Unexplained Physical Symptoms in a Post-September 11 World

Charles C. Engel, Jr., MD, MPH
Associate Professor of Psychiatry
Uniformed Services University
Director, Deployment Health Clinical Center
Walter Reed Army Medical Center

Emerging health concerns since the fall 2001 US terrorist attacks include “WTC Syndrome”, unexplained symptoms in postal workers, and health concerns over the anthrax mail irradiation process. In New York, unity has insidiously turned to divisive struggles over putative exposures, survivor benefits, and illness entitlements. Now the Global War on Terrorism has returned to the region that yielded "Gulf War Syndrome", a range of symptoms that remain enigmatic in spite of over $200 million in federal research and at least as much in medical care. Veterans’ illnesses have been compared to toxic exposure syndromes, fibromyalgia, chronic fatigue syndrome, multiple chemical sensitivities, somatoform disorders and post-traumatic stress. All but forgotten following the September 11 attacks, the syndrome has now recaptured our attention as armed forces fight again in Iraq. Questions remain about unexplained symptoms after terror and war, but federal health care has taken key steps to protect and aid troops and families at risk. This presentation will review lessons learned about unexplained physical symptoms after war and terror, the innovations these lessons have spawned, and how these innovations promise to offer psychosomatic medicine new medical relevance in the struggle against health consequences of terror, unseen toxins, and fear.