Interview with Matthew Puglisi, American Legion spokesperson. During the
Gulf War, Puglisi, a Marine Second Lieutenant, was an artillery officer
attached to an infantry company; he controlled artillery fires in that
company's area throughout the war. Interview conducted October 1997
Q: The role the media's played in this--have they helped or hindered in
A: [sigh] That's a good question. Media's done both. The media has
helped because of its focus on the person and that helped the American people
understand what these numbers mean. When we say tens of thousands of Gulf War
veterans report poor health since the Gulf War, I mean, what do tens of
thousands mean? The media's been able to go in veterans' homes, talk to them
and their spouses about the impact the veterans' illnesses had on the family.
They've been able to talk to veterans who have had bad experiences at the Dept
of Veterans Affairs and put a face behind these numbers. That's been
important. The media, to its credit, took seriously the beliefs of the
veterans and maybe it wasn't backed up by science, but the veterans had a
strong set of beliefs and those are important things that leaders have to
address and they didn't for a long time. So that's where the media's helped.
Where the media hasn't helped and through no conscious effort on it's part,
but just sort of the nature of the media, its short attention span, its rush to
get things out there as quickly as possible, the turnover in the media either
in personnel and agencies or giving different people the story to do this week,
is that they haven't remembered what's been learned and many times the media
will interview so-called experts to react to a scientific study and that expert
will lambast it. Maybe it was a good one, maybe it had information that's
important to Gulf War veterans, but instead many national media outlets have
undermined the findings, put doubt in people's minds about what we've learned
and that's not doing a good thing for --
Q: Why? Because they're seeing it as a political story that requires
A: The New York Times --which has some of the best medical reporters in
the nation-- hasn't been allowing them, hasn't encouraged their medical
reporters to cover this issue. Why not? They've been covering it from a
political angle with their Pentagon reporter. Doesn't help the nation
understand what's really important about Gulf War illnesses. Helps the nation
understand some of the in-fighting that's occurring in Washington, DC, but it
hasn't helped us understand what are veterans concerned about, what are the
medical complexities of this and how should we approach it.
Q: What about TV? 60 minutes? 20/20?
A: TV's got great images and great pictures but -- TV doesn't have the
time to educate the viewer about how sophisticated and complicated this is.
It's the Pentagon says this and they pick somebody to say, no, wrong. And
sometimes they pick somebody who isn't even a Gulf War veteran to express the
views of Gulf War veterans and again that's not really helping people
understand what's occurring with Gulf War illnesses.
If they really found that average Gulf War vet, that average Gulf War vet
would rail about how poor the care was at VA -- long before they would bring up
the Dept of Defense. And that's not to let the Department of Defense off the
Q: Are most of the veterans convinced they've been poisoned by chemical
A: I don't know. I think many are and while we haven't done any formal
survey of Gulf War veterans asking them what they think the causes of their
illnesses are, but I think it's safe to say that a great many are convinced
that chemical weapons are associated with their poor health. Now do they
believe that because of their experience in the Gulf? In many cases, probably.
I mean the alarms as we all know went off all the time- many times regardless
of what kind of chemical was in the air,- whether it was vehicle exhaust or
maybe even the fine dust that was in the Gulf and many of these ideas that the
veterans have were reinforced by what the national media has been saying about
Gulf War illnesses.
Q: Talk about some of the problems of the exaggeration..... What, for
instance, might be the downside of somebody saying that people who served in
the Gulf had a risk of having deformed children?
A: The Dept of Veterans Affairs has reported that in that in one
epidemiology study they're conducting, in one health survey that's being
conducted, a majority of male Gulf War veterans responded that they've delayed
having children because of reports of excess birth defects in the Gulf War
veterans population. That -- that's a tremendous change in behavior and that's
been affected by these reports that there --
Q: What kind of reports? Media reports?
A: Sure, the media. I mean that's how most people get their information
and particularly pictures. You look at the Life Magazine article two years ago
and the impact it would have. I'm a Gulf War veteran, I'm in good health and
I've had a child since the Gulf War yet I had relatives copying that thing and
mailing it to me, very, very concerned about my daughter's health yet so far we
haven't found an excess in birth defects in the Gulf War veterans children's
So should Gulf War veterans be concerned about their children's health?
Sure. You should always be concerned about your children's health from all the
different things that can happen to your children, but we just haven't found
the evidence yet and we're looking.
Interview with Dr. Stephen Joseph, Assistant Secretary of Defense for Health
Affairs, 1994-1997. Joseph, a veteran public health physician, led the DOD's
medical investigation of Gulf War syndrome. Interview conducted October
Q: Can you talk about the media and how they covered the story ?
A: I think it varies. I think you had different segments if you will of the
media. You had, I think, a group in the media that were looking for
sensational aspects -- what could be more sensational than this? "U.S.
Soldiers Gassed in the Gulf," or, "Mystery Illness Strikes Down American
Military After the War," or whatever. And there was a good deal of
sensationalism. I think there was some rather cynical self interest in some of
the media approach.
I think the media in general did a very poor job, both the print and the
electronic media, did a very poor job of covering what the medical facts and
what the scientific realities were. There was a kind of period where there was
the Disease of the Month. Anything that some Congressman could think up as
might be a cause of mystery illness would be in the headlines or on the
videotape as, The Cause of a Mystery Illness. There was not the kind of
coverage you would expect had you had science reporters. The story from the
beginning was not done by science reporters, or medical reporters. I think
that's a very important fact. It was treated as a political story rather than
a scientific or medical story. I think perhaps that's inevitable, but that's
Q: Take something like the Life Magazine piece. What do you think as a public
health officer when you see that?
A: I think the Life Magazine piece was both a charade and very cynically done.
We knew that a piece was in preparation. We talked to the people at Life
Magazine, told them what the scientific data showed, told them that within a
week or two of their proposed publication that there would be a scientific
journal article in the most prestigious medical journal in the country that
showed there was no evidence for congenital defects, asked them if not to delay
publication until the scientific article came out, to balance their story with
the information that was there. They went ahead and published in the most
sensationalistic way anyway. I think they did a great disservice to not only
the people who served in the Gulf, but to their families. I think they scared
a lot of people. There was no basis, no scientific factual basis for their
story. It was just a cover and a headline and I think represents the worst
kind of journalism.
Q: What was the antidote to this kind of journalism though? Where was the
other side being heard?
A: I don't think the other side was heard well and for that perhaps you can
criticize all of us, including the medical people. It was a difficult message
to get out. It was, as I've said, complex, it was not particularly palatable,
and there was some uncertainty to it. That's hard to portray as a message
against the kind of single-minded certainty of a sensationalistic easy answer.
In addition, messages from the government and messages from the Department of
Defense don't often have a great deal of credibility. I think, on any given
day, all other things being equal, John or Jane Q Citizen is going to believe
the worst rather than the more balanced account.
This is an enormous, this is probably the most significant public health
problem of our time, i.e., how you convey complicated probabilistic information
in a way that is acceptable and understandable by the public. I don't think we
did a particularly good job with this. I'm not trying to put the blame on the
side of the receiving public. It's not an area where public health does a
pretty good job in general. You can look at AIDS, you can look at
Legionnaires', you can look at any of the environmental threats to health, and
you see the same thing again and again. We need to learn to get much better at
this, both in terms of conveying scientific information and in marketing the
information in a palatable way. But in this case, in the Gulf War issue, it
was not at all successful.
Q: The DOD emerged from the Gulf War victorious....but then seemed to lose
their credibility so quickly and so totally. What do you think contributed to
A: I think there's plenty of blame to go around. I think in part it rests on
the clumsiness with which the government, and the DOD in particular, tried to
convey, first of all concern, which needed to be conveyed. And second of all,
what the data was showing. I think part of the blame rests on those who
continued to whip up the issue. I think there were certainly those in the
media. There were pseudo scientists. There were individual members of
Congress who just would dredge up the most fantastic hypotheses and
explanations without, absolutely without a shred of what I would call
acceptable scientific rationale behind them, and throw them out there and blow
them up in headlines and in video footage of GIs in gas masks. If I have seen
once I have seen 50 times that same segment of soldiers in MOPP gear, in
chemical protective gear, entering a slit trench, and it's always shown in
absolutely no context. Just whenever there's a Gulf War issue you'll see that
same piece of footage.
So there were those in the media. There were those who had axes to grind for
their own scientific research, and I think, most regrettably, there were
individual Congressmen, members of Congress, who just kept blowing this thing
up, I think created a great deal of anxiety, and also made it much harder to
get the message out. And then there were the vets. These people, the 20,000,
60,000, whatever number you want to use. They were hurting. They were ill.
They were worried about it. They were anxious about what the future of their
health was. And they also wanted answers, as we all do. They wanted answers
that were most acceptable to them. They wanted medical labels. I'm the same
way. When I have something that hurts I want a medical label on it and
hopefully I want a direct and complete therapy that will cure that symptom.
And in this case, especially with this most important combination of
psychological stressors and physical symptoms, this was a message that was not,
and is not today, palatable to the vets. They don't want to hear that. You
have to understand that.
But at the same time you also have to recognize it as a position that makes
it more difficult, both for them and for the rest of society. If we could only
find a way to get all of us, not just those who are suffering from the
symptoms, but the entire -- to accept that message, to understand that. When
the Presidential Advisory Committee brought out this issue, as I think they
were very correct to do, of the importance of psychological stress in this
whole equation, they were shouted down. There was a program from the "Wisdom"
of members of Congress and in the media. Why? Why is it so difficult to
accept the message that, when you put young Americans, or anyone, in a
situation that is uncomfortable, dangerous, and uncertain, that a number of
those people come back from that situation with a combination of physical
symptoms and psychological symptoms. I think we all know that. We look at
ourselves in the mirror, everyone of us knows that and understands that in our
lives. When you wake up in the morning and don't feel well and don't want to
go to work because you have something unpleasant that's going to happen to you
at work that day. You understand this combination of physical symptoms,
whether it's sleeplessness or depression, or pains in your joints, or pains in
your stomach, and what's going on in your psyche.
So we all know this, but we can't face -- it's kind of the last taboo of
being unable to face the truth about this. And it's very sad because, if there
is an area where we need to do a better job of protecting our young people when
they go in harm's way, and they will again, this is the area that we need to
make progress on. And it's very difficult when we consciously blind ourselves
from talking about it and facing it and understanding it.
Q: There's been quite a lot of messengers in this story. There's been five
blue ribbon panels, various studies. Pretty much all the scientific messengers
present a fairly consistent message, and they've all tended to be treated the
same way, haven't they? Am I correct?
A: I think so. But I think that's the nature of the issue. Let's talk about
both sides of it. One is the consistency of the message. There's an old
saying in medicine that says: When you hear hoofbeats in the street and you
look out the window expect to see horses and not unicorns. As the data has
piled up and piled up it's pretty clear that what we're look at are horses in
this situation. There is no unicorn here. There is no mystery illness. That
has been a consistent message in all the groups that have looked carefully and
scientifically at this.
Another problem that we have as scientists and public health people however,
is that we live by probabilities. And we are always reluctant, and for good
reason, to say something is certain when we know that there's some degree, some
small degree of uncertainty attached to it.
Now the rest of the world, the media and the public, and Congress, they live
by certainties. They like to have things clearly black and white, yes or no,
up or down. And we need to get better in my profession, we're not very good,
at conveying those uncertainties to people. So when the scientist says, this
was very clearly evident in the early days of the AIDS epidemic: "No, AIDS is
only transmitted through these ways and not by those. 'Are you sure doctor?'
Well, I'm almost certain, or it is highly probable." But I mean, how many
times have you heard people like me say, "It's almost certain, or We're quite
sure, or It's highly probable." Well when the public or the media hear that,
what they hear is the uncertainty side, and they focus on that as an indication
that this is not sure or not true or more than uncertain.
And of course, when people have reasons for wanting to hear the uncertainty,
either because they can't face the reality of the psychological/physical
symptoms combination, or because they want to make headlines the next day, then
it's easy for them to discredit the argument.