Meanwhile, 22 veterans a day (up from 18) commit suicide and this is beneath notice by the President of the United States of America.
Phi Beta Iota: Complete story below the line.
It’s not every day that a scientist creates such intense drama on Capitol Hill.
The American Conservative, 10 May 2013
But Dr. Steven S. Coughlin’s charges that the U.S. Department of Veterans Affairs (VA) officials hid, manipulated, and even lied about research pertaining to Gulf War Illness (GWI) and health problems plaguing Iraq and Afghanistan veterans are still causing fallout a month after his stunning testimony before a key House subcommittee.
“The implications of his testimony are profound,” declared Anthony Hardie, 45, a Gulf War veteran who serves on the congressionally appointed Research Advisory Committee on Gulf War Veterans’ Illnesses (RAC).
Veterans and their advocates, as well as many in the scientific community, have long believed that the VA avoids responsibility for veterans’ care by downplaying or outright ignoring evidence linking wartime experiences—such as exposure to Agent Orange, chemical weapons, or toxic pollution—to veterans’ chronic medical issues back home.
Coughlin, a senior epidemiologist with the VA’s Office of Public Health (OPH), gave the VA’s critics what they say is a smoking gun: after conducting major surveys of 1991 Gulf War veterans and “New Generation” veterans from Operation Iraqi Freedom and Operation Enduring Freedom-Afghanistan, Coughlin told the committee he quit his post in December. He claims the VA is hiding important survey results about the health of veterans and that his colleagues watered-down analysis that might have shed light on whether recent vets got sick from open-air trash-burning pits on overseas bases.
He told the House Committee on Veterans’ Affairs Subcommittee on Oversight and Investigations on March 13 that millions of dollars are invested in veterans’ heath studies each year, yet “if the studies produce results that do not support [OPH’s] unwritten policy, they do not release them.” And “on the rare occasions when embarrassing study results are released, data are manipulated to make them unintelligible.”
He tried to confront his supervisors about what he saw but was “openly threatened and retaliated against” when he did. “I took a beating, but I had to follow my conscience,” Coughlin told The American Conservative.
For example, Coughlin said he had been working on the ten-year National Health Study of a New Generation of U.S. Veterans, which cost taxpayers $10 million and targets 60,000 Iraq and Afghan war vets, of whom many are Gulf War I vets, too. Among other data, the questionnaire given to the vets produced information about their exposure to pesticides, oil-well fires, and pyridostigmine bromide tablets, which were prescribed to Gulf War soldiers to protect against nerve agents.
The breadth of research today indicates that these and other battlefield exposures played a role in making an estimated 200,000 (out of 697,000) Gulf War soldiers sick, yet Coughlin and others charge the VA is still bent on treating GWI as a psychosomatic condition brought on by battle stress—which would be a less expensive prospect for future benefits and health costs.
The new information could have been a treasure trove for researchers outside the VA. But the Office of Public Health has never released the study data, “or even that this important information on Gulf War veterans exists,” Coughlin testified. “Anything that supports the position that Gulf War Illness is a neurological condition is unlikely to ever be published.”
His charges were bolstered by pioneering Gulf War Illness researcher Dr. Lea Steele in her own testimony that day. “I regret to say … there seems to have been backward movement with actions that seem intended to ignore the science and minimize the fact that there is a serious medical condition resulting from military service in the 1991 Gulf War.”
Coughlin was co-authoring a paper for publication that he said would reveal connections between Iraq and Afghan war veterans who had been exposed to toxic burn pits on U.S. bases overseas and post-deployment diagnoses of asthma and bronchitis. He said the survey found that “a sizable percent” of vets had been exposed to the burn pits.
“My supervisor, Dr. Aaron Schneiderman, told me not to look at data regarding hospitalization and doctors’ visits,” Coughlin said. By ignoring that data, the “tabulated findings obscured rather than highlighted important associations.” The VA has initiated a new study but currently maintains that there are no long-term health risks associated with the burn pits, citing a limited Institute of Medicine study in 2011 that, based on old air samples, found no conclusive evidence that burning trash in the open was responsible for veterans returning home with scars on their lungs.
The original New Gen study could have provided fresh data, but it was deliberately ignored, said Coughlin, who testified that when he told Schneiderman he “did not want to continue as co-investigator under these circumstances,” he “threatened me.”
Since the hearing, Secretary of Veterans Affairs Eric Shinseki has directed the Office of Research Oversight to review Coughlin’s allegations. “Any retaliation against VA employees is against the law and is not tolerated by the Department,” the VA said in a statement. But even after repeated attempts by this writer, the VA declined to address Coughlin’s other claims, which include:
His supervisors lied
Coughlin was the principal investigator for the ongoing Follow-up Study of a National Cohort of Gulf War and Gulf War Veterans, a survey of some 30,000 vets that began in 2010 and whose results have never been published.
From the beginning, the Research Advisory Committee on Gulf War Veterans’ Illnesses, which is appointed by congress and is made up of outside researchers and veterans, had serious reservations about the way the questionnaire was structured, said Steele. She complained that while it “contained scores of questions” about “psychological stress, substance abuse and alternative medicine,” it did “not include the basic symptom data” nor define GWI, “by any case definition.”
RAC demanded changes to the questionnaire, and Coughlin tried to push them through. “The VA Chief of Staff [John Gingrich] directed my supervisor” to send it out for objective peer review, he recalled to the House subcommittee. But it was instead sent out to a friend of OPH’s Dr. Michael Peterson, who found a reviewer, “who had no background in Gulf War research,” and was told by “my direct supervisor, Dr. Schneiderman” that “the RAC’s comments were politically motivated.”
“Not surprisingly the reviewer’s comments were very favorable” toward the original questionnaire, he added. Additionally, Coughlin’s supervisors told Gingrich that making changes to the questionnaire would cost the government $1 million and delay the study for a year or more. “None of this was true,” testified Coughlin, “but as a result [Gingrich] ordered the survey to proceed without any changes.”
Data permanently lost
Coughlin pointed to the results of the Gulf War family registry as another set of “important data that has never been released.” Mandated by Congress, the registry began offering physical examinations to veteran’s families in 1996 in an attempt to screen for possible congenital disorders that may have been caused by wartime environmental exposures. Over 1,100 children and spouses of Gulf War vets were tested through 2001.
“I have been advised that these results have been permanently lost” from the registry database, Coughlin said.
Suicidal vets ignored
Coughlin said that in both the Gulf War and New Gen studies, thousands of veterans reported they had suicidal thoughts in the previous two weeks and “would be better off dead.” Coughlin said there was no protocol in place to offer these vets clinical assistance, and as a result only a “small percentage” got follow-up calls from mental-health specialists.
Coughlin fought for that, and “only after my supervisors threatened to remove me from the study and attempted disciplinary action against me” was he able to secure help for 1,331 vets in the Gulf War study. But he was not been so successful with the New Gen vets, some 2,000 of whom expressed suicidal thoughts. Only a small percentage of those veterans ever got assistance, he said, insisting, “some of those veterans are now homeless or deceased.”
He claimed the Inspector General’s Office would not take on the case. He quit and brought his concerns to the Office of Research Oversight and to Congress. Both are investigating his charges today.
He said it was his ethical duty to push, even if it cost him his job. (He’s now an adjunct professor at Emory University, and still looking for a full-time position.) “The only reason I testified was to help out the veterans,” he told The American Conservative. “As principal investigator for the study I heard from hundreds of veterans, I talked to them daily for months. I was happy to help out.”
Coughlin says this is an issue that affects all Americans: after $120 million in taxpayer dollars spent on research over that last 10 years, the VA is no closer to targeted treatment for GWI than it was in the 1990s.
Capt. Mark Lyles, a Navy scientist who’s been working on research based on a theory that a highly toxic “stew” of heavy metals found in the Iraqi dust is making veterans sick, says he is “not surprised” to hear of inside data manipulation and research bias.
“I’ve had meetings with the VA and their epidemiology people and basically was shocked at their lack of concern for the data I was presenting,” he says. “You have to realize the cost associated with a real pathology. A psychosomatic [illness] can be treated, thus cured. At the very least we can put you on some pills and ‘fix’ your problem. If there is an environmental toxin or exposure that is the cause of this, and they produce permanent neurological damage, than that is forever.”
Paul Sullivan, director of veteran outreach at the law firm of Bergmann & Moore, notes that research is the first step towards getting new regulations, which are required for expanding eligibility for service-connected healthcare and disability claims. Coughlin’s “substantiated charges,” says Sullivan, show the VA is undermining the process to avoid the burden of lifetime costs on the system.
“The only way to block claims is to block the research,” charges Sullivan. “That is the shameful tragedy of the VA’s actions, as described by Dr. Coughlin.”
For its part, the VA says it’s working vigorously on veterans’ behalf. While not responding to Coughlin’s accusations directly, Victoria Davey at OPH testified that “VA facilities throughout the nation are working on bold, innovative programs that combine primary care and specialty care services” for veterans with GWI, now referred to by the VA as Chronic Multi-symptom Illness (CMI). When pressed by members of the House subcommittee whether the VA believes GWI is physical or mental, she said, “We do not believe it is psychological.”
However, Hardie, who also testified before the subcommittee on March 13, tells The American Conservative that Coughlin’s testimony is just “the tip of the iceberg” of how far the “public health staff will go to lie and manipulate the outcomes they want.” As a veteran who’s been suffering from chronic illnesses since he returned home from Iraq 22 years ago, Hardie calls the officials’ behavior “criminal.”
Right now no one is going to jail, but since the hearing several top Veterans Affairs officials have quietly resigned, including Chief of Staff John Gingrich, Deputy Secretary Scott Gould, and Joel Kupersmith, the VA’s chief research and development officer. (The first two resignations could be connected just as much to the VA’s more widely publicized backlog scandal and revelations that officials were still getting millions of dollars in bonuses while the backlog grew.)
Coughlin’s claims affect at least two generations of veterans as they struggle with life-altering, chronic illnesses that so far, can’t be officially traced to their wartime service. But while his testimony validated many suspicions about how the VA research arm operates, it left many questions unanswered, the least of which is, what were the results of those studies Coughlin insists are being hidden away?
Veterans hope these answers will come upon further investigation, but note that money is bleeding through the system in the meantime. The culture of the VA needs to be transformed, they say, before real progress can be made.
“There is an element of hope here,” Hardie said, however, “if we keep following this ‘don’t ask, don’t find’ strategy, then we’ll end up having an overburdened healthcare system and an overburdened disability claims system, and you’ll have more people like me who would do anything to get their health back and live a normal life.”
Kelley Beaucar Vlahos is a Washington, D.C.-based freelance reporter and TAC contributing editor.