Waiting for an Army to Die (19 page)

“But the important thing here is that in the world’s literature one can find only about ten different compounds that will cause a positive Ehrlich reaction, and to our surprise we’re finding that 90 percent of the Vietnam veterans we see have this positive Ehrlich reaction. So naturally Dr. Petryka was intrigued by this and he went about searching the urine samples to see if they contained any one of these ten chemicals. And he discovered that the veterans’ urine contains none of the them. So we concluded that the compound that is causing the positive Ehrlich reaction must be a new compound and I jokingly told Dr. Petryka that he should name it
after himself, calling it the Petryka compound. But he went and named it after me, so now it’s called the ‘Codario-Ehrlich positive metabolism.’ But we do know the molecular weight—it is 220—of this compound, and Dr. Petryka is in the process of defining its chemical structure. And when he finds that chemical structure it may be very interesting because it could very well be a way of determining whether or not a person has been exposed to herbicides. Obviously, with the coproporphyrin elevation and the curious positive Ehrlich reaction, we now have a biochemical way of saying yes, these people are different. And there are abnormalities in these patients that we are not finding in those who didn’t serve in Vietnam.”

In addition to his willingness to work for very little financial gain (Codario sees all Vietnam veterans initially for free and often spends his weekends flying free of charge to the home state of any veteran who has called for help), Dr. Codario has another remarkable quality. During our interview the phone would ring, as one might expect in a busy doctor’s office, and he would listen patiently, replying to the caller’s questions or complaints with genuine concern. Then almost before he had replaced the receiver, he would continue exactly where he had left off, even if this meant in the middle of a complicated compound sentence.

“The other thing that is of interest is that Dr. Strik of the Netherlands, who is one of the world’s authorities on porphyrin problems resulting from exposure to chemicals, and has published several papers on what happens to people whose porphyrin levels are elevated due to their exposure to herbicides, has clearly stated that porphyria progresses in a stepwise fashion from asystematic coproporphyria auria to the much more devastating uroporphyria auria. And that disease is called porphyria cutanea tarda, which is a condition characterized by episodes of severe crampy abdominal pain, high fevers, schizophrenia, and often death. So it seems that the coproporphyria auria that we are seeing now merely represent the tip of the iceberg, or the beginning of the abnormality that if left unchecked may progress to porphyria cutanea tarda and death.”

Codario feels that he may have discovered a way to check the progressively destructive effects of herbicide poisoning; however, he fears that he may only be able to arrest, rather than cure, the problem. “I’m hoping that once we have established a significant statistical correlation, which we seem to be moving toward right now, that we can get approval to treat some of these porphyrin problems with the drug that they have developed in Minnesota called Hematin. But that may be an oversimplification because Hematin was designed to treat patients with acute severe porphyria—for example, patients suffering from porphyria cutanea tarda. The results have been nothing short of miraculous and are well-publicized in the journals of internal medicine. But in those cases the porphyrins they were producing in their urines were thirty to forty times higher than those we are seeing in our veterans. And we have to keep in mind that Hematin has never been used to treat chemically induced porphyrin problems, so we’re really treading in new territory and can’t be certain that it will work this way. But based on the mechanism of its action, it is certainly possible that it will be beneficial here. The thing we don’t know is, even if we are able to reverse the production of excess porphyrins, will we stop it forever just by giving the patient Hematin? And even if we return the porphyrin count to normal, will their symptoms go away? In examining the veterans and listening to their stories, I suspect that even if Hematin works it will only be temporarily effective and that after a period of time the individual will probably relapse. And I also suspect that all of the symptoms about which Vietnam veterans are complaining are not due solely to porphyrin problems but rather are a direct toxic effect of the herbicide in general and dioxin in particular.”

Another thing Codario would like to determine is how many of the veteran’s problems are due to the storage of TCDD in their fatty tissues because he believes it may be possible to flush these residues from the human body. But his efforts to test this theory have been hampered by the fact that the VA has done only a very limited fat biopsy study on Vietnam veterans, and when I spoke with him, he had already been waiting for nearly six months for the return of five biopsies.

“I sent the five fat biopsies to Dr. Thomas Tiernan at the Brehm Laboratory at Wright State University because Dr. Tiernan had done research on dioxin for the government and he is considered an ‘independent’ researcher. He was involved in studying dioxin levels on the ship
Vulcanus
,
^*
and seems to be an expert in the field.”

Although dioxin can be stored in the human body for many years, standard laboratory tests, commonly used by the VA in its “Agent Orange examinations” fail to detect traces of dioxin in the blood, urine, or spinal fluid. “They take your blood and urine,” one veteran told me, “and when they don’t find dioxin in it—which they knew goddamn well they wouldn’t in the first place—they conclude that you’re clean, you weren’t exposed to Orange in Nam. Just more fun and games, because they know that TCDD is stored in the fatty tissues of the body. Their own research has shown that.”

The research the veteran refers to is a “blind” study conducted by Dr. Michael Gross of the University of Nebraska, on contract to the Veterans Administration. In this study, thirty grams of fat were removed from twenty Vietnam veterans who believed they had been exposed to Agent Orange. An additional thirty grams were removed from ten veterans who presumably had no contact with Agent Orange and from three US Air Force officers who had done
dioxin research. The samples were forwarded to Dr. Gross’s laboratory, where they were analyzed for residues of TCDD-dioxin. Two of the three men who had been described as heavily exposed had TCDD in their fatty tissues of approximately twenty-five to one hundred parts per trillion, while three of the five who were classified as receiving “light exposure” had concentrations of from five to seven parts per trillion.
Ten out of the twenty Vietnam veterans had TCDD in their fatty tissues
. Two of the control samples contained low levels of TCDD in the abdominal adipose ranging from five to six parts per trillion.
¹

Called as an expert witness at the Environmental Protection Agency’s 2,4,5-T suspension hearings, Dr. Gross said: “It appears that Vietnam veterans heavily exposed to herbicide Orange will carry low levels of TCDD in their body fat. This conclusion is supported by the observation that two of the three most heavily exposed men have the highest levels detected in this blind study. It is extremely unlikely that this finding is a matter of chance or has occurred because of herbicides or other TCDD-related exposure in the United States. Furthermore, 50 percent of the veterans of Vietnam tested in this study exhibited low levels of TCDD in their abdominal fat whereas only 20 percent of the controls were found to be positive.

“Additional support for this conclusion comes from the replicate analysis of the adipose samples from the ‘heavily exposed’ veterans, and from the validation analysis performed by Mr. Harless. We recognize the need for additional validation studies, and these are planned.

“We propose that the results are relevant to the cancellation hearings. They constitute support for the concept that exposure to TCDD can lead to long-term storage in human fat tissues.”
²

Dr. Gross’s discoveries seem to have been received by the VA with the same amount of enthusiasm that the Atomic Energy Commission displayed when informed by John Gofman and other researchers that long-term exposure to low-level radiation could be dangerous, even deadly. In the two years following Dr. Gross’s testimony at the EPA hearings, the Veterans Administration
conducted no further tests to determine the extent to which Vietnam veterans may have TCDD in their fatty tissues. However, the VA recently announced that it does intend to conduct further studies on the adipose tissue of veterans.

Should he discover that the fatty tissue of veterans he has examined contain residues of TCDD, Codario will attempt to flush dioxin from their bodies with a drug used to treat victims of kepone poisoning. Kepone is an insecticide which, like dioxin, collects in the fatty tissues of the human body, producing numbness of the hands, headaches, personality changes, and other dioxin-like symptoms. Another similarity between kepone and dioxin is that it is eliminated in the bile fluid, passed into the intestine, and then reabsorbed in the body in what physicians call an enterohepatic cycle. At the University of Virginia, a researcher administering cholestyramine (a bile-salt binder commonly used to treat patients with elevated levels of cholesterol and, in some cases, jaundice) to workers who had high levels of kepone in their bodies discovered that within two months all of the workers showed dramatic improvements, and within one year seven of the twenty-two workers were totally kepone free. The results were published in
The New England Journal of Medicine
(1978, vol. 298) by Dr. Philip S. Guzelian et al., and Codario believes that Guzelain’s findings may be vital to physicians working with Vietnam veterans or victims of domestic herbicide spraying.

“So if dioxin behaves similarly to kepone, and we have evidence that it does,” says Codario, “it would certainly be tempting to postulate that it could be eliminated from the body by the aid of cholestyramine. And so, once I get the fat biopsies back, I can start giving my patients this drug and doing follow-up examinations to measure for dioxin in their bowel movements. In that manner I can determine if TCDD is actually being washed from their bodies.”

Ronald A. Codario seems to find nothing unusual about the fact that he is doing work that should have been done years ago by the Veterans Administration, or that, without a grant from any of the national health institutes or foundations, he has discovered a medical
basis for proving that Vietnam veterans were exposed to Agent Orange and that their exposure is now crippling and killing them. As a specialist in internal medicine he could demand fifty dollars an hour for his advice, yet he donates twenty to thirty hours each week to people whom many Americans still prefer to use as scapegoats for the Vietnam War.

Will the Veterans Administration listen to his theories, accept his statistics, and take action of behalf of Vietnam veterans? Codario thinks they will. He believes that the men and women who run the VA are honest people who are stifled by the inherent inefficiency of big government; moreover, he intensely dislikes what he calls “Monday morning quarterbacking,” and says that trying to place blame for what has happened to Vietnam veterans will only prolong their agony.

“Look,” he says, shuffling a stack of papers on his desk, “it’s just too easy if you ask me to say, ‘Hey, Dow did this, and the VA did that.’ Sure, maybe there was conflict of interest back then, and we all know that somebody makes, or rather made, a lot of money from selling herbicides. But it’s just too easy, if you ask me, to look back fourteen years and place the blame. That just isn’t the thrust of my work. I’m just trying to show that these fellas have a problem, and I want to get them some help. And in getting help for them I want to say, ‘Hey, listen, these things have caused the problems.’ Let’s just make sure it doesn’t happen again because certainly the people that can help the veterans much quicker than I can are the federal government and the chemical companies. I think that where we have to exercise our diligence and care now is trying to make sure that mass herbicide spraying and pollution of the environment doesn’t continue to happen in the future.”

Codario and I shake hands and he walks me to the waiting room, where his receptionist and an elderly black woman are watching television. I ask directions to the subway, explaining that on my way to his office I had gotten off at the wrong stop. Codario, the elderly woman, and the receptionist appear shocked that I would have taken the subway, and insist on calling a cab. During the drive to the train station, the cab driver chats pleasantly,
weaving skillfully in and out of the rush-hour traffic and laughing happily at his own jokes. But I am mesmerized by the clicking meter and unable to put out of my mind what Codario said as I was about to leave. The Green Beret, he told me, has continued to deteriorate. His liver and spleen are swollen, his arms and legs are often numb, and he has lost much of his coordination. Rising from a chair or sofa, he often falls down, walks into walls, stumbles about the room. He has episodes in which he goes blind for fifteen minutes, and has lost consciousness while driving, ramming into the car in front of him. Sometimes he “goes off” for a couple of days, flying into terrible rages, banging his hands through walls. X-rays have failed to determine why his urine is darkened and his head throbs and he has blood in his bowel movements.

As I pay the driver and prepare to enter the station, I remember something else Codario told me about the first Vietnam veteran to enter his office complaining of “bizarre” and “exotic” symptoms. The man’s wife, said Codario, had given birth to a horribly deformed baby girl who died in the veteran’s arms.