Legacy of Worry : Birth Defects Among Children of Gulf War Veterans Prompt Nagging Questions, Few Answers

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 Coats, learned about dozens more abnormal babies being born to Gulf War soldiers, 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 Coats 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 chemical arsenal.

Did any or all of these hazards make him sick, or damage his sperm, as some 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.”

And as Gulf War soldiers become fathers and mothers, some say 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. Pentagon officials recently concluded after a yearlong study that U.S. forces were exposed to no deadly gases or chemicals, and that no unique illness existed among veterans.

But some soldiers insist that something contaminated them, and that something seems to be maiming their children.

“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 Assn. 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 veterans, and Mekdeci says hers is the only group trying to find out. It was her organization that detected a number of heart defects among Gulf War children, along with a number of babies born with 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, the Coatses say they feel consigned to an anguished limbo. Each day, they watch Christian suffer and wonder if the cause is natural or man-made.

“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,” Brad Coats said.

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

Still, his parents do not know how many more birthdays their son will enjoy, and their doctors won’t venture a guess.

*

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

Brad and Lynn Coats 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 Coats holds a trashy paperback novel in her lap. She has been on Page 335 for two hours.

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

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

Lynn Coats 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, like the bleat of car alarms in a bad neighborhood, 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 Coats laugh.

Not long ago, she 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 facts 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 girl named Grace Burton, whose heart troubles were reminiscent of Christian’s.

Frightened, desperate for information, Lynn Coats wrote Ayers a letter, asking about Grace and describing all that she and her husband 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, 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 Coats 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,’ ” Coats recalled.

After months of careful thought, the Coatses 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,” Coats said. “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 the silence made him nervous.

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

Coats thought about hiding them under his tongue, or keeping one to take home, in case he ever wanted to have it analyzed.

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 this year show that officials--eager 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.

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

Politicians, meanwhile, are lining up to excoriate Pentagon officials for what they say was shoddy handling of an untested drug in the field. In addition to 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” in offspring, said James Moss, a former researcher with the U.S. Department of Agriculture, who contends that 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 recently 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.), blasted 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 Gulf War syndrome, Coats feels betrayed.

He acknowledges that Gulf War syndrome might be mass hysteria, or a cluster of real illnesses caused by unforeseen factors such as 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 the little white pills makes him seethe.

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

*

The Coatses 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 near-perfect, monastic silence.

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

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 Coats asks 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.

“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 . . . “