This is a book that the U.S. Department of Defense does not want you to read. It is about human medical experimentation—not that undertaken by the Japanese and Nazi doctors of World War II more than sixty years ago, but human experimentation being conducted on U.S. citizens by U.S. doctors and scientists working for the U.S. military. You may be familiar with some of the more shameful medical episodes in American history—the Tuskegee syphilis trials conducted by the U.S. Public Health Service or the Cold War LSD experiments conducted by the CIA. But this book is not about the past, except as the past is also prologue to our present and future. The unethical experiments detailed in this book are ongoing, with little prospect of being self-limiting. Why? Because they have been shielded from scrutiny and public accountability by national security concerns.

The victims of this story are the young men and women who volunteered for the U.S. armed forces, fully recognizing that they might be asked to risk their lives in battle and found themselves, without their knowledge or permission, the subjects of dangerous medical experimentation. Clinical evidence now exists that military doctors in both the United States and Britain have been testing a new anthrax vaccine on soldiers who weren't told they were getting an unlicensed immunization, let alone one that contains a substance shown in peer-reviewed scientific literature to be capable of causing incurable if not fatal disease. The justification for this secret experimentation was intelligence that Saddam Hussein had biological weapons that he might use if the war went against him. While Saddam had plans, if not an ongoing program, to develop a nuclear weapon, and certainly once had and indeed used chemical weapons, a sad irony of this story is that after years of U.N. inspections and now a war that has put Saddam Hussein behind bars, no samples of Iraqi dried anthrax have yet been discovered.

Following its stellar performance in the first Gulf War, the Afghan invasion and second war against Iraq, our nation's military establishment reached a level of popularity unseen since the years following World War II, in the process acquiring—the Abu Ghraib prison scandal aside—a patina of infallibility. This book will argue that the military has used public goodwill to shut off debate on a matter of vital interest to all Americans. I will show what can happen when the military is allowed to fend off criticism with national security claims and by equating criticism with disloyalty. Like any institution, the Department of Defense is as flawed and fallible as the humans who fill its ranks, and so the public must not assume that the DOD will always act honorably and with integrity because humans do not. Some will say that such talk is un-American. But I maintain that dissent against the abuse of power is one of this country's proudest traditions. It is a privilege that Americans have given their lives for, and one that we neglect at our own peril.

In 1990, when the United States launched Operation Desert Shield and then Desert Storm, I was an NBC correspondent covering the war from Saudi Arabia. Although the term was not yet used, I would become an embedded journalist for the ground offensive. Like the soldiers I covered, I was fully warned about the risk that the other side might employ biological or chemical warfare weapons. I had my protective gear and pills to take in the event of a nerve agent gas attack.

Fortunately, we won that war rather quickly. The air assault took little more than a month and the ground war ended in just four days. The Iraqi troops were simply no match for U.S. military power, and the "Mother of All Battles" that Saddam Hussein had threatened never materialized. As a result, American casualties were phenomenally low in comparison to those suffered in any other war in U.S. history. Sadly, many of the casualties that did occur were the result of friendly fire—we mistakenly hurt our own. But Saddam never put his dreaded biological and chemical weapons into play.

A little more than a year or so after war's end, reports began to emerge about a strange malady afflicting returning veterans. The symptoms were often vague, many subjective, but remarkably consistent—aching joints and muscles, rashes, fatigue, weight loss, weight gain, hair loss, sore gums, diarrhea, nausea, swelling of hands and feet, short-term memory loss and headaches. Of course, taken individually, these symptoms could each be attributed to a myriad of possible causes. Yet even grouped together they still did not add up to a recognizable disease, according to military doctors.

When people are scared, or in pain, as these GIs clearly were, when everyone is wondering who will be the next to be robbed of his or her meaningful life by crippling illness, rumors invariably abound. Because I am not, by temperament or training, the type of person to be caught up in idle rumor, my attention was caught not by the rumors themselves but by the military response to one of them, that a nerve agent might be the source of these complaints. Around 1997, the CIA and the military suggested a scenario that seemed to confirm these suspicions. It allowed for possible injury to about 100,000 troops, by remarkable coincidence almost precisely the number of Gulf War veterans who were registered as ill at the time.

The scenario went as follows: A U.S. Army engineering battalion inadvertently released a plume of nerve agent when it blew up an Iraqi ammunition dump at a place called Khamisiyah stocked with chemical munitions. If you read between the lines the subtext was clear: it was really Saddam's fault; he should not have been storing nerve agent. All this sounded quite plausible, except to those of us the military had trained to identify a chemical attack. The consequences we had been taught to look for in no way matched the symptoms the sick GIs were experiencing.

The military's own scientific literature—research with nerve agents tested on both animals and humans and published decades earlier—also undermined the idea that nerve agents released into the open air could cause the symptoms Gulf War veterans were reporting. Eventually, the military's own epidemiologists published data that further discredited the nerve agent theory, and angry senators censured both the Army and the CIA for releasing highly speculative, spurious information. The GAO has recently published a report saying there was no sound basis for the Khamisiyah theory.

But by that time, I had other reasons to see the nerve agent explanation as untenable. I strongly suspected that Gulf War Syndrome was not caused by something that had happened in Kuwait or Iraq. Why? Because soldiers from most of the countries in the anti-Iraq coalition did not suffer from this malady. No Arab soldiers or civilians, on either side, got sick. Nor did any journalists get sick, embedded or otherwise. Of all those who had been on the ground during the war, only soldiers from the United States, Great Britain, Canada and Australia were experiencing symptoms. Also telling was that GIs who had never left these shores were complaining of the same symptoms as those who had been deployed to the Gulf.

The more I thought about the nerve agent explanation, the more I wondered why the CIA and the Army would have propagated an explanation that would in time surely come to be revealed as bogus and thereby subject them to justly deserved ridicule. What were they hiding that was so uncomfortable that they put out such a manifestly unsupportable explanation? Or were they hiding nothing? Was I just missing something? My own first reaction was to assume that I had indeed missed something.

I am someone who had three uncles who served proudly in the U.S. Army—two of them were sergeants and the third retired a lieutenant colonel. My dad was a buck private too young to see combat in World War II, but he went through boot camp and did his tour of duty in Tennessee at the end of the war. I looked up to these men, in part, because they had served in the Army. As a young Japanese-American growing up in the 1950s, I played war, as young boys invariably do, even when the neighborhood kids taunted me about being a Jap. But I knew—even if they didn't—that one of the most decorated combat units in U.S. history was a band of "Buddha-heads" made up of Hawaiians of Japanese descent and volunteers out of the relocation camps for Japanese-Americans on the mainland—all American-born—who fought with valor in Europe. Still later, I learned about those colorful characters in the Pacific—guys like my cigar-chomping Uncle Thomas—who served in military intelligence as a translator. I heard less from my Uncle George, who served on the front lines in Korea as a sergeant in the Army Signal Corps; Uncle George lost so many of his friends in that war that he never wanted to talk about it. From his reticence I gathered that war was not quite the bloodless affair I saw on my favorite '60s TV show, Combat, though as a young boy I could not even begin to conceive its true carnage. It was my Uncle Shug—a lieutenant colonel in the military police who served as an Army criminal investigator in occupied Japan and then in Germany—who used to tell me with conviction that in the Army there was only one color: olive green.

With a 1-A classification and a low draft number, I was a prime candidate for the rice paddies of Vietnam, but President Nixon ended the draft just as I was about to be called up. Instead, I spent two years in a mandatory Army ROTC program at a religious college I attended outside of Chicago—a college that graduated at least one speechwriter for the current Bush administration. I come from a Midwest Republican family whose members are "born again" Christians. While I don't claim to be exactly like my family in dogma or politics (who is?), I am proud of my heritage, particularly of my family's service in the Army. As a TV journalist I sought out assignments involving the military whenever I could, and won awards for my reporting.

I have gone on at some length about myself because what I am about to relate in this book is more than a controversial story. It is an almost unbelievable story. All told it took me six years to pull all the pieces together. But once I felt I knew what had happened and why, I had only one goal in mind—to draw attention to the secret activities of a few (not all) U.S. military doctors, who, I came to realize, have been medically experimenting on troops for the past fifty years, almost without pause. There is clinical evidence that their most recent experiment led to an unknown number of formerly healthy young men and women—possibly tens of thousands of them—having their lives destroyed by illness. Some have even died.

This book will show that shortly after the war ended, the U.S. government, in response to the catastrophic nature of Gulf War illness, spent well in excess of $100 million on studies to learn what the illness was and what had caused it. These studies came to the conclusion that no single disease could account for all the medical problems experienced by sick Gulf War veterans. The degree of illness from one to the next veteran varied enormously—from aches and pains to death. U.S. military doctors used these studies to justify treating Gulf War veterans complaining of these symptoms as if they were suffering from nothing more than psychosomatic illnesses due to stress, denying them modern medical treatment.

I will then tell you about a researcher and her husband, a physician, and finally other scientists at Tulane University, who identified the symptoms experienced by Gulf War veterans in their study as autoimmune. What is autoimmune disease? It is the damage that occurs when the immune system mistakenly identifies the body's own tissues as foreign matter and then attacks it. Lupus, rheumatoid arthritis and multiple sclerosis—diseases that the anthrax vaccine manufacturer openly associates with its vaccine—are all autoimmune. Upon examination by civilian doctors, some veterans—said to be suffering from an indefinable syndrome—were diagnosed with autoimmune diseases. Most important, I will show that Tulane helped establish one of the most important and painful pieces of information—that these illnesses were iatrogenic, that is, induced by medical treatment.

By developing an assay—a test to determine whether an individual has antibodies to a particular substance in his or her blood—scientists from Tulane University Medical School established what they say is a "marker" for Gulf War Syndrome. This marker identifies whether a GI had been injected with a substance called "squalene" (pronounced SKWAY-leen). Those who had a so-called Gulf War illness consistently tested positive for antibodies to squalene in their blood; healthy Gulf War veterans do not have these antibodies. The Tulane scientists then tested their next hypothesis—that squalene had been introduced into these veterans through the anthrax vaccine the veterans had been given. The licensed anthrax vaccine, they knew, did not contain squalene, which explains why hundreds of thousands of soldiers did not get sick. To test the connection between Gulf War illness and a possible, unlicensed, experimental anthrax vaccine secretly given to an unknown number of military personnel, Tulane tested the blood of four Air Force reservists scheduled to get their anthrax vaccine. Before the vaccination, their blood did not contain the antibodies. Afterward, it did. All four had been injected with anthrax vaccine confirmed by the FDA to contain squalene.

Squalene is what is called an adjuvant. Adjuvants stimulate the immune system to respond—which is what a vaccine has to do to build up immunity. My book will show why the military doctors felt they needed an immuno-stimulant so desperately just as the Gulf War began—their licensed vaccine was not going to be effective quickly enough. It can take weeks to develop immunity with a good vaccine; with the licensed anthrax vaccine, a not-so-good vaccine, it can take months. When military doctors started vaccinating troops less than ten days before the United States would be at war, it was almost pointless to use the old vaccine. Using the Army's newest anthrax vaccines was the logical thing to do. At the time, Army scientists believed that they could generate more immunity in less time with just one shot of the new vaccine. Had Saddam launched an attack with anthrax resulting in mass casualties, not using this new vaccine would have been seen, in retrospect, as a near dereliction of duty. There was little downside to such a decision. Army scientists thought their new vaccine was safe. Sadly, as the clinical evidence now attests, U.S. and British military personnel paid a terrible price for this mistake, a mistake that might not have been made had the Army scientists been more familiar with the literature on oil-based adjuvants.

Rather than defend their actions as a hard judgment call, to this day, military doctors deny having used an experimental anthrax vaccine and deny that the anthrax vaccine given any veteran had squalene in it.

In 1999, I published an article in Vanity Fair magazine in which I laid out for the first time anywhere a connection between squalene, the anthrax vaccine and Gulf War illness. Counterattacks began almost immediately. One Army officer declared that I was "reckless, irresponsible and wrong." The Air Force Surgeon General at the time, who made it clear that he shared an equally dim view of the article, insisted there was no squalene in anthrax vaccine; there never had been, he insisted, nor would there ever be. In Vanity Fair I identified two lots of vaccine that correlated with a positive antibody response to the oil. In response to that article, the FDA ran tests on those lots of vaccine and three others and found squalene in all five.

The military's new response: squalene is a naturally occurring substance that the anthrax bacterium probably makes. This of course does not explain why with few exceptions only military personnel inoculated with anthrax vaccine confirmed by the FDA to contain squalene have tested positive for the antibodies. Later, I would discover peer-reviewed data that bacteria, and specifically B. anthracis, do not make squalene—contrary to the assertions made by military scientists. The Army and the FDA had little excuse for propagating a demonstrably inaccurate theory on the provenance of squalene in anthrax vaccine. The evidence had been published decades before and was available in just about any well-stocked medical library. Still, here and there, one scientist or another will note in the scientific literature, or before Congress, that the anthrax vaccination cannot be ruled out as a cause of Gulf War Syndrome.

But as I've said earlier, this is not a book about the past, but about the present and the future. There is now evidence that squalene—first injected into U.S. GIs because there was a perceived need for a vaccine that would provide effective immunity quicker—is still being given to GIs today when there is no verifiable battlefield threat from anthrax. Troops given anthrax vaccine for Operation Iraqi Freedom have now tested positive for anti-squalene antibodies.

More than a hundred U.S. troops who deployed to Iraq in 2003 developed pneumonia; at least two of them died. Many of these cases were "aseptic," which means they did not result from bacterial infection. An NBC News cameraman, Craig White, developed a transient pneumonia after anthrax vaccination. Later, he tested positive for antibodies to squalene, which has, in the past, correlated with vaccine lots subsequently proven by the FDA to contain this oil. In February 2004, the previous Army Surgeon General, Lt. General James Peake, conceded that some of these pneumonias may be a consequence of autoimmunity. Unknown to most members of the American public, the Secretary of the Army now possesses a patent for a new anthrax vaccine that allows for its formulation with squalene.

If that isn't frightening enough, the Bush administration has just ordered 75 million doses of the new, as yet unlicensed anthrax vaccine—enough to inoculate 25 million unwitting civilians—and has announced its intention to give it to all of us, license or no license, in the event of a broad-based anthrax threat. Of greater concern is the fact that with funding from the NIH, scientists have formulated vaccines for flu, human papilloma virus (to prevent cervical cancer), malaria, HIV and herpes that also contain squalene.

Scientists will tell you that there is no such thing as a 100 percent safe vaccine. This is true. While vaccines are imperfect—and for an unfortunate few, vaccination has caused permanent injury—vaccines remain one of the most successful public health innovations in the past 200 years. Along with sanitation and antibiotics, vaccines have saved countless lives. But with anthrax lots proven to contain squalene, the systemic reactions are now running 35 percent or higher, compared to what it was before the Army started using squalene additives—less than 1 percent. The General Accounting Office's research shows that the rate of adverse reactions among Air Force Guard and Reserve pilots and crew—perhaps less than coincidentally immunized during the time that the FDA has confirmed the presence of squalene in specific lots of anthrax vaccine—is running around 84 percent. What's more, the updated pharmaceutical insert—stuffed into boxes of anthrax vaccine after the FDA reported that it found squalene in some (but not all) anthrax vaccine lots—reports a wide range of autoimmune diseases now associated with anthrax immunization, including lupus, multiple sclerosis and arthritis.

Before you say that all this is impossible in this country—impossible after what happened at Tuskegee and after the horrible Cold War experiments with radiation on handicapped children and LSD on unsuspecting Gis—let me explain why it is more than possible. In this country, actions that have put the public at risk are generally challenged in litigation. Subpoenas force the production of relevant documents, truthful testimony is compelled under oath, reporters cover the proceedings and the media reports the sworn charges, defenses and countercharges. Just the threat of litigation now causes most organizations to anticipate vulnerabilities in the event of a suit and make changes that have the practical consequence of safeguarding the public.

But military physicians, and even the pharmaceutical companies who produce drugs and vaccines for military use, are shielded by law from medical malpractice suits. These physicians do not even bother to carry malpractice insurance. They do not need to. GIs, who have no right to refuse inoculations they see as dangerous, have no right to their own medical records when they find their lives ruined by illness. They are without recourse before the injury and after it.

The outrage that followed public awareness of the extent of medical experimentation once conducted in prisons and institutions for the mentally retarded, as well as elsewhere, successfully led to changes in the law requiring informed consent when an unproven drug or technique will be tested on human subjects. Today, there is only one venue where physicians can still test experimental drugs on humans without informed consent, and with impunity—the U.S. military. Existing safety regulations require informed consent for experimentation on military personnel. But subsequent memorandums of agreement have created loopholes in those regulations, allowing for the therapeutic use of investigational drugs without informed consent as long as such experimentation is undertaken strictly to protect the health of troops, if not their lives. Without strict oversight, there is always a risk that someone will interpret the rules too loosely and go too far. During the Gulf War, the FDA granted a waiver of informed consent for the use of selected investigational new drugs. Although the Army's new anthrax vaccine was not among them, Tulane's data raises this question: Did military doctors slip something extra past the FDA, specifically an unlicensed anthrax vaccine that contained squalene? The clinical evidence supports this conclusion.

In the years that followed publication of my Vanity Fair article, I have traveled across the country and as far away as the Ural Mountains in Russia and to Stockholm, Sweden, in search of the facts. I have interviewed research scientists and the military physicians who inoculated soldiers with this "new and improved" anthrax vaccine—a vaccine so hush-hush that they were told to destroy all the vials after use and not to record the vaccine in the GI's medical records unless specifically asked to do so by the GI. I have spoken with countless GIs who keep wondering why they can't get straight answers to their questions.

In 1994 the Senate Veterans Affairs Committee recommended that the Feres Doctrine—a 1950 Supreme Court decision that ruled military personnel cannot sue the Department of Defense for monetary damages over negligence—should not apply in the case of military personnel harmed by inappropriate medical experimentation when informed consent has not been obtained. Congress has never acted on that recommendation. There is now evidence that we are paying the price for this failure.

This book begins as a story of unexplained illness. But it is ultimately a story of betrayal, betrayal of the thousands of young men and women who signed up for military service, willing to risk their lives in battle, only to be secretly used in medical research. When I wrote this book, I had them in mind. This book is an IOU. I owe the soldiers of the 10th Mountain Division and the 24th Mechanized Infantry Division, who hauled my sorry behind, and those of my journalist colleagues, across the Iraqi desert in vehicles already overstuffed with soldiers who could have used the extra space. This book is for the 101st Airborne Blackhawk pilots and crew who hunkered down with us hacks when the sandstorms blew in, and shared their water. This book is for the men and women of Dover Air Force Base, some of whom I have gotten to know personally over the years, who are among those who have borne the brunt of the Army's campaignÑin concert with the FDA and National Institutes of Health—to test a new anthrax vaccine.

This book is for my Army veteran uncles and my dad, none of whom approve of the conduct by Army doctors and scientists that I describe in the pages that follow. This book is also for my daughter and for the children of my friends. I do not want to happen to them what has happened to the men and women who have worn the uniform of this great republic and that of the United Kingdom. They are all someone's children too. I have met some of their parents, and have seen with my own eyes their anguish for their injured sons and daughters.

The great mystery in this story, a mystery that I cannot completely solve, is why the scientists developing these vaccines are covering up their mistake and continuing to advocate the use of a new vaccine that will have such devastating consequences on their own people. There is some evidence that the corrupting influence of money has played a role in this. President Eisenhower long ago warned us of the dangers of an emerging military-industrial complex. Most of us believed that the danger involved only those highly visible contractors who produced gazillion-dollar planes, missiles and nuclear submarines. Let everyone be especially vigilant over companies making military vaccines that are intended for sale to the large and lucrative U.S. civilian market.

For those who read this book and say that our republic is not as great as I still maintain it is, I would argue that there are few nations on earth, at any time in human history, where someone could have written a book as openly critical of a government's national security policies as this one is, and then actually see it in print. Even in Britain, where I lived for more than a decade, I could not have gotten many of the documents that provide the foundation for this book. Britain has an Official Secrets Act; America has a Freedom of Information Act. As imperfect as that act is, this book is a testament to its value, and to the remarkable degree of freedom that we enjoy in this country. There are those who will argue—especially in times such as these—that I got my hands on too much information.

To them I say that a measure of this nation's greatness is its openness and tolerance for dissent. Our democracy was born of such stuff, and I thank God for that. As for the military doctors and scientists who allegedly perpetrated this experiment, there is a blurry line between what is legal and what is illegal in these matters. Although I have focused primarily on the scientific rather than legal aspects of this case, what limited reading I have done on the laws and regulations governing human experimentation in America leads me to conclude that a line was crossed. These were transgressions undoubtedly done with the best of intentions. Some officers were simply obeying orders given in good faith and with the welfare of troops uppermost in their minds. Others probably knew that they went too far, but it was a trade-off aimed at saving people. I am convinced that those who took the decision to test these vaccines on military personnel thought it would protect far more people than it would hurt. But that is the problem with public health risk/benefit calculations; with experimentation there are always unknown variables and the resulting damage can be irreversible. The scientists injecting squalene into humans assumed that it was safe. Many of them worked for the National Institutes of Health; and who would dispute the judgments of the NIH? But it was an assumption for which too many of our finest men and women have paid too high a price. Herein lies the moral conundrum at the heart of this book. The military doctors and scientists who run these experiments want to protect people; in exposing these doctors and scientists, so do I.

Whether or not such experiments should be allowed to continue is a matter for rigorous public debate. What is not debatable, I think, is the issue of accountability. Those who perform these experiments must be held responsible for their consequences. Those who are harmed must be helped.

An old Latin expression, quis custodiet ipsos custodes, asks the question: "Who shall keep watch over the guards?" American democracy is based on a system of checks and balances. All actions taken in the name of our republic must be subject to oversight and scrutiny by other branches of government. As I will show in this book, Gulf War illness is evidence this system is failing us. Where this oversight fails, it becomes the responsibility of the press to expose these actions to direct public scrutiny. The process can be painful, but it is only by doing so that we force accountability on those who act in our name. If individuals shielded under the rubric of national defense can continue to operate outside these rules, the consequences will be far worse than an epidemic of autoimmune disease. We will have lost an essential guarantee of personal freedom.

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