Nearly 15 years ago, shortly after I had become the editorial director of U.S. Medicine, I was attending a professional journalism event in Washington, DC, and was chatting with a young man who was looking for employment as a writer. When I told him how excited I was about covering healthcare issues related to the VA and military, he scoffed.
“My brother joined up after high school,” he told me. “He was in Iraq but never really saw combat. He got computer training, worked in an office and, then, when he got back, went to college on a free ride. He was no hero. It’s not what you think.”
Needless to say, I didn’t hire the young man. But I also never forgot what he said.
Over the years, I’ve realized that his is a more common view than you might expect—especially from younger people. In some ways, military healthcare is a victim of its own success. Such a high percentage of warfighters survive even serious wounds that many Americans 50 and younger have never met a Gold Star mother or even know what one is.
Less than one-half of 1% of Americans were on active-duty during the Iraq and Afghanistan wars, compared to nearly 10% during the Vietnam War. So, it is not surprising that many people might not have had that much exposure to veterans.
For someone my age, the draft touched nearly everyone during the Vietnam era and, because I grew up in a small town in Georgia, I knew many, many people who served in Vietnam. Of course, my father and nearly all the fathers of my childhood friends—and many mothers—were deployed during World War II and Korea.
Although I moved to Atlanta more than 50 years ago for college and then stayed, I still live in Georgia, which is one of the top five states for military recruitment and one of the 10 with the greatest number of veterans. Many of my friends and acquaintances have military backgrounds and/or work for the Atlanta VAMC, including my neighbor, a hospitalist and a close friend, a radiologist.
Because of my age, living where I do and having served as the editorial director for U.S. Medicine for all these years, I’ve come to understand something very important about U.S. military veterans: Whatever cynics might tell you, they give so much to their country during their years of service, but then their sacrifices never really end.
So many of the cancers and other diseases we discuss in this issue of the Compendium of Federal Medicine are presumptive conditions caused by exposure and harsh conditions that military personnel face. You didn’t have to be in combat to do your part and also be exposed to burn pits or contaminated water or toxic chemicals.
Many of the conditions linked to those exposures are now presumed to be related to service—blood cancer among them. In this edition of the Compendium of Federal Medicine, we have in-depth articles on chronic lymphocytic leukemia, polycythemia vera and other myeloproliferative neoplasms and multiple myeloma. Environmental exposure also can increase the risk of some solid-tumor malignancies, and articles on nonsmall-cell lung cancer, endometrial cancer and prostate cancer are included in this issue.
Neurological conditions such as Parkinson’s disease and amyotrophic lateral sclerosis also have different risk levels and presentations in veterans. In terms of psychiatric diagnoses, another article explores the link between bipolar disorder and high rates of military and veteran suicides. We also delve into lesser-known topics such as hypoparathyroidism and new treatment options.
Then there are the questions we address that are highly specific to the U.S. military and the VA:
- How does unintended pregnancy affect military readiness, and what can be done about it?
- What weight loss drugs are being used in the VA and military to address the obesity epidemic, and how are they working?
- What is the VA doing to make sure that the million veterans it treats for diabetes are protected against heart disease?
- How dangerous is respiratory syncytial virus to VHA patients compared to influenza and COVID-19, and how much does the vaccine help?
It is my hope that the information we provide in the 2025 Compendium of Federal Medicine will help you in your mission: to care for servicemembers and veterans. It is obvious to me that not only servicemembers and veterans but also those who care for them are heroes at a time when we really need them.