Gulf War’s Legacy of Worry Grows : Medicine: O.C. couple convinced that father’s service led to baby’s congenital heart defects.

He has a Purple Heart.

It lies beneath a ragged line in the middle of his chest.

His nanny coos at him as she unbuttons his cotton jumpsuit, exposing the vivid incision made last month by a surgeon’s knife.

“Yes,” she says softly, “he has his own battle scars.”

At first, no one saw a connection between Christian Coats’ congenital birth defects and the fact that his father fought in the Persian Gulf War.

Doctors simply called it fate when the boy was born last year with a deformed heart on the wrong side of his chest.

But when Christian’s parents, Brad and Lynn, learned about dozens more abnormal babies being born to Gulf War veterans, they couldn’t help suspecting the spate of poisons to which Brad was exposed in Kuwait.

While taking part in Operation Desert Shield, then Desert Storm, Brad breathed the black, cottony smoke of burning oil wells, stood beside sky-high stockpiles of radioactive ammunition and ingested fistfuls of experimental medicine meant to protect him from Iraq’s dreaded chemical arsenal.

Did any or all of these hazards make him sick, or damage his sperm, as so many soldiers and researchers now believe?

Nearly five years since the Gulf War ended, perhaps as many as 40,000 veterans--6% of those who served--have reported a mini-plague of symptoms--from fatigue and recurrent nausea to chronic joint pain and dizziness--all grouped loosely under the heading, Gulf War syndrome.

Now, the mystery is mutating. As Gulf War veterans become fathers and mothers, their sickness seems to be seeping into the next generation.

Defense Department officials express deep skepticism that the brief Gulf War could create a protracted health crisis. Most recently, Pentagon officials concluded after a yearlong study that U.S. forces were exposed to no deadly gases or chemicals.

The Pentagon tracked 10,000 soldiers, finding nothing to indicate that any unique illness existed among them.

But that conclusion was sharply denounced by experts at the National Academy of Sciences, who called it statistically improbable that not one of the Pentagon’s 10,000 test cases had a single illness related to Gulf service. The presence of such an improbability cast the whole study in doubt, critics said.

Meanwhile, soldiers continue to insist--to their doctors, to their senators, to whomever will listen--that something contaminated them, something bizarre, and that something now seems to be maiming their children.

Many point to a 1994 General Accounting Office report, which identified “several substances present in the war environment that, according to a number of studies, may cause reproductive dysfunction.”

“Our purpose is to demonstrate to those blokes in Washington that this is a big problem, and they better get their heads on straight,” says Betty Mekdeci, head of the Orlando-based Association of Birth Defect Children, which has built a detailed database on more than 150 abnormal Gulf War babies so far, including Christian.

No one knows how many sick children have been born to Gulf War children, and Mekdeci says hers is the only group trying to find out. It was her organization that detected a striking number of heart defects among Gulf War children, along with a high percentage of a rare disease called Goldenhar syndrome, which causes asymmetry in the head and face. But she says the work has been slow without cooperation from the government.

Until an answer is found, Brad and Lynn say they feel consigned to an anguished limbo. Each day, they watch Christian suffer and wonder whether the cause is natural or man-made.

For some reason, the answer matters.

“I’d certainly like to know,” says Brad, as Christian toddles around the Coatses’ Yorba Linda condominium, grinning and laughing despite his difficulty breathing. “When he grows up, you’d like to have an answer for him: why he’s so screwed up, why he had to go through all the pain.”

On the eve of his first birthday, Christian seems to be recovering well from last month’s open-heart surgery.

Still, Brad and Lynn don’t know how many more birthdays their son will enjoy, and their doctors won’t venture a guess.

“We’re just lucky he’s alive,” Lynn says. “There’s so many babies that have died.”

*

The waiting room at Children’s Hospital of Orange County is small and airless, a pastel-shaded cell overpowered by a pot of day-old coffee as thick as tree sap.

Brad and Lynn sit on a set of pink-and-blue chairs, staring at the walls, staring at the ceiling, staring at the clock, which never seems to move.

Lynn holds a trashy paperback novel in her lap. She has been on page 335 for two hours.

Brad keeps a grocery sack stuffed with car magazines next to him, but he has yet to flip one open.

Five minutes pass.

Ten minutes pass.

They stare at the walls.

They stare at the ceiling.

They stare at the clock, which never moves.

This warm September morning, Christian is undergoing a delicate operation to strengthen the transposed and malfunctioning parts of his heart. Down the road, when he is stronger, doctors will try to virtually rebuild the organ.

At 9 a.m., the hospital’s head cardiac nurse appears in the waiting room.

Brad blurts: “Do they have him split open?”

The nurse blanches at the question. She doesn’t know that Brad is a former Army mechanic, the kind of man who likes to roll up his sleeves and get down inside the nitty-gritty of things. She doesn’t know that Brad stays up nights, drawing elaborate color pictures of his son’s heart on the family computer.

“Yes,” she says quietly, “they have him split open.”

When Brad asks another graphic question about the state of his son’s exposed chest, Lynn gives him a look that says, Enough, Brad, enough.

Lynn is crustier and feistier today than when she married Brad six years ago. Tragedy has toughened her.

Besides Christian’s ordeal, she had to endure those long winter nights in 1991, watching on CNN as shrill warning sirens rent the air above the Persian Gulf. The alarms were constant and each one supposedly signaled another chemical attack.

Defense Department officials now say nearly all those sirens were false alarms, a claim that makes Lynn laugh.

Not long ago, Lynn read in the newspaper about a North Carolina woman named Melanie Ayers, who was forging a network of Gulf War parents and pressing Pentagon officials for the truth about Gulf War illnesses.

Besides Ayers’ infant son, Michael, who died from a congenital heart defect, the article described several abnormal and premature babies born to Gulf War veterans, including a little girl named Grace Burton, whose heart troubles were reminiscent of Christian’s.

Frightened, desperate for information, Lynn wrote Ayers a heartfelt letter, asking about Grace and describing all that she and Brad had been through.

“If we can finally solve this issue,” she wrote, “it would ease my husband’s burden. He feels it’s his fault that our son is in his condition.”

Weeks later, Ayers answered Lynn’s letter, expressing sympathy and solidarity.

“Thank God your son’s life was saved,” she wrote, explaining that Lynn’s letter had touched her deeply because Christian had nearly been the name of her own son.

Above all, Ayers wrote to deliver some bad news.

Days earlier, she said, “Grace Burton . . . slipped into the Lord’s arms.”

*

Brad had a funny feeling about those pills.

He asked if he could skip taking them, but his lieutenant told him to shut the hell up.

“He said, ‘This isn’t a [expletive] democracy,’ ” Brad recalls.

After months of careful thought, Brad and Lynn now believe those Army-issued pills probably caused their son’s birth defects.

“The whole time we were over there, I was thinking there was something up with these pills,” Brad says. “It would’ve been one thing if they said, ‘Here’s a drug, we don’t know what it could do, it’s experimental, it could save your life, take it.’ ”

Instead, the Army said nothing, and their silence made Brad nervous.

The pills were tiny, white and nondescript--like swollen grains of rice. Brad’s lieutenant never explained what was in them, just called them “PB,” short for pyridostigmine bromide, and ordered Brad to take one every six hours for a month, promising they would protect him if Iraq ever launched a chemical attack.

Brad thought about hiding them under his tongue, or keeping one to take home, in case he ever wanted to have it analyzed. Throughout the war, he worried about being shot, but he also fretted about the long-term effects of that pill.

He was right to worry.

Normally reserved for sufferers of myasthenia gravis, a chronic neuromuscular disorder, PB had never been subjected to a full-scale battery of tests on healthy human beings.

Until the Gulf War, that is, when it was tested on hundreds of thousands of unwitting soldiers.

Documents released by the Pentagon earlier this year show that officials--anxious for something, anything, to protect U.S. soldiers from Iraqi nerve gases--pressured the Food and Drug Administration to authorize experimental use of PB without soldiers’ informed consent.

Brad learned about PB’s experimental nature, and its many worrisome side effects, only after the war--and then only through news reports, Senate inquiries and Lynn’s dogged research.

The knowledge sickens him more than the drug ever did.

“The more I read, the madder I get,” he says.

Politicians, meanwhile, are lining up to excoriate Pentagon officials for what they say was shoddy handling of an unknown drug in the field.

Besides keeping no records of who took the drug--and giving the same dose to each soldier, regardless of gender, weight or medical history--officials may have boosted PB’s toxicity, by issuing it in tandem with a common household insecticide. The bug spray was meant to ward off swarms of desert pests; instead it may have combined with PB to create a powerful chemical compound that often proves lethal to laboratory insects and rats.

“You’ve got 400,000 people who ate this pill, and a lot of them are complaining of birth defects,” says James Moss, a former researcher with the U.S. Department of Agriculture, who contends he has been ostracized by the government-dependent scientific community because of his pointed remarks about PB. “There’s a little too much coincidence.”

Moss testified not long ago before a Veterans Affairs Committee hearing on the hazards of military research. But even before he spoke, the committee’s chairman, Sen. John D. (Jay) Rockefeller IV (D-W.Va.), opened the hearing by blasting Pentagon officials, who “threw caution to the winds, ignoring all warnings of potential harm, and gave these drugs to hundreds of thousands of soldiers with virtually no warnings and no safeguards.”

Later, Dr. Edward Martin, an assistant secretary of defense, defended the Pentagon’s actions.

“We were facing an enemy who had used nerve gas before,” Martin said, “and we had every reason to believe that they had integrated the use of nerve gas and biologic weapons into their combat arms. There was a very strong feeling that we had hundreds of thousands of troops who most likely would face chemical and possible biologic weapons.”

Whether or not PB turns out to be the root cause of his son’s birth defect, Brad feels betrayed.

He acknowledges that Gulf War syndrome might be “mass hysteria,” or else a cluster of real illnesses caused by unforeseen factors, like smoke from burning oil wells, contamination from uranium-rich ammunition, or something sinister released into the air by Iraqi President Saddam Hussein.

Still, the thought of those little white pills makes him seethe.

“You always assume there’s a risk involved with going to war,” he says. “You always assume you could come back hurt, or dead. You don’t assume it could happen to your kids.”

He holds out his hands and extends them toward Christian, whose blue eyes are enveloped in pouches of baby fat when he smiles at his father.

“I’m like, ‘Wait a minute, this wasn’t part of the deal,’ ” Brad says. “I went into this knowing what I was willing to give up, knowing what the risks were. And this is not something I would’ve accepted as a risk.”

*

Brad and Lynn are joined in the hospital waiting room by Brad’s parents, and by Lynn’s mom and sister, who caught the red-eye from Atlanta.

Throughout the morning, everyone observes a perfect, monastic silence.

When someone does talk, it is usually about the Gulf War.

“I wanted to keep one of the pills and bring it back,” Brad is saying. “I was thinking something like this might happen.”

Lynn’s mother and sister listen intently, then look away.

After four hours, Christian’s doctor appears. Still wearing his surgical gown, he pronounces Christian’s heart strong and says the chances of repairing it are good.

Brad asks, straight out, how long Christian can live with a rebuilt heart on the wrong side of his chest.

Frowning, the doctor says he has no idea.

Later in the day, Brad and Lynn will see Christian, and it will break their hearts to find that he seems angry with them, almost resentful that they let this happen to him.

But for now, they sit quietly, immobilized by relief.

They stare at the floor, they stare at the ceiling, they stare at the clock, which never moves.

“Take a deep breath,” Brad’s mother says. “The hard part is over.”

But in a far corner of the waiting room, Lynn’s mother strikes a less hopeful tone.

“That walnut-sized heart,” she says, her voice trailing off, “beating in that little baby . . . “

(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)

Gulf War Syndrome

About 40,000 of the approximately 700,000 veterans who served in the Persian Gulf War have reported various health problems, which, together, have been given the name Gulf War syndrome. The problems include:

* skin rash

* short-term memory loss

* diarrhea

* vomiting

* night sweats

* loss of bladder control

* muscle and joint pain

* bleeding gums

* personality changes

* sleeping problems

* shortness of breath

Despite a series of investigations, no conclusive link has been established between service in the Persian Gulf and the ailments. No single cause of the problems has been identified. Troops were exposed to a wide variety of potentially toxic chemicals, fumes and depleted uranium (used in munitions and armor). They were also given three drugs to prevent anticipated effects of chemical warfare--substances many blame for the Gulf War syndrome.

Source: Times reports