18 January 1999
Dr Michael Fitzpatrick on the origins of Gulf War syndrome
and other similar conditions
The conclusion of a survey of 3000 veterans of the 1991 Gulf War, published
in The Lancet last week, was that Gulf War syndrome does not exist. This is
unlikely to curtail the wave of claims from those who say they are victims
of this syndrome and their legal advocates whose cause is driven by a
powerful culture of compensation, which seeks redress for people who
believe that their misfortunes can be blamed on something or somebody,
irrespective of the weight of objective evidence to the contrary.
Many Gulf War veterans claim that a wide range of symptoms (including
chronic fatigue, insomnia, headaches, joint and muscle pains, skin
conditions, even cancers and congenital abnormalities in veterans'
children) are attributable to particular hazards of the war - vaccinations
against biological weapons, exposure to pesticides, chemicals, toxic gases
from burning oil-wells and wearing nuclear-biological-chemical protection
suits. Last week's report confirmed that servicemen returning from the Gulf
suffered more illnesses than those who came home from Bosnia, but could not
identify a specific illness or cause.
Gulf War syndrome is one of a number of conditions, which, though they lack
a clear medical definition, are driven by victims' claims for compensation.
These include conditions attributed to some immunisations, repetitive
strain injury supposedly caused by keyboard working, respiratory diseases
blamed on passive smoking, post-traumatic stress disorder and other
'stress' disorders, some cases of chronic fatigue syndrome/ME. As a growing
number of cases arising from such claims come to court, and victims are
encouraged by specialist solicitors to join 'class' actions with fellow
victims, the numbers suffering from these conditions is growing rapidly.
The culture of compensation is driven by a number of factors.
* a high prevalence of unexplained physical symptoms
Numerous surveys confirm that many people who consult doctors present
symptoms which cannot be explained according to recognised disease
categories. It appears that such complaints are especially common in public
services - the armed forces and the police, health, education and local
government. The common features of these occupational groups are low morale
and a widespread sense of being overworked, underpaid and undervalued.
* an enhanced sense of individual vulnerability
It is striking that soldiers and policemen, whose job has always involved
some exposure to the grisly side of life, now appear to experience
emotional trauma in the course of their work on an unprecedented scale. A
common feature of the compensation syndromes is a perception of damage to
the immune system, resulting from vaccinations, toxins, radiation, etc. The
immune system - more a physiological concept than an anatomical entity -
has become a metaphor for a sense of individual vulnerability.
* a breakdown of trust
Another common theme of the compensation syndromes is the conviction that
established sources of authority - government, doctors, scientists - cannot
be trusted. Indeed it is widely believed that such agencies are withholding
information or otherwise misleading the public in the pursuit of their own
or other vested interests (though this does not prevent claimants from
putting their faith in rival experts, so long as they confirm the claims of
victimhood). Healthy scepticism has been corrupted into a denial of even
the possibility of objectivity; the result is the elevation of subjectivity
and a descent into irrationalism. 'We strongly believe that the cocktail of
vaccinations has broken down the immune system and the neurological
system', says Tony Flint of the National Gulf War Veterans and Families
Association, indicating that this is for him an article of faith, beyond
any influence by the results of objective scientific inquiry.
* blaming and claiming
The belief that one's own misfortune is somebody else's fault is a familiar
infantile reaction. In parallel with wider trends towards the
infantilisation of modern society, it now drives the culture of
compensation. Claims for compensation from society for the misfortune of
illness are encouraged by lawyers and also by the inadequacy of welfare
provision for those suffering from chronic debilitating disease.
The origins of Gulf War syndrome - and other similar conditions - are not
likely to be found through studying the effects of diverse alleged toxins
on the immune system. A study of the relationship between the individual
and modern society might provide more valuable insights into the
contemporary malaise and the symptoms of distress to which it gives rise.
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