Agent Orange: a veteran's perspective

In 1978, Paul Reutershan, a Vietnam veteran dying of cancer, went on NBC’s Today Show and declared: “I died in Vietnam, but I didn’t even know it.” His story shows some compelling links to his fatal cancer and Agent Orange exposure.

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Barely three years after the fall of Saigon in 1975, the debate over the health issues caused by Agent Orange was already emerging. Definitive answers have been hard to come by. What has been overwhelmingly frustrating for veterans is the sense that no sincere effort has been made to find and monitor the long-term effects of exposure on the part of those who could do something about it.

Neither the U.S. government, who ordered its use in Vietnam, the chemical companies who produced it, nor the Veterans Administration (VA), whose responsibility is to veterans, have honestly tried to find the truth. There is evidence of the opposite—obfuscation and hiding of documentation when it proved damaging and had the potential for wide-reaching liabilities and costs.

Paul Reutershan’s case is a precursor to the controversies that have followed this issue for decades. A known health enthusiast, even in Vietnam, he died of cancer in December of 1978, convinced that flying through the chemical mists as a crew member was the cause of his cancer.

Differences among veterans remain in our views about the war. On the issue of Agent Orange, there is near unanimity of yet another betrayal. Decades ago, Vietnam vets lobbied their legislators and the VA to use them as a control group to scientifically study the effects of Agent Orange. This never happened. Haphazard approaches to the issue remain to this day. The opportunity for a double-blind study has passed.

Here is what we do know.

Twenty million gallons of defoliants were sprayed on the Vietnamese countryside during the Vietnam War. This totaled an area the size of Massachusetts, amounting to 15% of the total land area of South Vietnam. Some areas were sprayed multiple times, and some of the sprays were as much as fifty times higher than the recommended concentrations. Fifty years later, some areas have not recovered from the ecological damage.

Dioxins, one of the most toxic chemicals known to man, was in two-thirds of the sprays used by the U.S. Military in Vietnam. In people, exposure to dioxins have been linked to certain cancers and specific types of birth defects. Epigenetic studies (changes in the genome without alteration in the DNA sequence) support this link. So do several epidemiological studies. There is evidence it is transgenerational, congenital in the genes of subsequent generations.

As the themes of my novel, Poisoned Jungle, are explored in my blogs, aspects of Agent Orange exposure will be covered in greater detail. It is difficult to express how deeply this issue has reached into the Vietnam vet community. It remains a point of contention between the governments of the United States and Vietnam. Since diplomatic relations were restored in 1995, the two countries have had surprisingly amiable interactions. The exception has been Agent Orange.

Legal avenues for redress by U.S. Veterans and the Vietnamese have been dead ends. In 1987 a pretrial settlement was reached in a lawsuit brought by veterans against the chemical companies, but the 180 million dollars agreed to barely scratches the surface for the damages done with these defoliants. Since then, tens of billions in likely damages from exposure have accumulated. Long term affects to people and the environment have been ongoing. 

Here is the legal difficulty in a nutshell. While epidemiological studies show a connection statistically, no individual case of cancer or of a birth deformity can absolutely establish a causal link between exposure and the health problem. A smoking analogy is instructive.

Smoking cigarettes is known to cause cancer, but not all smokers develop the disease. Some nonsmokers also develop lung cancer. Epidemiologically, the link between lung cancer and smoking is irrefutable.

With Agent Orange, the effects are more diverse, and the timelines reach into decades after exposure, and in some cases are genetically passed on. Similar to smokers and cancer, some Vietnamese with high levels of dioxins in their blood have not developed cancer. Others who were known to be exposed, have purged any traceable amounts, but have still developed a cancer associated with dioxins. Science and medical research have not established how all of the complicated factors cause cancer in some and not others.

Fred Wilcox published a remarkable book in 1983, Waiting for an Army to Die: The Tragedy of Agent Orange. The title was strikingly prescient for how U.S. Vietnam Vets have seen the issue unfold. This one book should have changed the debate. Some veteran groups passed out copies and were hopeful it would. Soundly researched, the issue has never received widespread attention outside of the veteran community.

Wilcox wrote a follow-up volume in 2011, Scorched Earth: Legacies of Chemical Warfare in Vietnam. The book delineates the ongoing problems in Vietnam from the use of defoliants during the war.

I’ll close on a personal note. It is hardly an anomaly for a man in his seventies to develop kidney disease. But without high blood pressure and diabetes, the two main contributing factors of chronic kidney disease in our society? And to be at 18% kidney function? As a group, Vietnam veterans are still statistically more prone to kidney issues, including cancer, than other men our age.

In 2017 a friend from the war passed away from a form of brain cancer showing up at statistically higher rates than nonveterans of the same age. Agent Orange exposure? You decide.

Gene, a lifelong runner, remained fit his entire life. Never overweight, he hardly touched alcohol and never smoked or did drugs. Disciplined in mind and body, he spoke several languages and became a teacher. The cancer destroyed a brilliant mind before taking his life. A person I thought would live to be ninety died in his early seventies. In a letter to me before his mind became totally incoherent, early signs of the deterioration appeared. “We have paid a heavy fee for Vietnam,” he wrote. Indeed we have.