The Washington Post News Articles
Vietnam Vets Didn't Kill Babies, and They Aren't Suicidal
April 6, 1986
Give yourself the "Great Rorschach Test of Vietnam." What comes to
mind when you hear the words "Vietnam Veteran?"
Quite frankly, whether your reaction is anger, arrogance, sympathy
or respect, chances are it is also filled with negative
connotations. When we think Vietnam veterans, we think problems.
The problems of the Vietnam veteran have reached metaphorical
heights. They receive broad media play. One's perspective on them
often defines one's attitude about the war itself. Interpretation of
them often goes beyond facts causing those who served to become the
symbol of what one would like to believe about the war itself. Not
unlike Moby Dick, this has become more than a story about a whale.
On March 6, the prestigious New England Journal of Medicine
Published a 'special article' entitled Delayed Effects of the
Military Draft on Mortality, replete with an accompanying editorial
proclaiming that this "ingenious epidemiologic analysis ...
demonstrates the long-term excessive mortality, of men who served in
the military during the Vietnam war."
On that same day an article in The Washington Post outlined this
study under the headline, "Viet-Era Draftee's Suicide Rate High." The
article maintained that military draftees who served during the
Vietnam war era are as much as 86 percent more likely to die by
suicide than their peers who did not serve, and as much as 53 percent
more likely to die in motor vehicle accidents. Dr. Norman Hearst,
the chief among three co-authors of the study, was quoted as saying
that "we are looking at an expression, a final, tragic expression of
the very serious long-term effects that this experience of being in
Vietnam had."
The network evening news shows gave the study major play. CBS
proclaimed that "the study documents for the first time that there
is a cause and effect relationship between having served in the
military during Vietnam and problems later, including suicide." NBC
tied the story in with a recent double suicide in which a veteran
who had never been to Vietnam and his girlfriend killed themselves
and her three children "in protest over government treatment of
Vietnam veterans," and mentioned the study as finding that "Vietnam
veterans are 86 percent more likely to commit suicide."
These reports matched the study's major conclusion, which stated
that "before sending young men to war, especially one in which they
may have experiences similar to those of Vietnam veterans, those who
make the decision should weigh all the costs. The casualties of
forced military service may not be limited to those that are counted
on the battlefield."
Rather strange that a limited epidemiological study should result in
a major conclusion of sweeping political dimension. But well and
fair, except the study established nothing of the sort, even if one
accepts its methodology, which is questionable and very likely
flawed.
Among other limitations, the study dealt only with men born in three
years, 1950 to 1952, who died in California and Pennsylvania between
1974 and 1983. It failed to identify any of those who had died
specifically as a veteran or non-veteran. Its aggregate numbers did
not count as veterans men born in those years who began serving in
the military before they would have been screened by the draft
lottery. It wrongly presumed that the socioeconomic bias against men
who served was screened out of the study. It ignored the fact that
very few of these men would have served in Vietnam.
And yet this examination of blind data has already been extrapolated
and accepted by many who reported it. The study is "ingenious." In
the news accounts it is quickly found to apply to all Vietnam
veterans. It "demonstrates long-term excessive mortality of men who
served in the military during the Vietnam war."
What it does demonstrate is: that those who served in Vietnam
indeed continue to have problems - but perhaps not the one envisioned
by the study.
The real problem began in the 1960's with the debates about the war
itself and continues because of our inability as a nation to
assimilate that divisive experience. The affirmative public image of
a nations soldiers as basically good men involved in a just cause
and of the enemy's as somewhat less than good representing a cause
to be defeated, has been a vital underpinning of virtually every war
experience in history. One of the lingering and incredible ironies
of the Vietnam war is that these two assumptions were reversed by
many Americans, with the communist soldiers taking on the aura of
goodness in a 'just cause' while our own fighting men were sometimes
subjected to the sort of propagandist ridicule normally reserved for
enemy soldiers in other wars.
This defamation, which continues today in more subtle form, has been
carried on with such viciousness and lack of regard for the truth
that the typical veteran searches vainly to understand its depths. A
starting point, however, is remembering that the United States went
through an intellectual civil war during the Vietnam era, a war of
values and ideas, and the men who fought the war were the most
tangible reminders of the values and ideas the antiwar movement
wished to defeat.
Thus, the allegations of an "immoral, genocidal war" often
translated into "our soldiers are rapists and baby killers." Similarly, exhortation by antiwar leaders that the avoidance of
the draft was just and honorable translated syllogistically into
"military service is either dishonorable or stupid." That this logic
permeated the more advantaged members of the age group and
eventually polarized it along class lines is demonstrable in many
ways. Harvard College graduated 12,595 men from 1962 to 1972, and
lost 12 in the entire war. Princeton graduated 8,108 during that
same period, and lost six. MIT graduated 8,998, losing two. By
contrast, South Boston, Mass, which had perhaps 2,000 draft eligible
males, suffered 25 men dead on the battlefields of Vietnam, and West
Point lost 34 dead from the 679 men of the class of 1966 alone.
From about 1968, when the war effort began to be discredited after
the misperceived U.S. and South Vietnamese loss of the Tet
offensive, until about 1978, when hundreds of thousands of
Vietnamese began jumping into the sea in order to flee their
"liberators," those who had not served could and did perpetrate a
moral and intellectual arrogance over those who had. As James
Fallows, one of the very few of those who did not serve to have
spoken honestly of the long-term implications of such a split in the
age group, pointed out several years ago in the Atlantic Monthly,
"to those who opposed the war, the ones who served were, first,
animals and killers, then 'suckers' who were trapped by the system,
deserving pity but no respect; and finally invisible men... A
returned veteran might win limited redemption if he publicly
recanted, like a lapsed communist fingering his former associates
before the HUAC. Otherwise, he was expected to keep his experiences
to himself."
One would think that the brutal aftermath of the communist takeover
in 1975, with its continuing expansionism, bloodletting and Gulag
mentality, would have mellowed some of the earlier antagonism.
Whatever one's opposition to the Vietnam war or to its actual
conduct (which deserves no prizes, it is clear that the stakes for
which we fought were real. The loss of a country the size of Poland
to a Stalinist regime tied strongly to the Soviet Union was a
dreadful blow to the ideals our nation cherishes.
Unfortunately, however, the antagonism persists. A major reason
relates to the ongoing debate over what Harrison Salisbury a few
years ago termed "the mythology of the Vietnam war."
History's judgment is not yet firm as to why we failed in Vietnam. Was it because of the misplaced idealism, indeed the frequent
naiveté of those who opposed the war, which gave sustenance to our
enemy? Was it because of failed political policy? Was it because of
the impact of the media on our national morale? Was it because our
soldiers simply could not defeat their soldiers? Or all of the above
or maybe none? The lines seem still to be drawn, although the
arguments are more carefully muted than fifteen years ago. And in
many ways the symbolic center of man in this debate is the pursuance
of the war by, and its impact on, the veteran who fought it.
One reaction, perhaps intentional and perhaps subliminal, has been
to continue to degrade the veterans' experience and its later impact
on those who served so that the experience itself lost its
credibility in the debate, except on negative terms. This is the
1980s version of what James Fallows, described as the veteran's
alternative in the 1970s: Recant or shut up.
And so we see a tendency to ignore the good news accompanied by, a
compulsion to broadcast loudly the bad. Examples are voluminous. A
few:
The man who fought in Vietnam is typically depicted as a draftee,
unwilling and probably black. In fact, two-thirds of those who
served during the era were volunteers, 73 percent of those who died
were volunteers and 12.5 percent of those who died were black (out
of an age group that comprised 13.5 percent of the male population).
While readjustment Problems were great for many, (as was true in
World War II, where the National Academy of Sciences estimated 25
percent of returning soldiers had emotional difficulties upon
return), this is the first war where the problems rather than the
successes have become the dominant theme in the media. No
responsible Vietnam veteran would wish to diminish the difficulties
encountered by many of his comrades, and it is a lasting credit to
those who served that the impetus for the treatment of the
approximately 20 percent who experienced readjustment difficulties
came from within the veterans' community. What upsets Vietnam
veterans is not the attention given to those who have been less
fortunate, but that their plight is the unwarranted judgment
of the entire peer group.
For instance:
In the most comprehensive survey of Vietnam veteran attitudes ever
done (1980, Harris Survey), 91 percent of those who served indicated
they were "glad they served their country," 74 percent stated they
"enjoyed their time in the service," 80 percent disagreed with the
statement "the United States took unfair advantage of me," and 72
percent agreed strongly with the statement: "The trouble in Vietnam
was that our troops were asked to fight in a war which our political
leaders in Washington would not let them win."
The media response to this survey was almost total silence.
Similarly, during March 1985, a Washington Post/ABC news poll
conducted a random sample of Vietnam veterans, "precise to within a
4 percentage point margin," which indicated that Vietnam veterans
were more likely to have gone to college, more likely to own a home
and more likely to earn $30,000 a year or more than others in their
age group. A majority of the veterans interviewed felt they had
benefited from being in Vietnam, supported the bombing of the North
and the use of napalm and did not seem bothered by the fact that
others avoided military service. The Post, it must be said, reported
this survey fairly. No one else seems to have picked it up. One
needn't wonder what would have happened if the story had indicated
otherwise.
Dozens of features, both in print and visual media, have focused on
Vietnam veterans in prison, the implication being that service in
the war zone turned untold legions on to crime. To the contrary, the
Bureau of Justice Statistics figures indicate that Vietnam veterans
are less likely to be in prison than their nonveteran Peers.
And now the New England Journal of Medicine study. The issue of
veteran suicides has surfaced before. In 1978, the Carter
administration issued a presidential memorandum which was widely
circulated claiming that Vietnam veterans were 23 percent more
likely than their non-veteran peers to commit suicide. A few months
later, VA officials discovered that the statistic was erroneous,
arrived at by projecting the suicide rate among hospitalized
psychotic veterans onto the entire Vietnam veteran population.
Nonetheless, the damage done was almost impossible to reverse.
The New England Journal study analyzed 14,145 men who were born in
the years 1950 to 1952 and died in California and Pennsylvania
between 1974 and 1983. These were the principal years of birth
involved in the draft lottery system which came into effect in 1970,
basing eligibility for conscription on a man's birthday. Birthdays
were selected randomly under the lottery system, making some men
eligible for the draft and some exempt.
The researchers broke the deceased down according to their birthdays
and thus classified them as "draft eligible" or "draft exempt." The
"draft eligible" pool showed a 4 percent higher death rate overall
and a 13 percent higher suicide rate. The study did not determine
the veteran status of any of the deceased. Rather, it presumed that
25.6 percent of the "draft eligibles" were conscripted and that 9.3
percent of the "draft exempts" volunteered. Quite obviously, it did
not address whether a man had been in Vietnam.
The researchers claimed that the randomness of the lottery made it
possible for them to eliminate other considerations regarding the
cause of higher death and suicide rates, such as socioeconomic
status or medical problems. They then concluded that the one
distinction between the "draft eligible" and "draft exempt" groups
was the effect of military service. Consequently, they attributed
all of the excess mortality on the "draft eligible" side of the
equation to the effects of military service on the 25.6 percent in
the lotteries who were, in fact, drafted.
Thus, the 13 percent higher suicide rate for a whole group of
unidentified draft eligibles translated into an 86 percent higher
suicide rate among draftees who would have begun military service
between 1971 to 1973. In the media (with a little help from Dr.
Hearst) this conjecture suddenly covered all draftees in the Vietnam
era, and then in a flash all Vietnam veterans - all without a single
veteran having been identified!
Curiously, the cause of death which showed the greatest difference
between the two groups was cirrhosis of the liver - the draft eligibles
were only 75 percent as likely to die from this ailment as the
draft exempts. If we had pushed this inconsistency through the same
bottleneck as the suicides, the headlines might have read, "Viet
Vets Much Less Likely to Die from Cirrhosis." The researchers
dismissed this anomaly to "chance."
Despite the predictable media attention, there are numerous
questions which must be addressed before one could take this study
seriously. A few. The lottery process was not purely a function of
birthdates. In 1970, it included not only those here in 1950, but
others born from 1945 to 1949 who previously had been exempt.
Exempt. In all three years, it excluded those who were already in
the military, and others who were deferred or exempt for reasons
other than date of birth.
The study presumed that only 9.3 percent of those who were not
drafted ever served, which is the estimate for voluntary enlistments
after the lottery. To the contrary, two thirds of the people who
served in the military during the Vietnam era were volunteers. As an
example of how this affects the study, Department of Defense
historical data indicates that, by the time those born in 1952
became eligible for the lottery in 1972, 273,110 were already in the
military. In contrast, only 43,706 from this year's group were
drafted-including 1,678 from the non-eligible pool! The rather
cavalier usage of rough aggregates, when subject to this sort of
statistical bias, not only could affect the premises and analysis of
the study, but also its rather macrocosmic conclusions.
The study recognizes that mortality tends to be higher among men of
lower socioeconomic status, but claims that the randomness of the
lottery eliminated this bias. Hardly. The lottery may have brought
more of the advantaged elements in for physicals, but did nothing to
eliminate what James Fallows termed qualification standards that,
for college students armed with a doctor's letter and advice from
the campus draft counseling center, could so easily be parlayed into
the "unfit for service" designation known as a 1-Y.
This socioeconomic bias not only is important when considering
mortality rates, but quite often impacts on such things as the
"coding" of deaths such as suicides. Those of higher socioeconomic
status are frequently able, through legal and other means, to
negotiate the suicides of family members into such categories as
accidental deaths. The stigma, also include financial considerations
such as insurance benefits. When it comes to coding, the poor commit
suicide, while the rich merely die lonely accidental deaths.
Very few of this group of conscriptees could have served in Vietnam,
and particularly in combat. Hearst's assertion that the study
measures the "serious long term effects that this experience of
being in Vietnam had is highly improbable." By late 1971. when these
inductees would have first been eligible to serve in Vietnam, few
would have been sent, and by the time the men of the other year
groups were inducted it would have been almost impossible. Our
combat role had almost ended by late 1971 (387 Soldiers died in the
last six months of 1971, 172 in all of 1972), and was completely
ended by January, 1973.
The "case control" study which allegedly validates the major study
may actually invalidate it.
Since 1979, Pennsylvania has required a notation of veteran status
to be included in death certificates. For 2,003 of the men in the
major study, this status was known. Those who conducted the study
examined these numbers and claimed that the breakdown among these
men verified the major study. Twenty percent of the veteran deaths,
and 14.7 percent of the non-veteran deaths, were suicides.
But only 26 percent of the total Pennsylvania deaths were veterans,
while 33 percent of the population in the age group are veterans. This means that the overall Pennsylvania death rate among veterans
was lower than non-veterans, and inflates one particular cause of
death-suicides-that appears constant between veterans and
non-veterans. One-third (32.8 percent) of the total suicide deaths
were veterans, 30.7 percent of motor vehicle accident deaths were
veterans, and 31 percent of deaths from cirrhosis were veterans. The
major distinction was in the largest category deaths by "other
causes" (such as long-term disease) where only 22.9 percent were
veterans. This fits with the historic notion that veterans are less
"unhealthy" than their non-veteran peers, since those with serious
medical problems are screened from service.
What drives such macrocosmic political conclusions from such a
tenuous examination of data? One is tempted to take a hint from the
study itself. In the opening paragraphs, the three doctors mentioned
that "men of low socioeconomic status ... may be less adept at
avoiding military service." Perhaps in the wake of the Vietnam war,
men of high socioeconomic status should talk less about avoidance as
a goal and more about the dignity and importance of military
service.
The failure to ratify this principle for Vietnam veterans has been
the biggest problem, from whence all others have derived.
UNITED STATES MARINE CORPS