive Combat Injury Among U.S. Soldiers is Invisible — and the Pentagon Has Tried to Keep it That Way
Nora Eisenberg, AlterNet
March 17, 2009
March is Brain Injury Awareness Month and to observe it, the Pentagon did something special: it told the truth.
In a news conference on March 4th, Brig. Gen. Loree Sutton estimated that as many as 360,000 veterans of Iraq and Afghanistan may have suffered service-related brain injuries. Until now the Pentagon estimated that some 10,000 veterans of the Afghanistan and Iraq war had suffered brain traumas.
It’s about time they got it right. Almost a year ago, in April 2008, an independent report by the RAND Corporation estimated that some 320,000 troops — 20 percent of the deployed troops — had suffered traumatic brain injury (TBI). Included in the RAND figure were blast-induced neurotraumas (BINT) from new weaponry like improvised explosive devices, during which the head remains closed and, more often than not, the victim remains conscious. These closed-brain blast injuries are the most common injury — brain or otherwise — of the current wars, but until now, for the DoD, they didn’t count.
“Just a Concussion”
Admitting to the incidence of the injury is a start, but the DoD has yet to admit its potential gravity. The DoD did not count closed-head blast injuries because they deemed them mild traumatic brain injuries, commonly referred to as concussions. In December 2008, another independent report, prepared for the VA by the Institute of Medicine, warned that the blast-induced neurotrauma might be something distinctive and far more serious than the mild TBI or concussions associated with closed-head injury. According to George R. Rutherford, of the Department of Epidimiology and Biostatistics at UC Medical School, San Francisco, the chair of the OIM committee that wrote the report, these blast-induced neurotraumas, seem unlike injuries we’ve seen before: “We’re all worried that the blast neurotrauma hasn’t really made it into the human literature.”
Unfortunately, in the same news conference in which Brig. Gen Sutton offered new numbers, Lt. Col. Lynne Lowe, TBI Program Director in the Office of the Army Surgeon General, assured that blast injuries are just a concussion — “the same as we see in a football game on TV.” “Providers can give medication for headaches or dizziness, and reassure them that they will be OK … ” Not true. Many veterans have long-lasting and serious symptoms.
An IED explosion produces high-pressured air waves that move at 1,600 feet a second, spreading hundreds of yards. The blast then strikes again: high-pressured air displaced by the first blast flies back to the site of the explosion in a “secondary wind.” Even without penetration, the brain and other organs can sustain profound injury. According to Keith Young, vice-chair of research at Texas A&M and the VA Center for Excellence for Research on Returning War Veterans, “The blast is so close and so large, it seems to be shaking the brain. My guess is that this causes micro-bleeds.” Others speak of diffuse axonal damage.
Yet the “It’s Just a Concussion” theory pervades the DoD. The Walter Reed Army Institute for Research (WRAIR) website offers “General Questions an Answers” about blast injuries that deem them “no different” from concussions on a “football field,” which “usually resolve … within a few days.” The Q & A discourages screening, lest soldiers with simple concussions think they have a brain injury.
“It’s Just in Your Head”
Complementing the “It’s Just a Concussion Theory” is the “It’s Just in Your Head” theory that the DoD and VA developed after the first Gulf War to explain Gulf War illness. A much touted 2008 Army study led by Charles W, Hoge, Director of the Division of Psychiatry and Neuroscience at the Walter Reed Army Institute of Research, and published in the New England Journal of Medicine, reported that while soldiers with mild brain traumas were found to have more health problems, it was due to their “PTSD and depression” not their TBI. But as researchers like Johns Hopkins’ Ibolja Cernak, MD, PhD, have demonstrated, soldiers with blast injuries have a high incidence of PTSD and depression in addition to problems with attention, concentration, memory, headaches, dizziness, seizures, gait, nausea, mood, and vision, among others.
The Pentagon is a vast beast, as uncoordinated and incoherent as it is rigid and rule-ridden. Thus while WRAIR informational material minimizes the BINT, WRAIR’s own Blast Neurotrauma Research Program seeks “to characterize potential biomechanical and biological mechanisms of injury, and the pathophysiological, neuropathological and neurologic impairments that resulted from exposure to explosive blast.” And new initiatives like the Center for Neuroscience and Regenerative Medicine and the National Intrepid Center of Excellence as well renewed activity in older organizations like the Defense and Brain Injury Center are undertaking research into the nature and viable treatment of this new brain injury. This, like Brig. Gen. Sutton’s disclosure, is encouraging.
The Truth Is Beginning to Come Out
The OIM remarks and recommendations on injuries in the current wars appeared in “Gulf War and Health: Long-term Consequences of Traumatic Brain Injury,” the seventh of a series of OIM reports on the health outcomes of the 1991 war. Eighteen years after Desert Storm, the truth about the devastating illness that followed a third of our troops home, is only now emerging. In November, the Research Advisory Committee, a congressionally-mandated committee of high-level scientists, reported that Gulf War illness was “without a doubt” “caused” by neurotoxins the government had exposed troops to, including experimental anti-nerve gas pretreatment pills, insecticides and insect repellants, and sarin pluming from munitions facilities the U.S. had bombed. The committee criticized the “skewed” and “unscientific” research directed by VA and other bureaucracies, which suppressed evidence of the chemical causes and organic nature of Gulf War illness, in favor of bogus claims that wartime stress had caused an essentially psychological ailment. The report lamented that after 18 years there is still no treatment for the more than 200,000 troops suffering from Gulf War illness, a disease caused by profound neurological damage.
Eight years is better than eighteen for telling the truth. But there’s much more truth to learn and tell. The blast injuries of Americans — and Iraqis — will remain when Brain Injury Awareness Month passes. Robert Gates’s reformulated Pentagon has agreed to show us our dead soldiers. Now we need a thorough coherent approach to diagnosing, healing, and compensating the living afflicted by the current wars. Pre- and post-deployment neuropsychological testing and imaging studies would be an important step as would silencing the misinformation of Army spokespeople eager to discount the hidden wounds distinctive to this tragic war.
Nora Eisenberg, AlterNet
February 27, 2009
With rare exceptions, American politicians seem incapable of opposing an American war without befriending another in a different place or time.
Barack Obama, an early and ardent enemy of the Iraq War, quickly declared his affinity for a war in Afghanistan and/or Pakistan. And like so many Democratic leaders, he has commended Bush 41’s Gulf War over Bush 43’s, for its justifiable cause, clear goals, quick execution and admirable leadership.
It’s difficult to determine the proportion of expedience to ignorance that allows politicians and pundits to advance the theory of the good and trouble-free Gulf War. What’s clear, though, is that for close to 20 years, the 42-day war, in which we dropped more bombs than were dropped in all wars combined in the history of the world, maintains a special place in American hearts.
But as John R. MacArthur amply demonstrates in The Second Front: Censorship and Propaganda in the Gulf War, the real 1991 war was kept from the American public. This week, as we commemorate the 18th anniversary of the Gulf War’s end, and opportunities for new hostilities beckon, Americans, and our leaders, would do well to take a hard look at the war that we continue to love only because we never got to see it.
Despite our inability to detect it at the time, U.S. prosecution of the 1991 war with Iraq relied on all the now-familiar and discredited strategies used to promote the present war — with equally disastrous and far-reaching results.
When Saddam Hussein summoned April Glaspie, the U.S. ambassador to Iraq, to his office on July 25, 1990, it was to determine what the U.S. response would be should he invade Kuwait with the 30,000 troops he had amassed on its border. According to the Iraqi transcript published in the New York Times two months later, he told the seasoned diplomat that Iraq had defended the region against the Iranian fundamentalist regime, and that the Kuwaitis were paying them back by encroaching on their border, siphoning their oil, increasing oil production and driving down prices. His people were suffering, and his “patience was running out.”
Glaspie commiserated: “I admire your extraordinary efforts to rebuild your country. I know you need funds. We understand that, and our opinion is that you should have the opportunity to rebuild your country. But we have no opinion on the Arab-Arab conflicts, like your border disagreement with Kuwait. … I was in the American Embassy in Kuwait during the late ’60s. The instruction we had during this period was that … the issue is not associated with America. James Baker has directed our official spokesmen to emphasize this instruction.”
Glaspie later claimed that Iraq transcripts contained “distortions,” which may be so. But her own recently declassified cable to Washington closely resembles the Iraqi transcripts: She wrote that she asked Saddam, “in the spirit of friendship, not confrontation” about his intentions with Kuwait. She reports telling him that “she had served in Kuwait 20 years before; then as now we took no position on these Arab affairs.” She wrote that “Saddam’s emphasis that he wants peaceful settlement is surely sincere … but the terms might be difficult to achieve.”
Glaspie was not the only official to deliver this laissez-faire message. The next day, at a Washington press conference, State Department spokeswoman Margaret Tutweiler was asked by a journalist if the U.S. had sent any diplomatic protest to Iraq for putting 30,000 troops on the border with Kuwait. “I’m entirely unaware of any such protest,” Tutweiler replied.
Five days later, on July 31, Assistant Secretary of State for Near Eastern Affairs John Kelly testified to Congress that the “United States has no commitment to defend Kuwait, and the U.S. has no intention of defending Kuwait if it is attacked by Iraq.”
Two days later, when Saddam entered Kuwait, he had no reason to believe that the U.S. would come to Kuwait’s defense with a half-million troops. Or that when he tried to negotiate a retreat though Arab leaders, the U.S. would refuse to talk. In 1990 as in 2002, a Bush president had his mind set on war.
If the White House and Pentagon were fixed on a war with Iraq, during the summer and early fall of 1990, the American public and Congress were not. To change that, the week after Iraq invaded Kuwait, the Kuwaiti government, disguising itself as “Citizens for a Free Kuwait,” hired the global PR firm of Hill & Knowlton to win Americans’ hearts and minds.
In charge of the Washington office of Hill & Knowlton was Craig Fuller, a close friend of George H.W. Bush and his chief of staff when he was vice president. For $11.8 million, Fuller and more than 100 H&K executives across the country oversaw the selling of the war.
They organized public rallies, provided pro-war speakers, lobbied politicians, developed and distributed information kits and news releases, including scores of video news releases shown by stations and networks as if they were bona fide journalism and not paid-for propaganda.
H&K’s research arm, the Wirthlin Group, conducted daily polls to identify the messages and language that would resonate most with Americans. In the 1982 Emmy award-winning Canadian Broadcasting Corp. documentary To Sell a War, a Wirthlin executive explained that their research had determined the most emotionally moving message to be “Saddam Hussein was a madman who had committed atrocities even against his own people and had tremendous power to do further damage, and he needed to be stopped.”
To fit the bill, H&K concocted stories, including one told by a 15-year-old Kuwaiti girl named Nayirah, to another H&K concoction, the House Human Rights Caucus looking to pass as a congressional committee. According to the caucus, Nayirah’s full name would remain secret in order to deter the Iraqis from punishing her family in occupied Kuwait. The girl wept as she testified before the caucus, apparently still shaken by the atrocity she witnessed as a volunteer in a Kuwait City hospital.
According to her written testimony, she had seen “the Iraqi soldiers come into the hospital with guns and go into the room where … babies were in incubators. They took the babies out of the incubators, took the incubators and left the babies on the cold floor to die.”
During the three months between Nayirah’s testimony and the start of the war, the story of babies tossed from their incubators stunned Americans. Bush told the story, and television anchors and talk-show hosts recycled it for days. It was read into the congressional record as fact and discussed at the U.N. General Assembly.
By the time it emerged that Nayirah was a Kuwaiti royal and the daughter of the Kuwaiti ambassador to Washington and that she had never volunteered in any hospital and that the incident and her testimony had been provided by H&K, it was too late. The war had already begun.
Another concoction was top-secret satellite images that the Pentagon claimed to have of 250,000 Iraqi troops and 1,500 tanks on the Kuwait-Saudi border, visible proof that Saddam would be advancing soon on Saudi Arabia. Yet the St. Petersburg Times acquired two commercial Russian satellite images of the same area, taken at the same time, that showed no Iraqi troops near the Saudi border, and the scientific experts whom the Times hired could identify nothing but sand at the supposed location of the advancing army.
But the St. Petersburg Times story evaporated, and the Pentagon’s story stuck. When Bush addressed a joint session of Congress on Sept. 11, 1990, he reported that developments in the Gulf were “as significant as they were tragic”: Iraqi troops and tanks had moved to the south “to threaten Saudi Arabia.”
Saudi reluctance to host foreign troops and bases that would desecrate their sacred sites, the holiest in all of Islam, gave way in the face of an imminent invasion, and the war had its staging area. American discomfort with a war to defend a country most had never heard of began to transform into dread that the Saudi oil they relied on would be swallowed up by a monster.
In the lead-up to war, U.S. media organizations, with rare exceptions, had begun to back away from investigative reporting and journalistic scrutiny. Once the war began, government censorship combined with this self-censorship produced a media blackout. The restrictions on the press were tighter than during any earlier American war. Journalists could not travel except in pools with military escorts, and even then most sites were off-limits.
Pentagon censors had to clear all war dispatches, photos and footage before they could be released. Department of Defense guidelines stated that stories would not be judged for “potential to express criticism or cause embarrassment,” but journalists weren’t taking any chances. When news anchors weren’t hosting retired generals and pundits, or screening eerie green images of the coordinates of the day’s targets, they were praising the military on a job well done.
Two months after the war ended, the editors of 15 news outlets protested to Secretary of Defense Dick Cheney about the Pentagon’s control. But the damage had been done. The real war was never reported to the American public.
What We Missed and Need to Remember
Americans never saw images of even one of the 100,000 civilians killed in the aerial war, just coordinates of precision-guided strikes, the majority of which missed their marks.
We never learned that the government’s goals had changed from expelling Saddam’s forces from Kuwait to destroying Iraq’s infrastructure. Or what a country with a destroyed infrastructure looks like — with most of its electricity, telecommunications, sewage system, dams, railroads and bridges blown away.
There were no photos or stories of the start of the ground war on Feb. 24, 1991, after Iraq had agreed to a Russian-brokered withdrawal. We never saw the “bulldozer assault” of Feb. 24-26, when U.S. soldiers with plows mounted on tanks and bulldozers moved along 10 miles of trenches, burying alive some 1,000 Iraqi soldiers. Or the night of Feb. 26, when allied forces cordoned off a stretch of highway between Kuwait and Basra, Iraq, incinerating tens of thousands of retreating soldiers and civilians, in an incident come to be called the “Highway of Death.”
We saw no coverage of dead Kurds and Shiites who, at Bush’s instigation and expecting his support, rose up against Saddam. Nor in the months and years after, the news of the Iraqi epidemic of birth defects, cancers and systemic disease.
We heard little about the 20,000 troops occupying Saudi Arabia after the war, the growing regional resentment for the destruction and death, injuries and insults of invasion and occupation. We never heard of the Saudi Muslim radical Osama bin Laden, his outraged protests, for which he was banished, wandering the region, recruiting young followers to avenge the desecration of Islam’s sacred sites.
As for our own, there were no images of returning coffins filled with U.S. service members, nor, in the days and months after the war, coverage of the war’s aftermath: The 200,000 troops who returned profoundly ill from Gulf War illness; the trauma, addiction and/or brain damage that caused veterans to kill their wives, family, fellow citizens, and/or themselves; and, of course, on Sept. 11, 2001, the tragic event used by the George W. Bush administration to launch a second war against Iraq.
There was no mainstream media coverage of the roots, just of the proclamations of them versus us, hatemongers versus freedom lovers, barbaric cowards versus civilized heroes.
We could read about bin Laden’s jihad, but little appeared of the fatwa he and his counterparts throughout the Middle-East issued, except the often-quoted statement that it was the duty of every Muslim “to kill the Americans and their allies — civilians and military,” leaving out the second part of the sentence — “in order to liberate the al-Aqsa Mosque and the holy mosque [Mecca] from their grip, and in order for their armies to move out of all the lands of Islam, defeated and unable to threaten any Muslim.”
Barack Obama’s early opposition to George 43’s Gulf War was a sign of the integrity, knowledge, and depth for which Americans would elect him, trusting these virtues would guide us in hard times. Patriotic etiquette discourages politicians, especially presidents, from bearing complexities in public forums.
But war-weary, broke and scared Americans will welcome the president breaking rules and speaking awkward truths.
Invasion and violence, like chickens, do come home to roost. We’re ready for a leader who grasps history’s complications and heeds its lessons and who won’t release us from one war only to tie us to another, and another.