Gambit Weekly (New Orleans)

The Silent Killer

Ovarian cancer is called "the silent killer" because it usually goes undetected until its advanced stages. It is the fifth leading cause of cancer deaths among American women, according to the Ovarian Cancer National Alliance (OCNA), and strikes one in 55 women in this country. Christie Buckner, 32, is among them.

* * * * *

Silent killer? Not in my case. My cancer spoke up loud and clear, and so did I, but my doctor didn't listen.

It was the summer of 2000. I had just turned 30 and had just started working for the Ritz-Carlton as a market research analyst. One night I had a sharp pelvic pain while passing a small gas bubble. I'm not a hypochondriac or an alarmist, but this was such an odd thing that I went to my gynecologist, who ordered ultrasounds. One ovarian cyst was found.

Then I began to have pelvic pains, so I made another appointment. In July I had more ultrasounds. This was my idea, so my gynecologist could compare the two sets.

I was told the cyst had gotten slightly smaller. Well, the cyst hadn't gotten smaller -- it was another cyst on the other ovary, and the first one was gone! Apparently no one noticed. I didn't see the report. I was told I didn't have cancer, but no one ran a CA-125 (cancer antigen 125, a tumor marker). In January, I called back because the symptoms never went away; they got worse. I couldn't get access to my doctor by phone. When I demanded an appointment, the soonest they would give me was six weeks later.

I insisted on getting a third set of films, which were read by what I consider a grossly negligent radiologist. His report said it was possible I had pelvic inflammatory disease or endometriosis (which occurs when the uterine lining grows outside the uterus). The ultrasounds indicated I had fluid in my abdomen -- a red flag for ovarian cancer. He noted this in the report, but neither he nor my gynecologist put two and two together.

At the appointment I asked my doctor, "Do you want to know what my symptoms are?" I said they were mostly digestive and went on to explain them -- and the doctor said dismissively, "Well, have you seen someone for the digestive problem?"

I had done research and I knew I had textbook ovarian cancer symptoms. I knew that gynecologic problems can cause gastrointestinal symptoms -- and I've never been to medical school.

My doctor said I might have endometriosis. She suggested hormone therapy or a laparoscopy (when a physician inserts a telescope-like instrument into the abdomen to see the reproductive organs). I said, "What would you do?" She said she thought a laparoscopy was invasive, so she wouldn't do that.

I left there and returned to work, where a friend gave me her gynecologist's number. I got an appointment for two days later.

At my appointment the physician's assistant opened my file -- which I had demanded from the other doctor -- and said, "You need surgery." She left the room, I later found out, to go get the doctor -- and tell her, "I've got somebody here I think has cancer."

My new doctor said I needed surgery right away to determine if I had cancer or endometriosis. If the endometriosis was very bad, a hysterectomy might be required. If it was cancer, a hysterectomy and possibly a colostomy might be called for.

The doctor didn't trust my radiology reports. So before the surgery I went for more radiology work although we had 10-day-old ultrasounds. The second radiologist did a trans-pelvic and a trans-abdominal, and all the signs were there. He looked at the films from 10 days earlier and saw the same signs -- things that would lead a physician to suspect ovarian cancer.

I was praying it was endometriosis. I had surgery April 4th. In addition to performing a complete hysterectomy and appendectomy, the surgeon had to remove both ovaries, the layer of tissue called the omentum, a large, flat tumor and many small nodules of Ovarian Serous Carcinoma. I had Stage III-C ovarian cancer.

I woke up in terrible pain. I had asked my mom to tell me the results as soon as I woke up. She said it was cancer. I said, "Cancer."

* * * * *

Ovarian cancer presents a specific danger to women for several reasons. For one, there is no early screening test for ovarian cancer; Pap smears don't detect it. So women with ovarian cancer usually don't see a doctor until they have symptoms, and by then the cancer is usually advanced. Also, symptoms of ovarian cancer are vague and often mimic gastrological or digestive problems. Many women don't think to go to a gynecologist for such symptoms. In some cases, as in Buckner's, a gynecologist will recommend consulting another specialist.

Ovarian cancer is defined in four "stages," with the first three divided into subgroups A, B and C, depending on the cancer's progress.

In Stage I, the cancer is limited to one or both ovaries. In Stage II, it has spread (metastasized) to other reproductive organs. When caught in these stages, women have about a 90 to 95 percent five-year survival rate, according to OCNA.

In Stage III, the cancer has spread to the abdominal lining or lymph nodes. Stage IV cancer has metastasized to the lungs, liver or sites outside the abdomen. When diagnosed in these stages, the chance of five-year survival is only about 25 percent.

In the United States, 75 percent of ovarian cancer cases are detected in Stages III and IV.

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I was scared for my life, so losing reproductive organs wasn't the biggest issue. I've always believed in adoption and had planned to adopt regardless of whether I had children biologically. The hysterectomy was still a very big deal, on the vanity level alone. I'd always had a flat, perfect tummy. Now I've got this big scar that loops around my belly button and makes my abdomen lumpy.

But I was willing to give in to all that, and I knew that I'd have to have chemotherapy and lose my long hair. As important as all those things had been to me at one time, I immediately had an appropriate sense of perspective. My horror was full-blown at the prospect of losing my life.

Three weeks after surgery I rushed into chemo. I began the standard regimen of carboplatin and Taxol. At my first treatment, I cried at how many people came into the infusion room for chemotherapy. It's a terrible club to belong to, but there are some really great people in it. The hard part is that when you make friends in the chemo office, they die on you sometimes.

I lost my hair 10 days after that treatment. I had waist-length, curly, blonde hair and it started falling out rapidly. It hurt to touch my scalp. Every hair you'd touch would fall out, and these hairs were very long.

My mother cut it short for me. Both of us cried through the whole thing. She helped me tie a bandanna on my head and we walked outside my apartment. It was a very hard thing to do -- to step outdoors with that bandanna on my head. I was very proud of myself.

The treatments produced the usual side effects. I had some nausea, boneaches, bad acne. I had anemia, and the low white blood cells made infection a constant danger. People on chemotherapy can't even eat raw produce because the microbes found in anything uncooked can be fatal. The common cold can kill you.

After six treatments we switched from Taxol to Taxotere because I had signs of neuropathy -- nerve damage that causes numbness and tingling in fingers and toes.

I had one numb toe for a long time, but it's better. Neuropathy is irreversible and can become so severe you can't walk. That may come, and I know people who can only wear tennis shoes -- forever. On the Taxotere, my fingernails and my toenails came close to falling off.

The standard therapy was six treatments, and my gynecological oncologist thought nine was appropriate. I wanted to continue treatment after that. I did not like my odds; Stage III-C ovarian cancer patients have a 40 percent chance of five-year survival. I wanted to kill every bit of it as long as I could stand treatment.

My mother was with me every minute through three treatments. Then she had a seizure.

The CAT scan and MRI showed a brain mass. A biopsy was done and it was a glioblastoma (a fast-acting, aggressive primary brain tumor) -- the worst possible thing. Six to 12 months was the prognosis.

My mother died on April 10, 2002.

People were asked, in lieu of flowers, to donate to the Ovarian Cancer Research Fund. My dad and I knew she would want all resources to go toward fighting my battle.

My mom and I were so close; she was my best friend. Her ability to communicate began to diminish not far into her illness. When she died, nothing needed to be said. I have that peace.

I see it all the time -- trivial things that people allow themselves to be made miserable over. One person told me when her newspaper is stolen each morning it ruins her day. I felt like saying, "You want to trade?"

* * * * *

At my own insistence I endeavored to finish a year of chemotherapy. Before my last treatment, my platelets were too low and I couldn't get the chemo.

So I stopped treatment for two months and I was frightened the cancer would return. But at the same time, death didn't hold the same fear for me, since my mother had preceded me.

My next round of tests showed the cancer was back.

I sought advice from six physicians, none of whom agreed on what to do. These were all good physicians; it's just that with ovarian cancer, we're in the Dark Ages. I decided to attack it with surgery and chemo.

Journal entry: July 21, 2001

The prospect of this surgery is so frightening. We know it may not help at all but wind up so I've got a colostomy and/or urinary diversion device. And, I'm told, I've got -- well, here's how one doctor put it:

100 women are in your shoes with recurrent ovarian cancer.

50 do nothing.

50 are very aggressive -- surgery/chemo.

48 of the second 50 have exactly the same outcome as the first 50. Only two respond exceptionally well.

You have to hope to be one of the two.

I had a second surgery in July. Three weeks later, I embarked on the next round of treatments. I was given gemcitabine and a choice between carboplatin and cisplatin. I chose the stronger one, cisplatin.

It was pure hell. I had diarrhea, then for 30 hours straight I vomited every five to 10 minutes, long after there was nothing left to vomit. I prayed for death. When that receded, the antinausea medicines I took had blocked my digestive system, so I suffered terrible cramps.

I wasn't sure I could endure another treatment, but my CA-125 reflected a slight drop, so I did it again. I girded myself more heavily with antinausea medicines, and wasn't as sick. I experienced the same horrible cramping, though.

Then my CA-125 dropped dramatically. I went for a third round. This time I took some medications to ward off the gastrointestinal cramping. They worked, and it's been smooth sailing since then. The days following the infusion are certainly not fun, but I am not experiencing torment.

Right now it looks like I may be one of those two lucky ones. We'll see.

* * * * *

A range of symptoms involving various body functions can signal ovarian cancer. They are often so vague that some women ignore them for weeks or months. Such symptoms, according to the National Ovarian Cancer Coalition, include: unexplained change in bowel and/or bladder habits such as constipation, urinary frequency, and/or incontinence; gastrointestinal upset such as gas, indigestion, and/or nausea; unexplained weight loss or weight gain; pelvic and/or abdominal pain or discomfort; pelvic and/or abdominal bloating or swelling; a constant feeling of fullness; ongoing fatigue; abnormal or postmenopausal bleeding; and pain during intercourse.

Ovarian cancer experts recommend that women with any of these symptoms see a gynecologist within two to three weeks of their onset and order a full workup: a CA-125 blood test, trans-pelvic and trans-abdominal ultrasounds and a pelvic/rectal exam. If any of these tests indicate abnormalities, a visit to a gynecological oncologist is recommended to ask for advanced-imaging tests such as CAT scans, MRIs or PET scans. "Women need to know they are their own best advocate and not to be dismissed by their doctors," says NOCC's Cathy Hylinski.

* * * * *

I had attended church sporadically in recent years. Before my first surgery, I had a very rapid return to the church. When I couldn't have been more stressed and terrified, prayer was my only solace.

I have not been mad at God at any time. I asked God to spare my mother, and that didn't happen. I asked God to make me not have cancer, and that didn't happen. But these things are happening for a reason. My purpose here may be to strike a blow to this disease.

After my first surgery I asked my doctor, "Am I going to die?" -- expecting her to say something comforting. She couldn't answer. For a couple of weeks I was angry at my physicians who wouldn't tell me I was going to beat this.

I find it is a very common mindset -- now, people are angry at me. When they say to me, "It's going to be OK, right?" I can't tell them it's going to be OK. From the beginning, the odds have been overwhelmingly that I will die. The odds are that I will be dead before five years are up. I'm doing everything I can to beat this, but the Pollyanna answer would be untruthful. And no one wants to accept the bad news or the uncertain prognosis.

I would love to survive this disease. Whether I do for six months or to a ripe old age, I'll be grateful for whatever I get. This life is a gift from God. But there are worse things than dying, and death is not the end. Everything has the potential to remind me of my mortality -- whether it's organizing my filing cabinets and wondering if I'm wasting my time or buying a bottle of shampoo and wondering if I will be able to use it all up. I've made all kinds of arrangements. I've made notes about what hymns and what Bible verses I like. I volunteered on the Relay for Life committee -- I gave them the names of people I thought would be helpful next year, in case I'm not here.

One of my biggest concerns was who would get custody of my pets. My dad is going to care for them. I've thought about who could get use or enjoyment out of my possessions and have written down who should receive them.

Actually, one of the disturbing things I've thought about is who would treasure the things that my mom and I treasured -- some little tchotchke that had some crazy funny story attached to it, and no one will ever know. They'd just go to Goodwill.

* * * * *

Another problem with ovarian cancer is that doctors -- including gynecologists -- are often unaware of its symptoms.

Buckner is not the first woman whose doctors didn't catch her ovarian cancer in its initial stages. "That happens quite a bit," says Denise Saladino of LaPlace, president of the Louisiana division of the National Ovarian Cancer Coalition (NOCC). "Women often tend to get brushed off or dismissed. That seems to be a recurring story when I talk to women about when they were first diagnosed."

In 2000, gynecologic oncologist Dr. Barbara Goff, of the University of Washington School of Medicine, published a survey of 1,725 ovarian cancer patients. About a third of them had seen three or more health care providers before they were diagnosed. The most common misdiagnoses were stress, depression, gastritis and irritable bowel syndrome. Ninety-five percent reported symptoms prior to their diagnosis, but many were not tested for ovarian cancer during their first doctor's visit. Twenty-six percent were not diagnosed with ovarian cancer until more than six months after they first saw a physician complaining of symptoms. Eleven percent were diagnosed more than one year later.

Many women, like Buckner, are thought to be "too young" to have ovarian cancer, since the highest instances occur in post-menopausal women. Goff's survey showed younger women took longer to be diagnosed.

* * * * *

Ovarian cancer is, today, where breast cancer was 40 years ago.

It's wonderful that all this awareness of breast cancer has evolved over the years. That's a horrible disease, too, and it strikes one in nine women. But many forms of breast cancer are curable; many women are able to triumph over breast cancer. My mother did. But ovarian -- the odds are not so good. There needs to be more fundraising, more awareness of ovarian cancer.

We have practically a walk a weekend for breast cancer, and ovarian -- we're dying left and right. You see pink ribbons everywhere. I just found out the ribbon color for ovarian is teal. I didn't find out until Sept. 15 that September was Ovarian Cancer Awareness Month.

The best-case scenario is -- and this is very far-fetched -- that I keep myself alive for long enough and something dramatic occurs in terms of cure. However, there is nothing promising on the horizon. Nothing.

I have not given up hope. Cisplatin, the chemical I'm on, was discovered by accident. So all the money going to breast cancer research -- there can be sometimes a connection between breast and ovarian cancer, and maybe those people will stumble on a cure for my disease.

There's no way to ever know you are cancer-free. With ovarian cancer, the only way anyone can say whether you definitely have the cancer or not is to say "Yes, you do" while holding a chunk of it on a scalpel. That is the only way.

* * * * *

A family history of breast, ovarian or colon cancer puts women at heightened risk for ovarian cancer. A genetic mutation linked to breast and ovarian cancer is found on the BRCA1 and BRCA2 genes; women can undergo genetic testing to determine whether they have this mutation. Other risk factors include use of fertility drugs, uninterrupted fertility, increasing age (especially over 50) and being of Eastern European Jewish descent.

Removal of the ovaries greatly decreases the risk of ovarian cancer, though peritoneal cancer (of the tissue surrounding the ovaries) can occur without the ovaries present.

Women at risk could, along with an annual pelvic/rectal exam, elect to have a trans-vaginal ultrasound every six months or every year, or to alternate an ultrasound with a CA-125 blood test every six months. This type of screening is questionable at best, NOCA says, because the tests are expensive and not necessarily effective. The unfortunate truth is that there is simply no reliable early-detection method for ovarian cancer.

* * * * *

Journal entry: April 2, '02

I noticed something under my toenails, and I found they were oozing. Maybe I'm going to lose them. "What next?" I keep asking.

As I told the dentist today, when she tried (unsuccessfully) to get me on a prescription rinse that would stain my teeth brown, I can't take anymore assaults on my looks:

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The Mystery of the 364th

Were a thousand African-American soldiers gunned down by the Army in a racially motivated shootout in 1943?

Were members of the controversial 364th (Negro) Infantry Regiment killed at Mississippi's Camp Van Dorn to silence their relentless -- and sometimes violent -- demands for equality in a segregated Army?

Were the bodies buried in a mass grave somewhere on the sprawling base or "stacked like cordwood" and shipped north on boxcars?

That's a story that's been whispered since World War II. A Pentagon spokesman sums up its 1999 probe of the allegation: "Nothing egregious happened." But that isn't the end of it.

Historians and journalists -- including this writer -- in pursuit of this puzzling piece of American history are uncovering a nationwide trail of racial violence during World War II. There were hundreds of bloody domestic firefights from Camp Benning, Ga., to Beaumont, Texas; from Ft. Dix, N.J., to Camp Shenango, Pa.

Much of what we are learning about this racial violence is coming from recently released documents that were part of a massive, and largely unknown, wartime domestic intelligence operation. And much of what we don't know about the period is the result of government press censorship.

The ongoing controversy will be examined in an upcoming History Channel documentary, "The Mystery of the 364th," scheduled to premiere on May 20. The hour-long program explores allegations that, upon first read, seem ridiculous -- especially the charge that 1,200 soldiers were killed in a single massacre at Camp Van Dorn, and that a subsequent cover-up has gone on for almost 60 years. But even one Army commentator believes aspects of history can be hidden for generations. "Although almost too preposterous to consider at first," he wrote of the Camp Van Dorn massacre, "so too was the government's involvement in the Tuskegee Syphilis Study."

The Facts of the 364th

The 364th was an all-black regiment of soldiers that had been stationed in Jim Crow-era Centreville, Mississippi. At that time, the Army had begun intensifying its efforts to recruit blacks, but was still racially segregated. The few black regiments designated for combat were typically under-trained, under-supplied and sent to stations where they were isolated and subject to insult and attack from hostile, white civilians.

In May 1943, when the beleaguered 364th arrived in Centreville, Mississippi, the treatment it received was no exception. The men of the 364th, some of whom had already survived three previous race riots, came to Centreville announcing they were going to "clean up" the base and surrounding towns, and challenged Jim Crow laws at every turn.

White civilians, who were heavily armed, braced for a violent clash. The Army high command in Washington warned base and regimental commanders that they were to end racial violence or lose their jobs. But on May 30, within days of the 364th's arrival, the local sheriff killed one of its men, Pvt. William Walker, who had been scuffling with white MPs near the entrance to the base. Members of Walker's company broke into base storerooms, stole rifles and headed for Centreville, swearing revenge.

What followed the 364th's rally and cry is subject to conflicting reports. Allegations range from minor skirmishes and disciplinary action to wholesale slaughter. The largest newspaper in the region, The McComb Daily Enterprise, reported: "Many wild rumors floated about ... rumors of men being killed by the scores and of women being molested. All efforts to run these rumors down did nothing more than emphasize the chaotic way the public has of reacting to emotional disturbances."

There was chaos to be sure. The 364th's Morning Reports, a kind of company-by-company daily attendance sheet, note dozens of soldiers as AWOL following the Walker shooting and its aftermath. Files in the National Archives trace some who made their way north, seeking from their local induction boards asylum from what they called a life-threatening situation.

Whatever happened, in December the remaining men of the 364th were relocated to a far-off camp in the Aleutian Islands. It was then that their personnel roster began to show signs of hemorrhage. Records show that between 800 and 1,000 of the 3,000 men left the 364th before the war's end. In other words, from June 1943 until Japan's surrender, about one soldier's name per day disappeared from the 364th's roster.

Pressured by Mississippi Congressman Bennie Thompson and the NAACP -- who feared a massacre had occurred at Centreville -- the Army committed thousands of hours and hundreds of thousand of dollars to explain the massive losses. A report was finally issued on Dec. 23, 1999. "There is no documentary evidence whatsoever that any unusual or inexplicable loss of personnel occurred," the report contends.

But inconsistencies in the Army's report have diminished its credibility, leaving unanswered the same haunting questions that journalists have been investigating for years.

Not Colin Powell's Army

Before arriving in Centreville, members of the 364th Regiment had already been involved in three race riots. In fact, the Army created the 364th to reorganize the 367th, a regiment of black soldiers that had been demoralized by the January 1942 "Lee Street Riot" in Alexandria, Louisiana in which dozens were injured and, according to some reports, as many as 10 were killed. After the newly created 364th had been relocated to Phoenix, Arizona, racially motivated fighting erupted twice, killing at least three people. Ironically, it was in response to the Phoenix riots that the government shuttled the 364th to Centreville.

The 1999 Army report acknowledges a state of strained race relations as the 364th -- most of whom were from cities like Chicago, Philadelphia, and New York -- arrived in the deep South, coming by train to the isolated town of Centreville. "To a majority it was a trip into a virtually unknown and foreign land where a man of color often had to fear for his life," the report states.

These fears, according to late journalist Ron Ridenhour, were not unfounded. Ridenhour -- perhaps best known as the soldier whose letters to Congress prompted investigation into the My Lai Massacre during the Vietnam War -- spent nine years investigating the 364th's fate. During his investigation, he uncovered declassified documents that confirmed a pattern of racial violence. "Before the 364th came in, there were several unsolved murders of Negro soldiers. Their bodies were found in the field," according to Cpl. Wilbur T. Jackson of the 512th Quartermaster Regiment, another segregated black unit. "All the white farmers and civilians are armed at all times and seem to want a pitched battle with Negro soldiers."

Letters in the National Archive and in NAACP files describing the events that ensued following the murder of Pvt. William Walker echo the information in Ridenhour's files.

"We are catching hell here," a member of the 364th wrote. "Two of our men have been kill [sic] and we have only been in this camp for six days. Something worse is going to happen soon."

"There have been about 20 or 25 Negros [sic] hurt and kild [sic]," another white soldier wrote. "They [sic] have been 5 or ten shot right through the head ... and we are going to give them hell when they come around us."

Whatever happened that June in Centreville was of grave concern to the Army. "The Negro situation is fast approaching a critical stage," states one declassified memo. After the riots occurred, the Army responded harshly. An Army Inspector General report prepared after Private Walker's shooting describes the Army's reaction: "[Gen. McNair] is of the opinion that the best solution is to confine the organization to the limits of its regimental area and deprive it of all privileges until such time as it will disclose its real troublemakers."

Another Army Inspector General report concludes: "In light of the recent riotous conduct of the 364th Infantry, vigorous and prompt corrective action was necessary in order to place this regiment in such a disciplinary state that it would not again resort to mutinous conduct and to protect the lives of the citizens of Centreville and other innocent persons."

Ridenhour interviewed black vets who remember that punishment. In effect, they were subject to house arrest in a cordoned-off area within the base. White vets Ridenhour spoke to patrolled the perimeter in jeeps and half-tracks mounted with .50-caliber machine guns. More letters intercepted by military intelligence and other Ridenhour interviews make reference to sporadic gunfire exchanges across the cordon line.

In September 1943, Col. Lathe Row of the Army Inspector General's Office studied the situation and concluded, "The presence of the 364th Infantry constitutes a threat to the normal peaceful conditions at Camp Van Dorn ... [and] should be transferred at an early date ... for overseas duty."

According to most 364th regimental documents, those troops not transferred to other units left Camp Van Dorn by train Dec. 26, 1943. After waiting a month or so at Ft. Lawton, near Seattle, Wash., they embarked on three ships for the Aleutian Islands off the coast of Alaska.

Where Did They Go?

After investigating Army payroll records and hand-written notations in the Regimental Journal, Ridenhour estimated that nearly 1,000 enlisted men -- a third of the regiment -- disappeared from the Aleutians with no explanation. In fact, official records from the period raise more questions that they answer. Among the suspicious factors:

* Military personnel records crucial to the incident, along with millions of others, were destroyed in a fire in 1973.

* National Archives intelligence files released to Ridenhour were incomplete and heavily edited.

* The Army based some of the conclusions in its 1999 report on records it kept classified.

* The 364th's Regimental Journal shows no entries from the day the 364th arrives in Mississippi until Nov. 4, 1943 -- almost the entire period in question.

* The Regimental Journal's pages, starting in 1942, are signed by a Sgt. Malcolm LaPlace, whose service record proves he was not even in the service in 1942.

The 1999 Army report Executive Summary says, "There is no documentary evidence whatsoever that any unusual or inexplicable loss of personnel occurred." Attached to the report is an appendix that indicates hundreds of soldiers (almost one-fourth, it appears, of the regiment's authorized strength in the period) were transferred out of the troubled 364th to other segregated units prior to shipping out to the Aleutians. Further, the Army said it has accounted for all but 20 of the nearly 4,000 black enlisted men who served in the 364th during some period of time from April through December 1943.

But the Army's report is riddled with dozens of factual errors, marred by gaps, and suffers from internal contradictions and conflicts with other Army records that diminish its credibility.

Notably, in the report's appendix -- the document purporting to give a complete account of the enlisted men in the 364th -- Pvt. William Walker is listed as "separated from service" -- off the payroll -- as of May 15, 1943. But Walker, according to the report's own main narrative, was shot and killed in uniform near the Camp Van Dorn gates two weeks later, on May 30.

As part of the upcoming History Channel film, documentarian Greg DeHart questioned Army officials about these discrepancies. The Army penned a memo defending itself, saying that faulty record keeping in the 1940s, miscommunication about transfer orders and poorly copied records can account for the apparent conflicts.

Perhaps further research will show the worst violence at Camp Van Dorn and other bases occurred at the hands of civilians, not Army personnel. Or perhaps "troublemakers" were disappeared into a maze of secret court martials, open-ended "disciplinary" internments and dishonorable discharges.

But even if the Army's records do give a complete accounting of the whereabouts of all but 20 of the men in 364th, the records would not be the men themselves. When the Army sought to interview living members of the 364th, they turned up only 116 by the time the report was issued.

Until more witnesses to the events of 1943 step forward to speak, this dark corner of American history is unlikely to be further illuminated.

Geoffrey F.X. O'Connell's research is supported by a grant from The Fund for Investigative Journalism. He is preparing the book "Losing Private Walker" on the mystery of the 364th Infantry Regiment. Email O'Connell at

Why Are We Raising Them Fat?

The changes that have quickly advanced modern society over the past few decades have put humans in outer space and enabled scientists to protect people from once-fatal diseases. The accompanying evolution in lifestyle, however, has had a negative impact on our health: we're all getting fatter, even our children.There are lots of reasons: families are busier and depend more on high-calorie/high-fat convenience foods; people are more sedentary because of TV and computer games; and schedules have become more hectic, which affects eating habits, activity, sleep schedules and overall well being. The solutions are more simple (but not that easy): go back to basics and make good health a family affair, get adequate rest, eat a balanced diet, and get off the couch.Health professionals look at the fattening of America as a national health epidemic that is trickling down to younger and younger ages. In a report published last October in The Journal of the American Medical Association (JAMA), the national Centers for Disease Control and Prevention estimated that 22 percent of adults in this country are obese, a term that indicates body fat or a Body Mass Index (BMI) -- weight in kilograms divided by the square of height in meters -- of 30 or more. Physicians considered the topic serious enough to devote an entire issue of JAMA to studies researching the subject.Comprehensive statistics for obesity in children are not available, but health professionals believe they are comparable with trends seen in the older population. Reports printed in JAMA indicate that obesity has increased 6 percent in the United States between 1991 and 1998, and that it accounts for more than 300,000 premature deaths annually. It gets worse. The Washington, D.C.-based Worldwatch Institute research group earlier this month released a report citing statistics from the World Health Organization and other United Nations groups; it found that 55 percent of American adults are overweight, and that the obesity suffered by almost half of that number cost the United States about $118 billion last year.The prevalence of excess weight in Americans has caused a flurry of activity in the health profession, with a plethora of medical studies, renewed emphasis on exercise, development of wellness centers in hospitals, and even calls for new courses in medical schools to teach future doctors about obesity and nutrition. Former U.S. Surgeon General C. Everett Koop, who says "obesity is escalating to epidemic levels" and estimates that one in every two adults is overweight, has launched a Web site called Shape Up and Drop 10 (, an interactive weight management program that is customized for each patient.Some children are genetically inclined to have weight problems, but health professionals say about 60 percent to 70 percent of the cases can be attributed to inactivity and bad diet."Weight control, especially in kids, is a big problem today," says Melinda Sothern, who administers the 13-year-old Committed to Kids weight control program, whose findings have been published in the Journal of Obesity Research."This is a disturbing trend we've seen," she says. "We had to start a pre-school program" for overweight 3- to 5-year-olds. "At that young age, if they already are above 40 percent overweight, that's not going to go away."Cardiologist Dr. Gerald Berenson, the lead investigator of the 28-year-old Bogalusa Heart Study (conducted in Boglusa, Lousiana), says childhood weight problems can trigger other medical complications, including heart disease and diabetes. Since 1972, Berenson and his medical team have tracked health histories of people living in the doctor's hometown of Bogalusa. Children tracked in the first years of the study are now in their mid-40s, and about 1,000 of their offspring now are part of Berenson's research. The cardiologist's results, recommendations and programs for healthier living are contained in four books, 600 manuscripts and an equal number of presentations at national and international meetings."Kids are getting fatter and there is a lot less exercise," he summarizes. "I think it has to do with modern society, the availability of food, changes in diet, more inactivity." Berenson's project seeks to track indicators of heart disease in children and develop prevention programs in communities. The result is a public school program, Health Ahead, that includes instruction for food service workers, teachers, children and their families concerning low-fat food preparation, healthy eating, exercise, self-esteem and the importance of avoiding risky habits such as smoking and alcohol. He says the cost to schools is $5 to $10 per student, a small price tag considering his estimate that half of the country's 60 million school children eventually will die of heart disease."We want to try to break the natural course of heart disease," Berenson says. "What we've learned is that heart disease begins in early childhood. Children as young as 2 years old can begin to develop high cholesterol (a risk factor for coronary disease), and we've seen increases in certain diabetes in children." High blood cholesterol can lead to fatty deposits on the walls of the arteries, a condition Berenson notes was present in the bodies of children who were autopsied after they died in accidents."Very clearly, adult heart disease, hypertension, diabetes [type 2] ... and obesity begin in childhood," he says. "We know how to study risk factors in children, and we have an understanding that lifestyles begin in childhood. Most of all, we've learned the importance of prevention."The weight trends in the United States reflect a shift to a more sedentary lifestyle in which meals often comprise convenience foods, and families, especially youngsters, entertain themselves with television and computer games. Sothern says it is up to parents to minimize TV viewing times and use the computer as a learning tool instead of entertainment, and limit usage time to 30 minutes. Most of all, parents must serve as examples."The concept of 'normal' in America today is warped," Sothern says. "It's completely unnatural for the ways our bodies were designed. They were made to take in a certain amount and kind of food, get enough exercise and rest. When you deviate on both [diet and exercise], you run into trouble."


Happy Holidays!