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Iraq War – Toxic Exposure & the Toll on Veterans – Joshua Howe & Alexander Lemons
122 Plays5 days ago
Ep 055 – Nonfiction. Environmental Historian Joshua Howe & Marine Corps veteran Alexander Lemons discuss their new book, “Warbody: A Marine Sniper and the Hidden Violence of Modern Warfare.”
‘A friendship between an environmental historian and a chronically ill US Marine yields a powerful exploration into the toxic effects of war on the human body.
Alexander Lemons is a Marine Corps scout sniper who, after serving multiple tours during the Iraq War, returned home seriously and mysteriously ill. Joshua Howe is an environmental historian who met Lemons as a student in one of his classes. Together they have crafted a vital book that challenges us to think beyond warfare’s acute violence of bullets and bombs to the “slow violence” of toxic exposure and lasting trauma.
In alternating chapters, Lemons vividly describes his time in Fallujah and elsewhere during the worst of the Iraq War, his descent into a decade-long battle with mysterious and severe sickness, and his return to health; Howe explains, with clarity and scientific insight, the many toxicities to which Lemons was exposed and their potential consequences. Together they cover the whirlwind of toxic exposures military personnel face from the things they touch and breathe in all the time, including lead from bullets, jet fuel, fire retardants, pesticides, mercury, dust, and the cocktail of toxicants emitted by the open-air “burn pits” used in military settings to burn waste products like paint, human waste, metal cans, oil, and plastics. They also consider PTSD and traumatic brain injury, which are endemic among the military and cause and exacerbate all kinds of physical and mental health problems. Finally, they explore how both mainstream and alternative medicine struggle to understand, accommodate, and address the vast array of health problems among military veterans.
Warbody challenges us to rethink the violence we associate with war and the way we help veterans recover. It is a powerful book with an urgent message for the nearly twenty million Americans who are active military or veterans, as well as for their families, their loved ones, and all of us who depend on their service.’
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Transcript
Introduction to War Books Podcast
00:00:01
A.J. Woodhams
Hi everyone, this is AJ Woodhams, host of the War Books podcast, where I interview today's best authors writing about war-related topics.
Introducing Guests: Joshua Howe and Alexander Lemons
00:00:10
A.J. Woodhams
Today, i am extremely excited to have on the show Joshua Howe and Alexander Lemons for their new book, War Body, A Marine Sniper in the Hidden Violence of Modern Warfare.
00:00:20
A.J. Woodhams
Joshua Howe is an Associate Professor of History and Environmental Studies at Reed College and the author of two books on the science and politics of climate change. Alexander Lemons, enlisted in the United States Marine Corps in 2001, deployed to Iraq three times, and then served as a special assistant to General David Petraeus.
00:00:39
A.J. Woodhams
He is a recipient of the Bronze Star Navy and Marine Corps Commendation Medal with V, and left the Corps as a Staff Sergeant after seven years. ah Josh, Alex, how are you both doing today?
00:00:52
alex
Excellent.
00:00:52
Josh Howe
Doing great. Yeah. Thanks
Memorial Day Significance for Veterans
00:00:53
Josh Howe
for having us on the show.
00:00:53
A.J. Woodhams
Great.
00:00:54
alex
Thanks for the invitation.
00:00:55
A.J. Woodhams
Yeah. oh f Absolutely. Thanks for coming on. um Well, this is our, and this is just by chance, this is going to be our Memorial Day ah episode.
00:01:06
A.J. Woodhams
So, you know, ah a little bit fitting, I guess, and which I got a question about towards the end.
00:01:06
alex
more.
00:01:13
A.J. Woodhams
um but yeah I don't know. You know, actually, ah I'll ask it towards the end, but let me just I'll just ask it now. um ah Alex, or maybe Josh, but I don't know. Do you ah reflect differently during Memorial Day? Do you um celebrate differently?
00:01:31
Josh Howe
Okay.
00:01:31
A.J. Woodhams
i asked, actually, I had a ah ah veteran on
00:01:35
A.J. Woodhams
ah Phil Clay, who wrote a great book, um pretty critical of modern modern ah warfare. And I was like, it was before Fourth fourth of July. I was like, was like, Phil, like, you know, like, it's about to be Fourth of July. Like, do you have like any like deep like, um I don't know, reflections that come to you during July fourth He's like, no, I like to go to barbecues. You So if you don't reflect differently, that's fine. But I don't know. do Alex, do you reflect differently?
Exploring 'War Body': Unseen Violence and Slow Trauma
00:02:04
alex
No, every day is Memorial Day for me now, so I don't think about it as an official holiday.
00:02:08
A.J. Woodhams
Sure.
00:02:11
alex
Sometimes I think it's a little weird just how commercialized it's become. and um But I'm glad there's a day maybe for you all to be forced to reflect, but I just don't like the the delivery of that.
00:02:21
A.J. Woodhams
yeah
00:02:29
A.J. Woodhams
Yeah. No, I get that.
00:02:30
alex
that
00:02:31
A.J. Woodhams
Sure. um Well, yeah maybe we'll talk a little bit more about it you know later on.
00:02:36
alex
Sure.
00:02:36
A.J. Woodhams
and But yeah, Memorial Day episode and ah here. um I like to start off the interviews um first by just asking, like what is your what's your book about? ah Could one of you, or both of you if you want, ah one of you just tell us, what's this book about?
00:02:52
Josh Howe
um Our book is about ah what the violence of warfare actually like looks like. So you asked the question about Memorial Day. And I have a little bit of a hotter take than Alex.
00:03:02
Josh Howe
I think it is a make-believe holiday for make-believe wars that are meant for people to create make-believe veterans.
00:03:03
alex
you
00:03:12
Josh Howe
And what we're interested in is the the things that make up the majority of veteran experiences and the types of violence that they they suffer. And it's it engages with the violence of bullets and bombs because warfare is about that kind of violence.
00:03:25
alex
Thank you.
The Narrative of Military Service and Health Struggles
00:03:25
Josh Howe
But it's really interested in the lasting impacts of those things, those types of violence you can't see and that aren't the big explosions and an obvious wounds, wounds from things like ah lead and pesticides and and other toxic exposures, but also exposure to trauma and head injuries and how those things work together to impact veterans when they come home in ways that holidays like Memorial Day like to gloss over.
00:03:54
Josh Howe
um and that's that's what the book's about. So what we've done is Alex and I sat for these interviews. Alex, as as you'll know, and he can talk to you more about later. Alex did four tours and at the end of those tours, he started to get really sick.
00:04:09
Josh Howe
And when he came back, he spent about 10 years trying to figure out what was making him sick and how to get better. And toward the the latter part of those 10 years, he and I started working together. And so the structure of the book is us sort of chasing Alex through his service and his sickness and his quest for health. So through Iraq and Kuwait and then back to the United States and through a health care system that doesn't know what to do with him.
00:04:32
Josh Howe
um trying to figure out the things he was exposed to and what might make a Marine like him sick in those scenarios. It's not necessarily going to solve the riddle of what made Alex sick, but it's going to investigate the the kinds of um what Rob Nixon in a very different context called slow violence that that's entailed in modern warfare. So that's what the book's about.
00:04:55
A.J. Woodhams
Yeah, Alex, anything ah to add to that?
00:04:59
alex
um I'll just explain the same thing a different way. So if like my if you want to take like the most abstract painting you can imagine, like some crazy Picasso or something from the 20th century, and it just looks like craziness and insanity, Josh and I are trying to peel back like each brushstroke and each paint color back into the tube so that we can understand like how each thing contributed to me becoming this war body.
00:05:31
A.J. Woodhams
Yeah.
00:05:32
alex
And the three main things are trauma, um toxicants of any kind, and then head injuries, and have those separated in all these different chapters, and then bring them back together so you see the mess of the painting again, and then you feel a lot less frightened by the mess, and you know that it's like totally just a natural outcome of all these different forces happening on one individual
Alex Lemons' Background and Motivation
00:05:58
alex
at work.
00:05:59
A.J. Woodhams
Yeah. And um also too, for the the audience, I really loved how this book is structured. Alex, you you brought up a little bit about structure, but you know, it's ah so your Alex is laughing this and maybe you don't like how it's structured.
00:06:14
A.J. Woodhams
ah
00:06:14
Josh Howe
Oh, no, we just, we we fought really hard to make it this way. And
00:06:18
A.J. Woodhams
Okay.
00:06:19
Josh Howe
The hardest part of the of the job was to make this thing work.
00:06:19
alex
Yeah.
00:06:22
Josh Howe
So, I mean, as you suggest, AJ, it's structured in a way that readers won't seen.
00:06:23
A.J. Woodhams
That's so interesting.
00:06:27
Josh Howe
In a lot of ways, it's worth reading just to see how it works. We actually each write in our own voices the whole time.
00:06:33
Josh Howe
So we're more or less alternating chapters where Alex's parts are all memoir in his voice.
00:06:33
A.J. Woodhams
Yeah.
00:06:33
A.J. Woodhams
Yeah.
00:06:39
Josh Howe
And it's very distinctive, engaging writing. And um between those chapters, I'm doing these deep dives into the places Alex went, the things he was exposed to, ah doing my my best to make that make the science of those exposures accessible um and also the history accessible.
00:06:58
A.J. Woodhams
yeah
00:07:00
Josh Howe
And so we're going back and forth and the I mean, AJ, you have read it, so you can talk more about the reader experience. But the idea is to give a reader an experience of ah kind of both the chaos and the order at the same time.
00:07:16
Josh Howe
It can be a little disorienting intentionally, but ultimately rewards um attention to both the the kind of abstract scientific ideas and the individual experiences that Alex relates.
00:07:16
A.J. Woodhams
Yeah.
00:07:30
A.J. Woodhams
Yeah. I mean, i yeah, I really liked, I'm glad that you fought for that. um I love the structure of it. um Even down to the the fonts, you've got different fonts for you guys.
00:07:39
Josh Howe
Thank you.
00:07:39
A.J. Woodhams
um you know it's it's like It seemed a real intentional choice to make sure you both had distinct voices. And um I thought that was well done. ah let let Let's start at the beginning here.
00:07:51
A.J. Woodhams
um um My first question actually is for for Alex. Just if you could tell us a little bit about your background. um where you came from, um and what what motivated you to join the Marines?
00:08:05
alex
So I am born and raised out in the West. Um, was born in Provo. My parents took me over to Denver when I was about one, grew up there, bounced around, um, Alberta, Canada, and back down here to Utah. i really had no interest in going to college. I love to learn, but hate school.
00:08:32
alex
And, uh,
00:08:33
Josh Howe
Thank you.
00:08:34
alex
I got a scholarship, a biology scholarship, and I could keep skiing. And that was like my real mission was to try to make the 2002 Olympics. That didn't work out. And by the end of my college life, um I was getting burned out.
00:08:50
alex
I also didn't have enough money for graduate school. I wasn't going to take any loans out for that. And nine eleven happened. And two days later, I was down the recruiting station kind kind of i was I was a history major and English major. I dropped out on biology, even though I still love biology.
00:09:09
alex
But I kind of saw the history in the moment, and then I predicted that We would probably be in a long war, probably a confusing one.
00:09:23
alex
i was i was raised by a lot of Vietnam vets, but both like in my family and some of my professors.
00:09:26
Josh Howe
Thank you.
00:09:30
alex
And i just thought, okay, this is going to happen, and I want to be there for definitely some of my poorer friends. And it just seemed like the right thing to do at the time.
00:09:44
alex
And from there, it just... it took me where it took me.
00:09:49
A.J. Woodhams
Yeah.
00:09:49
alex
Um, all I could do was kind of control my, my own life, my own like little circle while I was in it. And then I just, um, I, I, you know, I did what I could and worked hard, but some things just randomly happen the way they do in life, but especially warfare. And, um,
00:10:09
alex
that That kind of brought me through seven years. um i originally thought I was just going to do one enlistment. So I did my, I did the invasion 2003.
00:10:21
alex
ah went back in 2004. This is with 1st Battalion, 4th Marines. My second deployment, I was a sniper, school trained. um Third deployment, I did what's called a Western Pacific, where you just get on the boats in San Diego. And then I floated the Pacific out, kind of toured around down to Australia, up through the Philippines, and then over to Kuwait, where we sat as the operational reserve.
00:10:46
alex
And then floated back, didn't go into Iraq that year, thankfully. um That was 2006. And then um i had re-enlisted at the end of 2006. And instead of like getting what I wanted, but which rarely happens in the Marine Corps, I got flagged with recruiting and I told the Marine Corps to pound sand, got out.
00:11:09
alex
And then in the winter of 2007, got reactivated from the Inactive Ready
Experiences as a Marine Sniper
00:11:14
alex
Reserve. um I don't know how familiar art you and your audience are with that, but when you he sign up, especially in the Marine Corps and the Army, but you sign up for four years active, but there's four years back here that's in the reserve. You don't show up for drill or anything. You can...
00:11:32
alex
get your nose pierced and get a little bit of a gut and a beard but if they want they can pluck you back and this has been how they've gotten around the draft uh or since the end of the draft in 73 but i got plucked in um to go to the surge and rather than just get uh placed anywhere i volunteered to go with one of my uh friends to serve as an advisor to the commanding general david petreus and i did that for
00:11:41
A.J. Woodhams
Yeah.
00:12:01
alex
It was almost a year. I did 10 months in theater. And so I was basically sent on special assignments or I'd basically go find information. And then I was living with special forces for most of that time.
00:12:16
alex
And then I came back and my my body basically fell apart. And that's what's led to this whole book.
00:12:23
A.J. Woodhams
Yeah.
00:12:24
alex
you know book
00:12:26
A.J. Woodhams
Well, what is, so you were ah you were a a sniper, um Marine Corps sniper, um you know obviously, basically, mean, not for the entire war, but seven years, very long time.
00:12:39
A.J. Woodhams
um Well, you mentioned being a recruiter, though, too. So I guess you you weren't completely.
00:12:44
alex
I was forced to do that for a hot minute.
00:12:44
A.J. Woodhams
like yeah
00:12:47
Josh Howe
Thank you.
00:12:47
A.J. Woodhams
ah Well, just um just for for the audience, um i talk a little bit about kind of the conditions that a a sniper operates in. in you know I'm thinking about just like before we get into um like the the really like then ah toxic stuff the chemicals and and you know the burn pits and stuff, um like you know it's you it's constant it's constant heat. You're always dirty. You're always sweaty.
00:13:13
A.J. Woodhams
You're in a fixed position for a very long period of time. you know Talk about the actual conditions that you're operating in.
00:13:20
alex
it's It's probably, I'll all explain that by way of like what I would do with recruits who came to my platoon because um eventually I became the chief scout. So I was the main trainer and I got to pick my recruits and send them through like a one week hell week. It's kind of an indoctrination. And the thing that I was always looking for is people who can accept a large amount of boredom and have really good um observational skills like sight, smell, touch, sound, everything, because most of what you're gonna be doing isn't involving any weaponry.
00:13:59
alex
I think that this is part of like Hollywood and the sexiness of war. Most like sniping operations are actually reconnaissance and surveillance missions where you go out with glass,
00:14:12
alex
um optics like spotting scopes and whatnot binoculars but also your own natural um skills and you're trying to pick up whatever is out there well um the infantryman which i was
History and Impact of Toxic Exposure in Warfare
00:14:24
alex
an infantryman my first tour so that's why i when i became a sniper i knew how to support these guys and gals as best as possible and their you know they've got a main and ah mission while they're out there, but I'm somewhere kind of hiding above them or nearby them, looking for things that they might not necessarily see with the rest of my team, and then telling them that, making decision about that, or in like the most important cases, because a sniper operates in the Marine Corps anyway, which we no longer have snipers in the Marine Corps.
00:14:45
Josh Howe
Thank you.
00:15:00
alex
So you're talking to like basically a dinosaur right now.
00:15:03
A.J. Woodhams
No.
00:15:04
alex
um
00:15:04
A.J. Woodhams
Yeah.
00:15:05
alex
It got rid of them last year. um But we I live in the intelligence shop.
00:15:09
A.J. Woodhams
Okay.
00:15:13
alex
So that's the S2 because I'm an intelligence asset because I go out there and I get information. And information is what you convert into intelligence and intelligence drives all operations and warfare.
00:15:24
A.J. Woodhams
Sure.
00:15:25
alex
So I am out there to get the truth as much as I can.
00:15:25
A.J. Woodhams
Sure.
00:15:28
A.J. Woodhams
Yeah.
00:15:29
alex
And then combine that with other pieces of information like human intelligence where they go talk to folks or um any other kinds of information and that becomes the bigger picture.
00:15:40
alex
So a lot of what we do in those hide sites, whether we're like living in the sand, living in the trees, living in a building,
00:15:40
A.J. Woodhams
Yeah. Yeah.
00:15:49
alex
is just looking and seeing what's there and then trying to put that into a bigger picture of how we can assist or how we can stop the enemy and
00:15:53
A.J. Woodhams
yeah
00:16:02
A.J. Woodhams
Well, yeah. um Well, let's let's but let's let's get into then um some of the toxic ah chemicals and and and things like that um that you you were you were exposed to.
00:16:19
A.J. Woodhams
First um question for Josh. i If you could just give us um a little bit of history about um ah you know toxic you know chemical warfare, um you know these types of toxic exposure type agents. You you talk a little bit about like going back to World War I, obviously. you know You've got um chemical weapons being used and you you kind of bring us up to the present day.
00:16:45
A.J. Woodhams
But give us a little bit of ah a history lesson.
00:16:48
Josh Howe
Yeah, so I guess the the nuts and bolts of the argument about modern warfare and toxic exposure revolve around the the advent of sort of large-scale ballistic warfare.
00:17:01
Josh Howe
And so to say that differently, like think about ah the scale of the First World War and the the scale of the munitions are involved. So it's one thing to shoot a few bullets and move.
00:17:13
Josh Howe
it's It's one thing and say, you know, the American Civil War. to be able to to shoot a musket ball, reload in 45 seconds or 90 seconds or whatever it was and shoot again.
00:17:24
Josh Howe
It's another thing to over the course of of five years, see 9 billion bullets fired, and including just, and that' that's excluding all of the large scale ordinance in a warfare that, a context of warfare that's dominated by fixed positions.
00:17:26
alex
Thank you.
00:17:44
Josh Howe
um And so every time a bullet is fired. You have a release of a bunch of things that at scale can be toxic. um The first and most obvious is lead. Almost everything that you shoot is made out of lead.
00:17:59
Josh Howe
And you have all of the the particles that come off of the projectile the bullet. So there's lead dust that comes out of the out of the barrel of the gun or the cannon or whatever it is.
00:18:10
Josh Howe
And then all the lead fragments and lead dust upon impact. And that's a big deal. But the way that those things are propelled, the primers, the things that light the powder, um those also tend to be lead based, so lead aerosols.
00:18:25
Josh Howe
and And those things are released right in, if you're shooting like a rifle, they're right in the the immediate breathing space of the shooter. um And so ah you can see um from the farmland all around kind of northern France and Belgium, it's closed to agriculture, the zone rouge, that there's lead, there's arsenic, there's cadmium, there's all this toxic stuff in the soil that's left over from the First World War.
00:18:42
alex
Thank you.
00:18:53
Josh Howe
And a lot of people have have studied that, but not a lot of people have thought about the extent to which in the moment, all of those soldiers were living in trenches, just engulfed in aerosolized toxic stuff.
00:19:08
Josh Howe
um So from the get go, all of the munitions of warfare um that expanded just dramatically in scale in the First World War, created a situation where you have potential toxic exposures like you really hadn't had in any previous war. And that's gonna continue through the 20th century.
00:19:28
Josh Howe
It's no coincidence that that is also the era that brought about large scale neuropsychiatric disorders. In the first world war, they called it shell shock.
00:19:39
Josh Howe
And i don't wanna say that shell shock was PTSD because PTSD is like a culturally situated disorder. And I won't go into the details now necessarily.
00:19:48
alex
Thank
00:19:50
Josh Howe
I talk about it in the book. um I think it is misleading. But shell shocks and neuropsychiatric disorder that's actually really well named because the same things that are going on um chemically in the brain from exposures to toxic things like lead, those same neural structures are getting compromised by trauma.
00:20:14
Josh Howe
And we know that from later PTSD studies. So When I say it's sort of modern warfare here, it's really kind of since the First World War that you have these like large scale exchanges of potentially toxic ballistic things and neuropsychiatric disorders.
00:20:32
Josh Howe
The third thing to think about is like the increased concussive power of everything in that warfare.
00:20:33
alex
Thank you.
00:20:37
Josh Howe
I mean, if you're if you're shooting that many rounds from big guns, um you're going to have more head injuries. And all these things are sort of what we found in the 21st century are wrapped up together.
00:20:50
Josh Howe
That's kind of the, that's one side of this equation. And then the question you asked is about chemical weapons. And that's one of the things that in Alex's War in Iraq, we were really worried about. so um chemical weapons also show up in that first world war. It's one of the reasons I think that we have, that that war is so traumatizing.
00:21:09
Josh Howe
um And so in, you know, 1915, the, the same guy who helped establish the, Haber-Bosch process and, um, you know, make nitrogen fertilizer a thing, um, also creates a way to, to synthesize, uh, uh, nitrogen explosives.
00:21:31
Josh Howe
Meanwhile, these other German scientists are creating chemical weapons like chlorine gas, um, that they're releasing over the, the fields of, uh, of Northern Europe.
00:21:33
alex
you
00:21:40
Josh Howe
Um, and those things, um, develop over time into the second world war into the, into what are going to be anti-collagenic drugs, which are, are very similar to pesticides, um, or to many pesticides.
00:21:56
Josh Howe
Uh, and so that ultimately that trajectory of chemical warfare is also going to continue alongside this kind of large scale availability of, um, heavy metals, um,
00:22:07
alex
Thank
00:22:09
Josh Howe
in the context of war. mean, think about war in the modern sense, we talk about blowing stuff up, right? It's a really apt phrase. Stuff goes from being solid to being airborne, from like one thing to many little things.
00:22:22
Josh Howe
We know that our bodies can absorb many little things a lot better. Think about the stuff that gets blown up. You start with all the munitions, right? And those have metals in them and that gets blown up. But You also have to think about like what's in every building in Iraq and Kuwait that's getting hit and aerosolized.
00:22:40
Josh Howe
um and And then what's getting burned. ah And, you know, that's everything from like household cleaners to asbestos in buildings um to sort of fuel dumps that have leaded gasoline.
00:22:54
Josh Howe
So by the time you get to the 21st century, when you're using these sort of massive buildings, massive ballistics devices to blow up societies that are made mostly of synthetic chemicals since the middle of the 20th century warfare is becoming this incredibly toxic environment beyond just the sort of the fact that bullets are bad for your health.
00:23:21
Josh Howe
Um, you have a lot of, a lot of stuff, um, that is suddenly available to bodies in ways that it ever has been.
00:23:28
alex
Thank you.
00:23:31
Josh Howe
And so that's kind of, I don't know if that true well that's what you're looking for in terms of like a trajectory of toxicants, but.
00:23:33
A.J. Woodhams
Yeah. No, that's that's great. um Very helpful. i I had put on here just like a short list of um some of these things. Lead from bullets, jet fuel, fire retardants, pesticides, mercury, um open air burn pits. you know there's just you're You're absolutely right. there's so There's so much that you don't think about.
00:23:54
A.J. Woodhams
um ah lead Lead from bullets is not something that I would have thought about it until um You write about it in your book as being um ah toxic you know something a toxic material that you're exposed to on the battlefield. But
Awareness and Response to Toxic Risks
00:24:08
A.J. Woodhams
yeah, you're right. like You fire a bullet and like your face is right there.
00:24:12
A.J. Woodhams
um it's It's immediately all around you. i wonder, Alex, um in the field, did you... now ah probably the the last, I want to talk maybe the last half or so about your post-war experience um for our interview here.
00:24:28
alex
for it.
00:24:29
A.J. Woodhams
But when when you're in the field, were there any obvious signs to you, or rashes, um you know, like coughing, um you know, anything that in the moment really made you think, gosh, there's there's something chemically here that should not be here or some other kind of toxic substance?
00:24:50
alex
No. I mean, we were always coughing because Iraq is such a dusty place. And as the Middle East, like everywhere else along the equator gets drier and drier from climate change.
00:24:55
A.J. Woodhams
Yeah.
00:25:02
alex
Plus there was a, there was a drought happening. Um, I think, again, have, or like my team and i just have a mission that we have to accomplish.
00:25:14
alex
And that's all that I have the bandwidth to think about um during that time.
00:25:20
A.J. Woodhams
Sure. was Was there ever any... um i i got ah the the feeling in the book that the and leadership, Marine leadership was was not necessarily open to um thinking about like some of the the nuances of modern warfare and these these toxic things that could be going on.
00:25:43
A.J. Woodhams
Was there ever a discussion um that you know of, or Josh, maybe that you know of where, ah for for example, the burn pits, um you know, obviously like you, you look at a burn pit and you're like, that can't be good to inhale.
00:25:57
A.J. Woodhams
Was there any kind of discussion amongst leadership from your experience, Alex, or what you know of Josh, that, that, that that's not a good thing to do? None.
00:26:08
alex
None.
00:26:09
Josh Howe
ah Yeah, so Alex wouldn't have seen it. yeah This is one of the things that's super messed up about Alex's experience is that a lot of this stuff was identified and outlawed in the late 90s after the first Gulf War.
00:26:20
A.J. Woodhams
Yeah.
00:26:21
Josh Howe
So there's this study that comes out, ah research advisor the Congressional Research Advisory Committee on the Iraq War. in 1997. And they identify a lot of the things that I've already talked about, but they're particularly worried about like smoke, film, oil, fires, JP8, which is jet fuel, the stuff called pyro, pyro stigmine bromide, pyro stigmine bromide, which is a prophylactic against chemical weapons.
00:26:48
Josh Howe
And then a whole like host of pesticides and other things. uh, that operate synergistically in their operated synergistically in the first Gulf War to create something called Gulf War illness. So we knew all this, um, and the, like essentially the downsizing and defunding of the military between, um the late nineties and the early two thousands created a situation where they were essentially like running day to day, week to week and not implementing any of the things they learned.
00:27:01
A.J. Woodhams
yeah
00:27:18
A.J. Woodhams
I think you're right, actually, that that safety was outsourced to contractors since like the 90s in the entire military.
00:27:18
Josh Howe
Um,
00:27:25
A.J. Woodhams
um So I guess that shows you maybe the priority.
00:27:26
alex
yeah
00:27:28
Josh Howe
Yeah, i mean, I've been, I a joke, but I've been waiting for Joe Buck to, at one of these seventh inning stretches, thank our military contractors instead of our our service personnel, it'd sort of more honest ah thing to say. And they don't, I mean, they don't have any rules. That's not, true that's not totally true. I probably shouldn't say that because the lawyers will come after me, but it seems like they're not operating with the same kinds of ah rules and and particularly in Interac after There was this provisional authority created in the the green zone um that based on ah I think the 2007 decree um essentially ah created immunity for military contractors operating in Iraq um from both local law, but also ah in like American law.
00:28:14
Josh Howe
They're operating essentially in a lawless zone.
00:28:16
A.J. Woodhams
Yeah.
00:28:17
Josh Howe
and Yeah, so there's, the short answer is, there's actually a fair amount of knowledge that's already in place. And there's there is neither the will nor the infrastructure to implement it um at the beginning of of the war.
00:28:29
Josh Howe
And that's, you know, I think Alex got to live that, got to, Alex had to live that experience. And so probably saw it in certain ways without having the resources to know what was happening because command is so, it's so obscure when you're in Alex's position.
00:28:36
A.J. Woodhams
yeah
00:28:48
Josh Howe
Is that accurate, Alex?
00:28:50
alex
Yeah. and i i also I also think that this is not unique to the Marine Corps or the Army. This is also like something that's happening here in civilian land.
00:29:04
alex
I mean, we do have the EPA and we do have like state like departments of environmental quality. but they may not be monitoring every little thing and every little school and every little house and every little activity that you're doing and sometimes you're just going about i need to make a living today i got to keep the you know the roof over my head and you may just inadvertently do something that maybe in your gut you know okay that's a little sketchy but you do it nonetheless
00:29:23
A.J. Woodhams
Sure.
00:29:34
A.J. Woodhams
Yeah. Well, is there a, um you know, these things are all all bad things, but I wonder if either of you would say if there's like a worst offender um of all of these toxic substances, is there is there one that sticks out?
00:29:44
Josh Howe
Yeah.
00:29:49
A.J. Woodhams
I noticed you started the book talking about lead. um Is there one that just sticks out as being like like stupidly obvious or maybe they're all stupidly obvious?
00:30:00
alex
I mean, i'm I'm going to say lead. That's why we put it up front.
00:30:02
A.J. Woodhams
Yeah. Yeah. yeah
00:30:04
alex
and it it just is it's kind of like a gateway heavy metal i mean they all are but lead in particular has such uh fearsome effects on memory and the way all these other different toxicants interact with the body and your emotions and we know that from decades of studies on lead on kids and on adults and like in particular in like flint michigan for example
00:30:19
Josh Howe
Thank you.
00:30:34
A.J. Woodhams
Yeah.
00:30:35
alex
So, but you've got to fire bullets and you and lead is just such a wonderful like way of delivering a cartridge and taking an enemy out.
00:30:37
A.J. Woodhams
Well, right.
00:30:48
alex
So it's one of these things where I think we all know it's bad, but we haven't come up with an alternative.
00:30:49
A.J. Woodhams
Yeah.
00:30:58
A.J. Woodhams
Yeah.
00:30:58
alex
So we'll keep using it until where we find something otherwise.
00:31:02
A.J. Woodhams
Well, Alex, talk talk a little bit about kind of, and I know there's there's a ah lot of, and there's a as a reader, we'll find out in the book, there's a real correlation between ah mental health and physical health and um that experience for you.
00:31:20
Josh Howe
Thank
00:31:20
A.J. Woodhams
But ah Maybe just talk about when you first started to to realize, um and you we can we haven't talked so much about your service, but um you know if you want to talk during your service or when you return from service, what were some of those first physical um symptoms that you started to notice in yourself?
00:31:40
alex
on I mean, honestly, i didn't really... notice it until the summer of 2010 and that's when my health really collapsed i my brother and i had moved up to portland oregon and we both got mononucleosis and i just remember being like incapable of carrying a very like light five-weight fly fishing rod it felt like i was carrying i don't know like a timber or something over my my arm and at the same time i was like
00:32:11
A.J. Woodhams
Yeah, sure. Yeah.
00:32:16
alex
in the kind of months leading up to that. So I got back from my last deployment in 08, but my allergies just started spiking on all kinds of random things that I'd never had problem with, like gluten, um garlic, pineapple.
00:32:32
A.J. Woodhams
well
00:32:32
alex
um But I and didn't really know what to do that. I just kind of pushed through it or stopped eating it. And the The other thing that's kind of hard to separate is I've got my own like feelings about the war itself, which I never was a believer in, but I was a believer in my friends and I'm angry about even now, like the loss of all my friends. So I'm dealing with that.
00:33:00
alex
Plus I've been blown up several times.
00:33:00
A.J. Woodhams
believe.
00:33:02
alex
i have a few concussions, thankfully not bad ones. Um, But it was kind of in those more like little ways that I was just noticing, wow, I'm not really recovering from colds. I can't um work out as much.
Health Battles and Emotional Coping Post-Service
00:33:20
alex
But I think it it took a lot longer.
00:33:20
A.J. Woodhams
yeah i believe
00:33:23
alex
It took a lot longer to figure out like this kind of earlier description of like the abstract painting and separating the colors from other colors because they all seem to kind of bleed together.
00:33:35
A.J. Woodhams
Yeah. And I think coming back, like you're um an outsider looking at you would notice you've lost a lot of weight by the time you return.
00:33:43
alex
yeah
00:33:43
A.J. Woodhams
um And you're also having some you know problems with ah with your memory. And um um there' is you it seems like very quickly you start to, maybe not very quickly actually, um but you you gradually do realize like, you know something something's up here.
00:33:51
alex
yeah
00:33:59
A.J. Woodhams
um
00:34:00
alex
Very slowly. I would say this like this is the This is like the cleaned up brain, not just the writer looking backwards, but I feel like right now as I talk to you both, um I'm in the healthiest state of mind I've ever been.
00:34:09
A.J. Woodhams
Sure.
00:34:15
alex
But now when I look back, I'm thinking more um um like 2003 when we came back from my first deployment.
00:34:25
alex
A lot of us just had, we got back to Pendleton and we were like, wow, it's easier to breathe here. And then we all just had crazy runny noses. We were blowing crap out. But we seem to be feeling like we were improved.
00:34:38
alex
Then we go back to a rock and then the sneezing and the congestion comes back and then you come back again, blow it out.
00:34:40
A.J. Woodhams
Yeah.
00:34:46
alex
And so there's, now I can see those weird little crumbs of evidence.
00:34:53
A.J. Woodhams
Well, um talk about your, um your mental health journey. um When you, when you returned um and talk about, talk about some of those struggles, whatever you, you wish to share um talk about some of those struggles um immediately when you, you returned and through maybe we don't have to go to today, but you know, some of the, the, the, the real challenges that you've experienced since your service.
00:35:21
alex
Um, I think, i think the thing that I had struggled with the most on every deployment, but then it came like raging back in 08 was just, uh, uh, like an Olympic level of survivor's guilt.
00:35:37
alex
Um, I I'm lucky. I never got wounded. i you know, fell through the roof. I got blown up a few times. Um, but I, i never, I never got sent to a cache.
00:35:52
alex
But I had a lot of friends who did. for fur a long time I thought that was my fault, especially the sniper, because I'm supposed to be kind of up there with my team as guardian angels.
00:36:05
alex
And if somebody slips around our protection, um then going to immediately kind of take that as my own failure.
00:36:16
alex
And maybe that was just the younger... um the younger combatant in me. But that kind of that kind of stuck around because when I got back in 08, I remember going up to a family reunion up in Idaho because that's where all my family's from, where Josh is from.
00:36:37
alex
And I just remember being completely out of place, but I was like, okay, i'm I can't go back to the Marine Corps. um but how am I going to fit into all of this? And everybody seems like they're having a good old time and they're worried about the recession. And I'm still thinking, well my friends are there, American and Iraqi.
00:36:58
alex
And then I have all my other friends here who are also split to the winds. And that kind of isolation, plus like I'm here, but they're not, it, it drove me a little crazy. And that is what activated my,
00:37:15
alex
like my coping mechanism, which was I had pretty severe eating disorder. So anorexia was always like my way of controlling the guilt and controlling the sorrow and just kind of putting a check on it so that I wouldn't have to feel it at all.
00:37:30
alex
But like any addiction, it's going to eventually blow up in your face. And that's what was kind of already happening and for the second time in 08 when i one of my vietnam vet mentors i write about the book uh robert welsh uh he took me aside and just said if you don't deal with this stuff it's gonna it's gonna deal with you and i he had showed me and told me how that had consumed his life after vietnam and i couldn't really argue with him because
00:38:04
alex
i mean Unlike, say, if my mom had had that conversation with me, I would have told her to, you know, I would have told her to off. um I couldn't do that with Bob, like, because he's been there and done that.
00:38:16
alex
And so that's why I got. into VA mental health care system like way earlier, i think, than most. And it was able to help me understand that the addiction that I had was just a ah way of escaping the feelings that I really didn't want to feel.
00:38:39
alex
And that that was just a very slow, slow process um to all these different ways of dealing or managing or looking at mental health.
00:38:52
A.J. Woodhams
Yeah. And you, you write, I'm pretty sure you write about being at the VA hospital and um like the, all the Vietnam vets, like thinking you're there to pick somebody like, you know, pick, pick an older person up.
00:39:06
A.J. Woodhams
You're not there for like your own treatment. um So then at this time, then it, it, it seems like there were not a lot of veterans, Iraq war veterans like yourself who were seeking treatment.
00:39:19
alex
No, and, you know, that's that's this kind of plugs back into the book um that just because you're going to talk to somebody about these experiences that may not relieve you of whatever's troubling you because...
00:39:36
alex
maybe you're not able to remember things because of the lead you've been exposed to, which is affecting your memory. Or maybe you're not remembering enough because of the concussions that you took when you got hit by an EFP on route Irish, which is like the main road in Baghdad.
00:39:42
A.J. Woodhams
Yeah.
00:39:51
A.J. Woodhams
yeah
00:39:53
alex
So that's, I think maybe where therapy has its place, but if it's not bound into these other things and making sure that we haven't checked you and screened you for a TBI and all these toxins, it may not actually produce any of the effect that we all want it to have.
00:40:13
alex
And so the veteran will be frustrated. The therapist will be frustrated and everybody around the veteran will be like, um, what's wrong with you? Like you're, you know, you're not giving it ah enough of a chance, maybe you need to try these medications when it could be a little more complex than that.
00:40:31
A.J. Woodhams
Sure. Well, what do we know about um from from veteran from Iraq war veterans? And this is a question to either you Alex, or you, Josh. um Statistically, you know what what are some of the numbers that we've got for for people who have come back from Iraq and have been diagnosed with PTSD or or some other kind of disease?
00:40:54
A.J. Woodhams
It doesn't actually have to be mental health, um some kind of war related illness. um What are, I guess, you know, the numbers are, it's not a complete story because you you just kind of alluded to this, you know, Alex, and a lot of people aren't, they don't seek treatment or um it's it's a very complicated thing. But what do we know from the numbers that we've got?
00:41:14
alex
Yep. Good. All right.
00:41:15
Josh Howe
I don't have the numbers like right in front of me, but we know from from a 2012 Congressional Budget Office report, um the the takeaways there are first that there's lot of people coming back and we're and we're not talking like one or two percent.
00:41:16
alex
ah
00:41:30
Josh Howe
We're talking like, you know, 25 percent. People coming back with TBIs, with PTSD and with other types of exposure. The the
00:41:40
A.J. Woodhams
And TBIs traumatic brain injury, ah correct?
00:41:42
alex
right
00:41:42
Josh Howe
Correct, yeah, concussions.
00:41:43
A.J. Woodhams
Yeah.
00:41:44
Josh Howe
So the that two of those things have been studied in relationship to each other, and those are are traumatic brain injuries and PTSD. um and And what that that report found is that um Like we're talking like a quarter to a third of the people who are diagnosed with with PTSD also have a TVI and vice versa.
00:42:06
Josh Howe
And those that that overlap is pretty significant because how you treat um either a brain injury or PTSD when the other one is also there changes.
00:42:13
alex
you
00:42:19
Josh Howe
It's also likely that all of those numbers are underreported. for a variety of reasons. ah The screeners miss all kinds of things. And I got to work with al Alex's medical record enough to know that like the screening itself is really problematic, but the interpretation of the screening is is just really tough.
00:42:38
Josh Howe
um The other things we know are that um even in the sort of Millennium Cohort Study, which is this long-term study of veterans that started around 2000, run out of the the Naval Research Center in San Diego,
00:42:52
Josh Howe
um You haven't had a lot of really good looks at um toxic exposures and either of those two categories, TBI or PTSD um among veterans.
00:43:06
Josh Howe
um But you have had some ah some some correlations, studies of toxic exposures and or at least the things that travel together with toxic exposures in veteran populations. And so you can see that um Eating disorders like Alex's are you know between two and five times higher and ah in veteran populations.
00:43:27
Josh Howe
um You can see that autoimmune disorders are way higher in veteran populations, particularly um female veterans, but also in male veterans. and And that's a big deal.
00:43:38
Josh Howe
um and And then a bunch of other mental health markers that are associated with PTSD and tpa TBI, but are not the same as those. um are also over indicated in veterans.
00:43:52
Josh Howe
So you see generally that you know ah this shouldn't be rocket science. War is not very good for your health, um but it's not very good for your health in some ways that are a little bit unexpected.
00:44:04
Josh Howe
um and And ultimately, there's a lot of triangulation that has to happen to be able to kind of figure this stuff out because ah folks have not studied um the veteran population in this way.
00:44:22
Josh Howe
So trying to screen for like burn pit exposure is really hard because people aren't like clocking in and clocking out of burn pits.
00:44:27
A.J. Woodhams
Yeah.
00:44:31
A.J. Woodhams
Sure.
00:44:32
Josh Howe
Having that exposure and having the symptoms is what we need to know about to provide disability and medical benefits. um But when it comes to sort of the rigor of research associating say burn pit exposure with um sort of unresolved PTSD,
00:44:48
Josh Howe
That's a kind of relationship that's a lot harder to tease out.
Collaboration and Research on Veterans' Health Challenges
00:44:52
A.J. Woodhams
Yeah.
00:44:53
Josh Howe
So that's kind of what we know.
00:44:53
A.J. Woodhams
So, Yeah. So, so Josh, so then you get so ah Alex, you've you've become a student of Josh's in ah graduate school and Josh, you're, you're an environmental historian.
00:45:03
alex
Right.
00:45:06
A.J. Woodhams
So, you know, you know that, um you know, there are certain environmental ah toxins cause certain things. while at the same time you've got Alex as a student who has has got these symptoms.
00:45:22
A.J. Woodhams
um I guess my question really is kind of how this book has come together. um Did you connect the dots in your mind that I've got this student here with these symptoms?
00:45:33
A.J. Woodhams
It just so happens that the environmental toxins that cause these symptoms, Alex was exposed to. Tell me the story of, of I guess, how that how how this came together.
00:45:46
Josh Howe
Yes, Alex showed up at Reed in 2012. Reed College is the the college i work at. And it's ah just sort of for reference, it is a very idiosyncratic, really high achieving, small, liberal arts school in the Northwest.
00:46:02
Josh Howe
um
00:46:02
alex
yeah
00:46:03
Josh Howe
we are ah we We may be majority queer at this point. We're generally the politics tend to skew heavily left. We don't have sports teams. The students are really academically engaged.
00:46:16
Josh Howe
Um, and our non-traditional student population in terms of age is pretty small and we have very few veterans. So, um, when Alex showed up in my class in 2012, taking advantage of the the GI bill to get this mass, yeah, to get a master's of liberal studies, which is the small master's program that we have at Reed.
00:46:28
A.J. Woodhams
It's a big deal.
00:46:36
Josh Howe
Um, And he's wearing a Giants hat. So, you know, I know he's a sports fan, which is ah especially then. Now it's a little bit different. I just taught a class on sports in American history at Reed. And like people are are owning up to being sports fans. But in 2012, like no none of the Reed students are wearing sports gear.
00:46:52
Josh Howe
um And so he's in my class. I noticed him, but he just ghosted after four weeks, just gone. And i asked the director of the program about it and she told me it had something to do with with his military service and with heavy your metals poisoning. And um I didn't think too much of it because I was pretty new.
00:47:11
Josh Howe
um ah wasn't even a tenure track professor yet. so But he showed up again and was it 2017 or 2018, Alex?
00:47:20
alex
2017. Yeah. yeah
00:47:23
Josh Howe
and took a couple classes with me and and we got to be we got to be friends talking about sports, but also just, um, Alex and I, uh, Alex talked a little bit about his, um, skiing background. He's a freestyle skier, bump skier. We were sort of kind of remarkably,
00:47:43
Josh Howe
disconnected in a very small universe where I was on the ski racing side growing up in Boise. And we would have been like, we must have passed each other in 15 passenger vans in the middle of the night on the highway going to events.
00:47:54
alex
Yeah.
00:47:55
Josh Howe
um I also ah did a double in English and history.
00:47:57
alex
On the ski lift.
00:47:59
Josh Howe
Yeah. We were like studying ski lift. So, um so we had stuff to talk about.
00:48:03
alex
home
00:48:04
Josh Howe
um As Alex started telling me a story, I was pretty interested in it. and I was working on this project. about how, and this is, I'm not going to go too far into this because it gets pretty esoteric, but I was looking at how, um, American foreign policymakers during the cold war were essentially redistributing toxic things around the globe by thinking about like what strategic minerals they should get where.
00:48:25
Josh Howe
And so making it possible to be exposed to like high levels of manganese in salt lake city, when that's not a place where you have like naturally occurring really high man, high levels of manganese. Um,
00:48:37
Josh Howe
But I had this like list of of metal, of ah materials that could potentially be toxic from a 1952 document that I'd been working with. and Alex and I were talking and he had just gotten this hair test that now in retrospect, having done a lot more research, I actually don't think is a great test.
00:48:55
Josh Howe
But at the time he showed it to me and looked at these lists next to each other.
00:48:57
alex
Thank you.
00:48:58
Josh Howe
And I was like, these are he's a really similar lists. Like the the metals that that this person thinks are in Alex's body are, there's a lot of them that that I'm looking at in this other context that are being sort of shipped around the world um in the cold war and making people sick, kind of what's going on. And so we talked about it and danced around a little bit.
00:49:22
Josh Howe
And then finally thinking I was like super kind of creative and and on it and ahead of the game sort of pitched this thing to Alex and turns out Alex been thinking about the whole time and was probably one step ahead of me. So.
00:49:36
Josh Howe
We put the project on hold for a year um so that Alex could write his thesis ah and i didn't want to have like a conflict of interest in that in that part. So I advised Alex's thesis. And then as soon as soon as that was done, we started digging in. And I mean, the first thing we did was this like series of interviews. I think there's like 20 hours of tape.
00:49:58
Josh Howe
that were just kind of no holds barred oral histories um where I was working from Alex's medical records and asking him questions about his tours and taking notes. And it gave him a place to start writing and me a place to start researching.
00:50:13
Josh Howe
And then once we had done those, it was on. There was no turning back at that point.
00:50:16
A.J. Woodhams
Yeah.
00:50:20
A.J. Woodhams
So I wonder, um you know Alex, you're getting you're you're getting treatment at the time. you know You're still experiencing a lot of these ah these illnesses.
00:50:31
A.J. Woodhams
you know yeah i'm I'm wondering, I guess, you know what... So the last part of the book is about are you know how how our medical system right now deals with people with illnesses like yours.
00:50:44
A.J. Woodhams
um i'm I'm wondering if I guess my question is like, how how would you characterize um the the current, how we currently deal with these types of illnesses, how our system right now deals with them?
00:50:59
A.J. Woodhams
And, um you know, as you're writing this, you know, I'm i'm i'm wondering if, you see this as maybe a call to action, it maybe is a good way to put it.
00:51:11
A.J. Woodhams
um So I'm curious on your assessment of the the treatment you received. And then, you know, i you know what are you what are you hoping that, what changes are you hoping get made?
00:51:21
alex
um I mean, woefully, but unsurprisingly unprepared. if If we kind of just look at the way our society operates around nature, it's a pretty thing. It's also a place where we get resources, but we've...
00:51:40
alex
Especially in America, we kind of like tried to kind of separate ourselves from the natural world for so long that we've forgotten that the natural world includes this room I'm sitting in that has a whole bunch of unnatural things in it that could or could not be getting absorbed into my brain and body.
00:51:58
A.J. Woodhams
Yeah.
00:51:58
alex
um I think... Especially for me, i leapt onto mercury as like the cause of all my woes and obsessed about it for the longest time because mercury is ah toxin. There's no safe level in your body.
00:52:15
alex
um But I kind of got focused on one thing, and that's indicative of not just like my own obsessions, but my own wish to just have one solution to a very complex health problem. And I think that's really how our health care system, whether it's the VA,
00:52:36
alex
the Affordable Care Act, Medicare, Medicaid, even private care is it doesn't really put an individual in the complexity of all these different crazy forces, environment, brain, your family history, um your emotions, and how all these different things are actually pulled together and interacting. It's very specialized and it tries to treat each thing on its own.
00:52:59
alex
And i think that often leads to um unsuccessful outcomes because maybe these two things are actually quite interrelated and unless you deal with this one first you're not going to be able to solve this one and i think um we're still a long way from where we need to go i think that ultimately for me has that's really what the objective of the book is, is maybe before we can change any systems or make any systems, we have to change the way that people think. And that's what Josh and I want. That's why he came up with this phrase, historical anatomy, to describe like the type of thinking that we would need to do in order to get to the right system that would say, all right, let's check you for toxins.
00:53:46
alex
Let's screen you for a TBI.
00:53:48
A.J. Woodhams
yeah
00:53:48
alex
And then also, um, open up those old wounds. um
00:53:54
A.J. Woodhams
Yeah, absolutely. And what what I think is what really struck me, um actually, Josh, is a line that that you wrote that to me was a real aha moment for a lot of this.
00:54:07
A.J. Woodhams
And that was, so Josh, you write, like environmental health conditions resulting from things like lead, mercury, and pesticides, PTSD is fundamentally a condition of exposure. We think of the impacts of PTSD as primarily psychiatric, and
00:54:18
Josh Howe
Thank you.
00:54:21
A.J. Woodhams
And those of something like lead is primarily neurobiological, but the borders between those two ways of understanding a disorder are always fuzzy and contested. And me reading that, I'm like, oh, like that's, there's like, there, you know, i think like we we think of a lot of mental health things as there's not a cause. It's just like something that happens like,
00:54:44
A.J. Woodhams
you know, in your mind or, you know, whatever. um But it to connect the dots to the toxins, to me, I thought was like a very profound thing to say. um Talk a little bit more, Josh, about like what but what we know about the connection between these these toxins and um the the illnesses that Alex has suffered.
00:55:09
Josh Howe
Yeah, it's I mean, I'm glad you you sort of brought that up. And and I'll go to something that Alex wrote right at the beginning of book when he's going through the like who gets recruited.
00:55:21
Josh Howe
And he gives a lot of statistics on on what the typical recruit looks like. At the end of that, he asks, you know, why did I get sick? Maybe I'm just lucky.
00:55:32
Josh Howe
And that's, I think, it's a good way to think about both neuropsychiatric conditions and toxic exposures, that not everybody is going to get sick from the same amount.
00:55:43
Josh Howe
um and And not everybody is going to have the same kind of experience with that sickness. And so with you know with something like lead, the CDC is going to try to come up with, for very good reasons, like a dose response curve um that says this much lead is going to do this much bad to you.
00:56:01
Josh Howe
And the reality is that different people have a bunch of other different things in their bodies that they might be responding to lead. They might be more or less sensitive to lead. um And the the exposure is really important in in kind of understanding what the potential response is, but the response itself is part of a whole person.
00:56:20
Josh Howe
um PTSD is very similar. So they did this really famous study in Detroit. where a huge percentage of the population were exposed to what are called potentially ah traumatic stressors. um But with which one, um one researcher calls traumatic exposures, which I really liked.
00:56:38
Josh Howe
um This one, Rachel Yehuda. um And, ah In that population, there's really low incidence of PTSD, despite being exposed to trauma at such high levels.
00:56:51
Josh Howe
it's It is a condition that is expressed based on a bunch of other things, right? So Sebastian Younger recently wrote a ah book about, in which he argues that
00:57:07
Josh Howe
In historical periods, warriors with ah some specific social functions and community um within their tribes experienced less of what we would call PTSD um than modern warriors might. um And I haven't sort of dug into his evidence, but the idea is that this is like a culturally specific condition.
00:57:27
Josh Howe
It's not to say that it's not real. It's very real. But the things that will make you respond to it um are are contextual. The same same with but toxicants.
00:57:38
Josh Howe
For example, you've got a little bit of of lead in your body, it might do one thing. If you've got a little bit of lead in your body, but you've also been exposed to mercury, it magnifies what that lead does significantly.
00:57:52
Josh Howe
So the things that are...
00:57:53
A.J. Woodhams
I think you're right about just even like mild stressors too, when combined with some of these things in your body um have these these types of triggers.
00:57:53
Josh Howe
Yeah.
00:57:57
Josh Howe
yeah
00:58:01
Josh Howe
And so it's synergistic, right? Like the the the things that a modern warrior is exposed to are operating together and they should be understood together on the front end and they need to be treated together on the back end.
00:58:15
Josh Howe
And that's, I think, kind of the bottom line of the book, if there is one.
00:58:20
A.J. Woodhams
Well, why do you think that, and this is my this will be my my last question. um Thank you both, by the way for for your time and for being very generous with your answers.
00:58:28
alex
Sure
00:58:28
A.J. Woodhams
so um this could actually This question might have a super long answer. um Why do you think modern medicine ah can't can't address these problems? why aren't Why aren't we able to to easily treat these types of things?
00:58:42
Josh Howe
i don't I don't think can is the problem.
00:58:42
alex
though.
Holistic Approaches to Veteran Care
00:58:44
Josh Howe
ah I think that, so we have we have a medical system, both in the VA and elsewhere, that's rooted in sort of bureaucratic structures that are captured by a profit imperative.
00:58:58
Josh Howe
For years and years, the VA was potential exception to that. Like when the VA was really beginning to be strong in the late and early 2000s, the VA was where you would go um the ver was where you would go um to be able to get an integrated approach to a ah whole person.
00:59:15
Josh Howe
There's no better institution, I don't think, than the VA for being able to do this. But when you strip funding from the VA, and more recently, when you eliminate the funding for their partnerships with the NIH to be able to study these things in the long term,
00:59:30
Josh Howe
and eliminate um jobs for veterans at the VA and try to quote unquote streamline it to make it look like what is essentially a not particularly functional civilian medical system.
00:59:43
Josh Howe
um You eliminate the what is the sort of beauty of an organization like the VA and that is that they can be tailored to provide the integrated care that um veterans specific conditions require.
00:59:58
Josh Howe
So I think modern medicine totally can do this. And we write about this a little bit, right? So I have this this friend who's a rheumatologist at NYU and and she would have been the the person for Alex to to go to, but there's just no way that he would end up in her office because of the way that we've structured medicine bureaucratically.
01:00:18
Josh Howe
This is not a technical problem. um This is a problem of administration.
01:00:23
A.J. Woodhams
Well, I know I just said that my last question is going to be my last question, but it's not. I've got one more question. I'm sorry. um I was
01:00:30
alex
and
01:00:32
A.J. Woodhams
ah i'm hoping both of you could leave us with um a takeaway for this book. What are you hoping that readers take away from this? This is a question to both of you, and then we'll end.
01:00:47
alex
You want to go first, Josh?
01:00:52
Josh Howe
Yeah, I mean, I've said a lot already, but I guess the last thing I'll say is that back to your Memorial Day questions, so veterans get used as a lever. They are a talisman and they are this like fictional one dimensional thing that gets used in politics um for a variety of reasons.
01:01:10
Josh Howe
And if nothing else, um following Alex's history of of service, sickness and exposure um gives a ah window into the, not just what it's like to be at war, but what it's like to be a returning veteran and and then civilian.
01:01:27
Josh Howe
um in in a modern world that doesn't necessarily pay that close of attention to to what that veteran experience is like. So if there's nothing else to take away, it's to take away that Alex, like every other veteran, a whole person.
01:01:43
Josh Howe
And treating veterans like whole people isn't just ah a medical imperative. It's also a social imperative.
Conclusion and Call for Societal Change
01:01:51
alex
Yeah, but I like that. I second all that. think the thing
01:01:55
A.J. Woodhams
Me too.
01:01:56
alex
the thing that you should take away even if you're not a veteran is that you too have a war body because maybe you haven't gone through these experiences but you may have grown up in a home that had light paint you maybe have experienced high amounts of sexual assault and maybe you were in a car crash and have an undiagnosed tbi so so everybody is walking around in their own war body. It's just matters of severity and degree.
01:02:30
alex
And if we could maybe declare that universally, we could start to build the thing that Josh and I are desperately wanting to like transpire today.
01:02:42
alex
But it's going to be an uphill fight.
01:02:43
Josh Howe
Thank you.
01:02:44
A.J. Woodhams
Yeah.
01:02:46
A.J. Woodhams
Well, well said. um Well, if people want to stay in touch with ah your guys' work, um are there any social media channels, any websites that people should know about?
01:02:56
Josh Howe
Yeah, I mean, we we would always want to shout out to places like Burn Pits 360 and Woody Warriors Project. We don't have a specific nonprofit up and running.
01:03:07
Josh Howe
We're sort of not there at the moment. You can obviously check out the book, ah make decisions, and and we're not that hard to find on the internet if you want to find us.
01:03:18
A.J. Woodhams
Great. Well, Joshua Howe and Alexander Lemons, War Body, A Marine Sniper and the Hidden Violence of Modern Warfare. um go buy a copy, go pick it up from your library. um a really, really, really great story here.
01:03:33
A.J. Woodhams
ah So glad you guys have put this book out. And thank you both for ah for coming on the show today.
01:03:40
alex
Yeah. Thank you, AJ. Appreciate it.
01:03:42
Josh Howe
Thanks a lot, AJ.