Fort Stewart, Ga. Col. Paula Underwood, an Army doctor, had just returned to her post in Germany from the 1991 Gulf War when she saw a patient whose condition baffled other doctors.
The patient was a soldier, also just back from the war, who complained of memory loss. He could no longer find his way from home to work. He had trouble remembering how to make his morning coffee.
He was the first of 72 patients with unexplained illnesses Underwood would see before leaving Germany in 1993. Some complained of aches and pains. Others said they got sick more often than normal.
"There were a variety of concerns they had, none of which fit into a neat category," said Underwood, now chief of the medical staff at Fort Stewart's Winn Army Community Hospital. "These were the days before anybody talked about the so-called Gulf War Syndrome."
Twelve years later, Underwood and her staff are preparing to screen 16,500 soldiers of the Army's 3rd Infantry Division returning from Iraq for any symptoms that might point to a new wave of illnesses.
It is part of a militarywide effort to avoid the delays and denials sick soldiers faced after the first Gulf War, as well as the lack of early data that stymied scientists trying to solve the mystery.
"We're prepared this time, whereas in the first Gulf War we really weren't," Underwood said. "We're doing it across the board, and we're not waiting for them to come to us. When I stop and think about it, this is unprecedented, really, in military medicine."
The Pentagon has ordered health screenings for every U.S. service member deployed for the Iraq war -- from Army infantrymen and Marines who fought on the ground to Air Force fighter pilots and Navy crews serving aboard aircraft carriers.
Within 30 days of their homecoming, everyone will fill out a health questionnaire, review it with a health provider and give a blood sample that will be kept in case the person develops symptoms later.
The five-page questionnaire will ask troops if they developed any symptoms while deployed such as chronic cough, rashes or diarrhea. They will be asked to list possible exposures to such things as pesticides, oil fires, or biological and chemical weapons.
The form also asks whether they have had problems with depression or stress.
An estimated 250,000 troops -- including National Guardsmen and reservists -- were sent to the Persian Gulf region during the war.