Nerve gas is highly toxic and has more potential to kill than other rarely used chemicals that could be unleashed during the Persian Gulf conflict, says a Baltimore Veterans Administration Medical Center specialist.
Nerve gas attacks the entire nervous system, making breathing and movement difficult and possibly causing the victim's heart to stop beating, Dr. Sandra T. Marshall, an internist, said yesterday.
Like mustard gas, another debilitating chemical that causes blisters on the surface of the body and respiratory and intestinal burns, nerve gas can be delivered by shell, rocket, missile or by spray from an aircraft.
Marshall will be in charge of a team that will treat American casualties from the Gulf who soon may be arriving at the Baltimore hospital on Loch Raven Boulevard.
It is one of 80 VA hospitals that, for the first time, will be serving as medical and surgical backups to military hospitals.
To perform that mission and to augment its regular staff, the center issued a call yesterday for volunteer doctors, nurses and civilians.
Military experts at Aberdeen Proving Ground have told representatives from East Coast VA hospitals to be prepared to treat patients who have been wounded by chemical warfare and are suffering from the effects of anthrax and cholera and other germ warfare agents.
"We have been told we could see people who have been exposed to mustard gas and phosphorous gas, which produce burns that are very debilitating," Marshall said. Anyone who has been exposed to burns that cover more than 15 or 20 percent of their bodies will be transferred to Francis Scott Key Burn Center in Baltimore, she said.
Marshall and others who will examine casualties have been alerted that some bombs that might be used have "firestorm" capabilities which severely burn victims. When they are dropped from above, they release a vapor which ignites and covers a very large area, trapping soldiers in a kind of incinerator.
Dr. Robert Fiscella, the center's assistant chief of psychiatry, warned that statistics show that for every physical casualty in war, there will be several psychiatric casualties.
What Fiscella is worried about is a "malignant" form of post-traumatic stress disorder that first emerged during the Vietnam war and which, he predicts, will arise again in the Gulf conflict.
"Those affected are people who go through lives with feelings of confusion, isolation, hostility, detachment, poor marital relationships, poor work histories and high incidences of alcoholism and drug abuse," he said.
Fiscella explained that one of the reasons for the extremely high incidence of the malignant form of the disorder in Vietnam may be that the Vietnam war and the Persian Gulf conflict "tended to draw men and women from the lower social economic classes." World War II, on the other hand, basically attracted troops from all social classes, he said.
"Clearly, the volunteer military tends to draw kids who could not get a college education otherwise, who come from poor social economic groups," he said. "What we see is that the people who seem to be more subject to malignant post-traumatic stress syndrome had a very high incidence of parental abuse or neglect or chaotic childhoods in general."
War tends to bring out these vulnerabilities, with which these kids may have been able to cope otherwise, he said. It's the stresses of the carnage of combat, he said, that pushes these soldiers into the malignant form of the syndrome.