bookstore1.gif (6054 bytes)

April 15, 2000, 11:23PM

Death ruling raises issue of Gulf War ills

Syndrome called a contributing cause

By ALLAN TURNER
Copyright 2000 Houston Chronicle

For seven years, Michael Ingram suffered from a painful, debilitating disease that no one seemingly could diagnose or successfully treat. Blackouts, numbness, bleeding and weight loss -- those and other symptoms took the Houston musician and Army veteran to the hospital more than 20 times.

By the time Ingram died last winter, there was no doubt in his mind, or in the minds of his family and closest friends, that he was a victim of Gulf War Syndrome -- the baffling, wide-ranging and controversial group of maladies some associate with military service during Operation Desert Shield/Desert Storm.

Officially, Ingram, 47, died of heart disease. But in a precedent-setting finding that buoyed Gulf War activists, Harris County pathologists found that Gulf War Syndrome contributed to the ex-soldier's death.

"This is very, very significant," said Paul Sullivan, whose Washington, D.C.-based National Gulf War Resource Center is a leader among groups demanding the government acknowledge and address Gulf War health concerns.

"This is an independent doctor's assessment that the Gulf War contributed to the death of a veteran, and it flies in the face of massive public relations efforts by the Pentagon to make the issue go away."

County Chief Medical Examiner Dr. Joye Carter said she cited Gulf War Syndrome as a contributing cause of death -- it was last among nine causes -- because it had been diagnosed by Department of Veterans Affairs doctors.

"This is a syndrome with multiple aspects," said Carter, who served as an Air Force medical examiner during Desert Storm. "We're not sure what it is. Its symptoms run the gamut -- strange chemical tastes, benign tumors, heart disease, heart palpitations. ... "

Another symptom is a psychological reaction similar to post-traumatic stress disorder, which is sometimes marked by substance abuse in former servicemen.

Ingram, said Dr. Sara McCarron, the Harris County pathologist who performed the autopsy, had a history of depression and alcohol abuse.

"He may have been self-medicating due to depression and/or post-traumatic stress disorder," she said.

Ingram's mother and stepfather, Kitty and Vincent Buildt of Baytown, suggested that the former Green Beret drank to ease his physical pain.

A professional guitarist and chauffeur, Ingram joined the Army at age 34 to provide greater financial security for his wife at the time and their young daughter, his mother said.

"He loved the Army," she said. "I think that was the life he was born to."

At the onset of the Persian Gulf conflict in 1990, Ingram was deployed to the Middle East with the 528th Psychiatric Medical Detachment. He was among nearly 700,000 men and women the United States dispatched to the Middle East to drive Iraqi leader Saddam Hussein from Kuwait.

"He was very precise. He was very astute," Vincent Buildt said. In the early months of his service, Ingram sent home almost poetic evocations of the Middle East. "Shooting stars are everywhere," he once wrote. "Scary! Beautiful."

"When he came back," his stepfather continued, "he was washed up physically and in his mind."

Ingram's problems began shortly after his return to the United States in 1992.

"He was involved in a field training exercise and he just went numb," said Ingram's close friend and fellow disabled Gulf War veteran Paul Lyons. "They said he had a stroke. I've never been able to understand. He was coughing up blood."

Shortly after his initial health crisis, Ingram left the Army and moved to Clarksville, Tenn., a community near the Fort Campbell Army post in Kentucky, where he met Lyons, a director of the National Vietnam & Gulf War Veterans Coalition.

As his health worsened, Ingram was admitted to the hospital at least 22 times, his family said.

"One diagnosed him with cancer, then they did a blood test and said it wasn't cancer," Vincent Buildt said. "Then he had a metallic taste in his mouth. ... He'd stay in a hospital a day or two and it always came down to the same thing: They didn't know. He was taking pills as big as a quarter. He had to break them into pieces to take them."

Ingram's mother recalled a long-distance telephone conversation that ended with her son exclaiming in pain and surprise that blood was gushing from his nose. Another time he called to say he had fallen and broken his teeth.

Though he ate robustly, the 5-foot, 10-inch Ingram steadily lost weight, dropping from about 185 pounds in his prime to 149 pounds at the time of his death.

The former soldier suffered frightening flashbacks as well.

"They caught him in a tree one time, crying about the babies he saw, little babies with their arms blown off that he couldn't take into the helicopter," Kitty Buildt said.

Little in the Harris County autopsy would explain such symptoms.

"His cardiac system had been under assault," said Carter, noting that Ingram smoked as well as drank. "His heart was slightly enlarged, he had hardening of the arteries, he appeared to have a little bit of heart failure."

Pathologists also found a cyst in Ingram's spleen, which, while not life-threatening, could have been indicative of a bleeding/clotting disorder sometimes found in Gulf War veterans.

Pathologist McCarron said she was "never completely comfortable" with designating Gulf War Syndrome as a contributing factor in Ingram's death. She said she unsuccessfully requested additional time to review medical literature in the matter and to examine all of the dead man's hospital records.

"Even now it's kind of a gray area," she said.

McCarron said Carter pushed to sign off on the case.

McCarron was dismissed in February, but has since protested on the grounds she was targeted by Carter after bringing irregularities at the medical examiner's office to her boss' attention.

Dr. Garry Peterson, president of the National Association of Medical Examiners, said pathologists often include observations in autopsy reports that can't be "anatomically verified." Such a practice is considered a "responsible and good approach."

The cause of Gulf War Syndrome symptoms -- or even whether the syndrome exists -- has been the subject of emotional debate. Lyons, however, said Ingram told him he had been sprayed by a fallen Iraqi Scud missile.

"He approached it -- just a soldier going to see what was going on -- and it sprayed him," Lyons said. "Stuff was externally emitted. He remembered that there was somebody behind him who said, `Man, you're cooked.'

"The Gulf War was the most toxic war our troops ever fought in, bar none."

It also was one with the fewest casualties -- at least initially.

Out of 700,000 military personnel who served in the Persian Gulf during the war, fewer than 500 died from all causes. Since the war's end, 6,500 have died of all causes. Roughly 80,000 veterans seeking care at Department of Veterans Affairs hospitals have been found to be suffering from diagnosable illnesses; 20,000 suffered from undetermined illnesses. Of those in the last, undiagnosed category, 3,117 have been granted some level of disability compensation by the VA.

As Gulf War veterans returned home to their families, some to get sick and face perceived official indifference, ill will toward the nation's military establishment grew.

"Six years and hundreds of millions of dollars have been spent in the effort to determine the causes of the illnesses besetting Gulf War veterans," a U.S. House committee reported in 1997. "Yet, when asked what progress has been made healing sick Gulf War veterans, VA and (the Department of Defense) can't say where they've been and concede they may never get where they're supposed to be going. ...

"Sadly, when it comes to diagnosis, treatment and research for Gulf War veterans, we find the federal government too often has a tin ear, a cold heart and a closed mind."

"When we came to them with our Gulf War sicknesses," complained one veterans activist, "they acted like we were goldbrickers."

Today, many critics believe the government has become somewhat more open and responsive.

"The VA, for instance, has tried to turn the battleship around," said the National Gulf War Resource Center's Sullivan. "They've created guides for VA doctors; they've launched research into depleted uranium (used in weapons); they've been amenable to reassessing disability status for Gulf War veterans. But it still needs to make more improvements."

In addition, the Defense Department has conceded that as many as 100,000 U.S. troops were exposed to low levels of deadly sarin gas when an Iraqi weapons installation was destroyed. Fortunately, spokesmen said, the exposure level appeared minor.

Last fall, researchers working under government contract essentially confirmed earlier findings by Dr. Robert Haley, epidemiology chief at the University of Texas Southwestern Medical School in Dallas, that pyridostigmine bromide pills -- given to thousands of servicemen as a poison gas antidote -- could cause neurological problems.

The VA notes that 145 federally supported Gulf War research projects worth $135.5 million are in progress or have been completed. Four of the VA's 172 medical centers, including the one in Houston, have been designated special referral centers to gather data on Gulf War health problems.

None of these changes, though, offers much consolation to Ingram's family.

When the ex-soldier returned to Baytown in July 1998, his family was distressed by the way he had changed.

"He was `spacey,' " his mother said.

"He kept asking me if we had funny smells and funny colors when I was in the service," said Vincent Buildt, who served in the Army. "He was always trying to compare my days and what was going on in his. It was the difference between day and night."

Toward the end, his parents said, Ingram spent much of his time sleeping.

"It wasn't but three weeks before he died," his mother said, "that he came over here and got on the floor. He said, `Mom, look at me.' I said, `I'm looking, honey.' He said, `Look at me serious. I accept Jesus Christ as my lord, and I'm going to die. Oh, Mama, I know I'm going to die, and it's OK.'

"What can you say? I just said, `OK,' and kissed him on the forehead. Said, `You're my angel, honey.' "

Gulf War Vets Home Page