The American soldiers came home sick. The government denied any responsibility.


That’s when Shulkin said that throughout his three years as VA head, no one had ever discussed burning pits with him. But that seemed impossible: During his tenure, the VA had already begun logging details of toxic exposure claims in its National Combustion Hearth Registry, and in 2017 Shulkin signed the National Academy of Sciences review. , engineering and medicine. use of data. PBS, The New York Times and others had reported on the burning controversies. The class action lawsuit against KBR was winding its way through the courts, making headlines along the way. Shulkin had also visited a New Jersey research facility focused on studying airborne hazards and exposure to combustion fireplaces in 2016.

But Shulkin doubled down, even suggesting the topic may have been deliberately downplayed: “The burning pits weren’t even an issue while I was there,” he said. “There are really good mechanisms that keep things from appearing, and I can’t say if it was deliberate. There was no discussion or visibility on it.

I repeated Shulkin’s description of VA’s silence about fire pits during a phone call with current VA officials. “I would find that surprising,” finally said Dr. Patricia Hastings, the VA’s chief consultant for the health effects of military exposures.

Over the months of reporting, I’ve interviewed a range of current and former VA employees, both on and off the record, and encountered many knowledge gaps. No one at the AV seemed willing or able to articulate a cohesive explanation for the department’s shifting stance on hotspots. Officials pointed out that the agency was huge, the largest after the Defense Department, and that some of the clashes over science took place a long time ago. The VA, they said, has always prided itself on its rigorous research, academic freedom and compassionate care for veterans. Over the years, the agency has commissioned four reports related to airborne hazards; none of them found any links between health problems and burning fireplaces, officials said. Nevertheless, after reviewing existing research in late 2020 and 2021, the VA last year decided to reverse its position. The science, the VA said in a statement, “has changed and represents less of an abrupt change than an evolution in the understanding of the VA.”

Miller’s biopsies remained a historic, albeit controversial, breakthrough in burn pit research. Some returning soldiers became so desperate to prove they were really sick – not faking or delirious, as other doctors had suggested – that they traveled to Tennessee and paid for a biopsy using a private insurance. But Miller has also been criticized, including by military doctors, for encouraging patients with normal test results to undergo the painful and invasive procedure.

In the controversial field of combustion hearth research, doctors have clashed with an unusual grudge. The stakes are both professional and personal, with some scientists feeling that their life’s work has been ignored or misused for political purposes. There are burn-pit proponents (activists, say their detractors) and burn-pit skeptics (filibusters, say others).

In 2013, after years of silence, Miller heard from the VA: he was one of two pulmonologists who were asked to develop a criterion for assessing respiratory incapacity. But when it comes to constrictive bronchiolitis — the disease Miller believed he found in his biopsies — the agency thwarted his efforts to create a criteria, he says. In an email exchanged that year, Miller pressed Dr. Gary Reynolds, a physician with the VA Benefits Administration, for an explanation, even threatening to “investigate Congress,” citing his past work with the Senate Committee on Veterans Affairs. But Reynolds deflected, citing “a few unforeseen administrative issues.” In an email he sent me, Reynolds said he couldn’t comment.

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