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Studying the Effects of Agent Orange on Veterans

September 26, 1987

While in general sympathy with the intent and substance of The Times editorial concerning Agent Orange ("Mysteries of Agent Orange," Sept. 15), I do feel compelled, as someone working closely with this problem, to offer some additional comments that pertain to the activities of local Veterans Administration facilities.

As you may know, for more than 10 years the VA has been intensively involved in coordinating and monitoring a variety of clinical and epidemiological studies designed to better understand the long-range clinical affect of agent orange exposure. The information gained from the investigations thus far has been fragmentary and often unhelpful in terms of assuaging the fears of exposed veterans and their families.

Nonetheless, the VA, in good faith, continues to pursue these efforts in hopes of arriving at some final answers that will meet the standards of rigid scientific as well as public inquiry.

Integral to this total investigative process has been the establishment of a central registry for all veterans claiming exposure to Agent Orange in the course of their Vietnam tours. Each VA medical facility is required to provide a thorough clinical evaluation on each veteran claiming exposure to Agent Orange.

The evaluation itself includes a history, physical examination, laboratory tests and sub-specialty consultations when indicated. The information, once obtained, is then forwarded to the registry collection point in Washington, D.C. As the coordinator of this project at our VA Medical Center, I can assure you that no test, consultation or other diagnostic procedure is spared in our endeavor to detect any and all disease processes that could be associated with exposure to this toxic agent.

The veterans are then informed verbally and in writing as to the results of the studies and the clinical implications of any positive findings. Furthermore, at our facility, we have continued to provide education, support and additional clinical evaluations when medically indicated or so requested by the veteran.

Thus, I believe it can be amply demonstrated that many individual VA facilities, particularly our own, are keenly aware of and sensitive to the many legitimate fears and anxieties of the veteran exposed to Agent Orange.

Accordingly your statement in the editorial that, "Bureaucratic lack of interest" is all that has greeted the veterans' need for peace of mind and medical advice seems to me grossly presumptuous and misleading. While this may seem to be the case at the federal level, it is certainly not a valid appraisal of the performance of individual VA's at the local level.

BASIL CLYMAN, M.D.

Associate Chief of Staff

Ambulatory Care

VA Medical Center

Sepulveda

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