WASHINGTON -- The doctor's diagnosis hit gulf war veteran William Kay like a bombshell.
Mr. Kay, 52, a Naval reservist, had been exposed to chemical or bTC biological warfare while in the Persian Gulf war, determined Dr. Charles Jackson of the Veterans Affairs Medical Center in Tuskegee, Ala.
It was the first diagnosis of "Persian Gulf syndrome" among the 4,000 veterans who believe they were exposed.
"It blew my mind," recalled Mr. Kay this week. "I expected it to say emphysema!" But Mr. Kay was gratified. "I said: 'That's what we've been looking for. Somebody's finally telling the truth!' "
But the truth about whether Iraq followed through on its threat to unleash "an unusual force" that "will astonish our enemies," is not so clear as the two-paragraph diagnosis waved around on the floor of the U.S. Senate the day after it was delivered to Mr. Kay.
For although the Department of Veterans Affairs is beginning a nationwide effort to test ailing gulf war veterans, and tapped the prestigious National Academy of Sciences for help, doctors and scientists who've investigated similar medical mysteries say the odds are against ever identifying a clear cause.
It took a generation -- until last July -- before medical detectives linked the defoliant Agent Orange to three kinds of cancer and other diseases suffered by Vietnam War veterans. And it was a half-century before the U.S. government accepted responsibility -- only last January -- for the maladies of World War II troops used as guinea pigs in American mustard gas tests. (The Pentagon had denied the existence of the mustard gas tests until two years ago.)
In both those cases, the medical community knew precisely what agents they were dealing with. After all, the grunts sweltering in the Southeast Asian jungle or sweating in a sealed gas chamber with ill-fitting chemical suits were attacked by poisons dropped or sprayed on them by the U.S. government.
The gulf war puzzle, on the other hand, presents a much more difficult challenge. Even before the VA attempts to link the veterans' ailments to their service in the gulf, it first must confirm that chemical or biological agents were dispersed, deliberately or accidentally, during the 1991 conflict. Then the VA must determine what substances were used.
Pentagon officials have denied that there were any chemical attacks on U.S. troops during the gulf war, although they acknowledge the threat of such attacks existed throughout the conflict.
However, the Pentagon's position shows signs of softening. Officials acknowledge that a new report showing that traces of chemical weapons were found on the battlefield is probably correct.
Lawmakers were angry yesterday after the Pentagon postponed a briefing on the report, compiled by the Czech government, which also had troops in the Persian Gulf war. Defense officials said the delay was needed to inform Defense Secretary Les Aspin of their findings first. They said the briefing would be held next week.
This week several lawmakers were calling for hearings into the puzzling matter.
"Soldiers are suffering without knowing what ails them," said Rep. Lane Evans, Democrat of Illinois and chairman of the House Veterans' Affairs oversight subcommittee.
Democratic Sen. Richard Shelby of Alabama, who took Mr. Kay's diagnosis to the Senate floor, said, "The VA and the Department of Defense had better not reject this diagnosis out of hand."
The VA doctor heading up the investigation is skeptical of the diagnosis that Dr. Jackson handed Mr. Kay that day in Tuskegee.
"These are diffuse symptoms which are hard to characterize into a clinical syndrome, and that's what's been so baffling about this," said Dr. Robert Roswell, head of the VA Medical Center in Birmingham, Ala. "What we do see is a clinical picture that is not inconsistent with the late complications of exposure to a nerve-agent-like compound."
Thomas Thomas, a Tuskegee VA spokesman, said Dr. Jackson "has no conclusive evidence. . . . A diagnosis implies proof, and he doesn't have proof."
Dr. Jackson acknowledged that his diagnosis was lacking. "I don't have any positive facts to back it up," he conceded.