The Irritable Heart: The Medical Mystery of the Gulf War [Hardcover]

The book has some serious methodological flaws. Wheelwright has apparently chosen his subjects with care -- each winds up being dislikable, or is proven to be a liar. Wheelwright is disingenuous about his purposes, and condescends to the veterans in a coy way.

When it comes to the evidence, he has already decided, based on his work with oil spills and his reading of the Agent Orange literature, that Gulf War Illness(es) may be real, but since they can't be tied to any particular single event, they can't be paid for by the VA.

This book proposes to be in-depth reporting, but reveals a writer with an agenda, a science writer from Life magazine who ironically is unconcerned about environmental claims, and a method that is as badly flawed as the studies he attacks.

For an alternate viewpoint, read Seymour Hersh's _Against All Enemies: Gulf War Syndrome: The War Between America's Ailing Veterans and Their Government_.

The mind/body is one paradigm, however, it is not the only plausible paradigm - what it boils down to is bio-politics and "according to whom." A thorough reading of the scientific biomedical literature reveals plenty of objective biomedical evidence for all the organic diseases referenced in this book.

For example, ME/CFS is an organic brain disease (ICD-10 G93.3) where patients suffer from pathological exhaustion - not garden variety tiredness - among many other neurological symptoms and signs. And fibromyalgia is classified under musculoskeletal diseases not memes. Three different subgroups of veterans with GWS have been objectively identified although there is no current diagnostic category.

These diseases are no more or less mysterious than Parkinson's disease, ALS, Huntington's disease, Multiple Sclerosis, SLE, migraines, diabetes or Alzheimer's Disease. Given the dearth of adequate funding in these areas, there is surprisingly a great deal of evidence supporting biomarkers, non-psychogenic genetic considerations, and objective neurological signs which are significant even when there is no "known" pattern as well. There are also biomedical patterns consistent with both toxic and microbial exposure.

As for psychiatric disorders there is no known cause, no objective biomarkers, and the hypothetical symptoms are often confused with medical symptoms - in short a complete mystery.

Like many less than transparent health advocacy journalists, Mr. Wheelwright fails to rigorously examine the unproven hypotheses of psychiatrists (and disability insurance conglomerates) hoping to expand their influence and profit by expanding the boundaries of psychosomatic medicine in the DSM-V and the ICD-11.

The inadequate and inappropriate methodological methods of this small, but well funded group of Neo-Freudian adherents have come under heavy fire from their peers both in psychiatry and epidemiology as well as the biomedical fields. A good reporter using objective methods would have caught that. It is unfortunate that patients are caught in the cross-fire of murky reporting.

The Irritable Heart is a stunning achievement, its calm, persuasive tone reveals the widespread suffering attributed to Gulf War Syndrome. It is excellently researched, clearly written. Wheelwright is a science writer who speaks from the heart.