December 7, 2005
When Steve Miles saw the pictures from Abu Ghraib, his first thought
was to wonder how the hell the medics in the system had let it happen.
"The immediate question was, why haven't the docs blown the whistle?"
he remembers now. "Docs are in every prison, and so in essence they are
the frontline human rights monitors. They are there when the Red Cross
isn't. They are in places where the Red Cross never gets to go. They
should be performing that role, and in fact they are mandated to play
that role by their professional ethics." Miles began collecting all the
available medical records of prisoners who had died in U.S. custody,
discovering along the way, he says, that "about 50 percent of people
who have been tortured report that docs are involved."
That research turned into an August 2004 article in the British medical journal The Lancet
titled "Abu Ghraib: Its legacy for military medicine," the first study
of the military medical corps' involvement in the prisoner abuse taking
place in Iraqi prisons and detention camps. It has now grown into a
book, Oaths Betrayed: Military Medicine and the War on Terror,
that the 55-year-old Miles, a physician and professor of bioethics at
the University of Minnesota, expects to see published in the first half
It will be the fourth book in a career defined more by Miles's actions
than his writings. I spoke with him in mid-November, on the eve of his
most recent trip to Thailand. Back in the late '70s and early '80s,
Miles spent a lot of time working there in Cambodian refugee camps. He
developed a standard for tuberculosis care in such camps that is still
in use around the world. He also developed TB and hepatitis himself,
and nearly died. Locally, he is probably best known for his political
work on behalf of medical practices reform and universal health care,
which was the keynote of his failed 2000 campaign for the Democratic
nomination in that year's U.S. Senate race. He also played a vital role
in shepherding and promoting the program that became MinnesotaCare, the
state's health care safety net.
City Pages: Can you detail further some of the injuries
you've seen evidence of, and some of the specific practices that caused
them? The Jane Mayer New Yorker article from November 14, for
instance, referred to the practice of cuffing people's arms behind
their backs and then suspending them by their arms.
Steve Miles: The range of interrogation techniques, or abuse
techniques, is pretty much the whole array of usual stuff that happens
in countries that torture. It includes beatings, suspension,
near-asphyxia, chemical burns--there were instances of burns with
lighter fluid--kicks, slamming against the wall. There was at least one
thumbscrew I saw. Electrical shocks with, in our case, external
electrodes. I did not see any internal electrodes. There were instances
of asphyxiation, food and water deprivation, deprivation of access to
toilets, deprivation of access to medical care, forcing people to
urinate on themselves, forcing people to masturbate, to renounce their
religion, to put the urine or feces of other people on themselves,
other forms of nudity, forced fondling, verbal abuse, threats against
family, mock executions, forcing the victims to watch other family
members being abused. They also used what's called "perceptual
monopolization," which included loud noise...
CP: Sensory assault, basically.
Miles: Right. There was apparently also some administration of drugs to enable interrogation as well.
CP: How were medical personnel involved in the abuses at Abu Ghraib and elsewhere?
Miles: Actually, I found there had been four separate kinds of
abuses or neglect by the medics in the system. There had been silence.
There had been an active involvement of the medical system in the
interrogation system. There had been a wholesale failure to meet
minimal standards for the health and sanitation of the prison camps.
And there had been a deliberate effort to delay public reporting of
homicides of prisoners.
CP: Explain what you mean when you say they had "active involvement...in the interrogation system."
Miles: When [Secretary of Defense Donald] Rumsfeld wrote his
April 2003 memo [approving more extreme interrogation techniques], he
described integrating the medical system into interrogation by, first,
having medical personnel assess the suitability of a prisoner for the
course-of-interrogation plan, and second, setting monitoring and
termination criteria for that plan. So essentially what he did was lay
down a rule that the severity of the interrogation plan would be
adjusted in consultation with medical people to exploit emotional or
[Rumsfeld] then sent that plan south to Guantánamo, where [base
commander] General [Geoffrey] Miller implemented it and created a
specific mechanism called a Biscuit--that's BSCT, for Behavioral
Science Consultation Team--to perform that function. Biscuits are a
standard military type of committee. For example, if you need a
combination of medical and military advice, say, to evaluate the
flight-readiness of a depressed pilot, or to help POWs integrate back
into society, that's a standard BSCT-type role.
What Miller did was to create these counter-therapeutic
Biscuits that took clinical information, either by direct consultation
or by accessing medical records, and then devised ways to exploit
detainees' weaknesses. And they passed this information on to military
intelligence as military intelligence was developing an interrogation
plan--which was unique for each prisoner.
The other thing that Rumsfeld did that was new, and that Miller
was enthusiastic about, was that previously, the guard force [in
military prisons] had been passive with regard to the interrogation
process. That is, the guards were maintaining the security of the
prison, and they would escort prisoners to interrogation and back. That
was the extent of it. What Miller and Rumsfeld did was, they said the
prison cellblock environment will be part of the process of breaking
the prisoners down. And so this interrogation plan--which included
stress deprivation, humiliation, bags over the head, being nude, sleep
deprivation, all that jazz--was implemented in the cellblock areas. So
there was no area of the prison, really, that was outside the
interrogation process. The other thing that did was, it wound up
totally disintegrating the command of the prisons, because now you had
so many people with roles in interrogation. Intelligence people had a
role, guards had a role, the independent contractor intelligence
agencies like CACI had some role. The facility command structure itself
didn't include any overarching command for these interrogation centers.
That meant nobody was in charge. This goes for all the prisons where
they were doing interrogations, which was most of them. The major ones
were Guantánamo, Abu Ghraib, and Bagram in Afghanistan.
CP: What's the official number of prisoners who have died in custody now? In your book manuscript, you allude to 20 such cases.
Miles: I allude to 20, but you'll also notice that I list a whole lot of exclusions.
[Editor's note: In Oaths Betrayed, Miles elaborates
that this figure "does not include criminal homicides on the
battlefield or during the time between capture and imprisonment. It
does not include murders of prisoners by Afghan or Iraqi forces who
were working with U.S. forces. It does not include homicides of ghost
prisoners in U.S. custody. It does not include homicides among the
deaths that were incompletely or inaccurately investigated. It does not
include homicides among persons who disappeared after U.S. authorities
sent them to be interrogated in countries that practice torture. It
does not include prisoners who died of medical neglect, those who were
needlessly and illegally exposed to mortar attacks on prisons, or at
least 20 justifiable homicides of 'rioting' prisoners."]
One of the things is, the military won't provide a listing.
They throw out various numbers from time to time, but they always throw
out partial lists of names. So it's impossible to get a firm bead [on
the numbers]. One of the things they're obliged to do under the Geneva
Conventions--which, by our own admission, do apply to Iraq--is to
supply a list of every prisoner who died. They won't do that. So I
don't know. Certainly one could say that my number is the absolute,
impossibly low end. How high it goes, I don't know. Much higher.
CP: The official excuse for Abu Ghraib was that some grunt
soldiers got overzealous, but you're describing a system in which
virtually everyone who deals with these prisoners is a party to either
devising or executing an "interrogation" plan.
Miles: Well, there are different kinds of prisons. For example,
Abu Ghraib had its intelligence area. It also had an area for common
criminals--car thieves and that kind of thing. But it's clear that
there was an essentially unified system of interrogational abuse, and
deprivation of fundamental prisoners' rights, which varied in quality
from site to site. For example, the hospital at Guantánamo is actually
a pretty good hospital if you have a ruptured appendix. But the
approach is fundamentally the same across the prisons at Guantánamo and
inside Iraq and Afghanistan, in terms of interrogational abuses. So,
for at least the various units at Guantánamo, with the possible
exception of the CIA facility there, and for at least 30 prisons in
Iraq and at least nine in Afghanistan, the policies are the same.
It's not a gulag. Amnesty [International] is wrong on that. But it is
an archipelago. The gulag was the Stalin labor camp system, and the
scale of it was absolutely gargantuan. This is an archipelago of
prisons in the sense that all these prisons were operating under the
same set of policies. This is not a few bad apples. The policy poster
for Abu Ghraib came from Bagram. The Biscuit concept at Abu Ghraib came
But it wasn't a gulag, because dissent [by facility staff] was
possible. Dissent was not possible in the [Soviet] gulags. If you
worked in the gulag and dissented, you were put into the gulag
yourself. Whereas here, there was a smothering of dissent, or
occasionally dissent would lead to very local disciplinary actions. But
none of the people who dissented were ever at risk of dropping into the
system itself. That's an important difference, because it raises the
question of how we got so far off the beam. It was not because we
terrorized our own staff. They just went along.
The other thing the public has missed in this story is that
there's a huge body of literature showing not only that torture doesn't
work, but that it's counterproductive. Torture radicalizes people. In
fact, the Israeli torture of Palestinians was actually seen by some as
redemptive, in terms of validating the evil of the Israeli side and the
rightness of the Palestinian cause. It validated their own importance
as torture survivors, and it validated their membership in the group.
The CIA did about 200 studies of torture from 1953 to 1974, under two
successive projects, one called MK Ultra and one called MK Search. That
collective body of work found that torture didn't work. The Brits found
the same thing when they were using interrogational torture on the IRA.
Whether torture works as a terrorizing tool is a different matter. But
what happens is, any intelligence system has more data than it has
analytical capability. And what torture does is to flood the analytic
system with bad data. So you wind up with people like this guy we took
to Egypt and had tortured there, who said that Saddam Hussein had a
deal with al Qaeda to do biological weapons. You wind up making very
bad policy decisions from that kind of advice. You also wind up
alienating potential informants or potential recruits who are in the
The other interesting thing is, some of the proponents of
torture cite some dubiously documented tactical successes with
interrogational torture by the French during the Algerian war, but the
fact of the matter is that the use of interrogational torture by the
French was a key factor in inflaming the Algerian population against
the French, and the French lost the war. A similar phenomenon has
happened in Iraq. According to our own government's surveys, we took
about a 50 percent hit in terms of the legitimacy of the occupation
between the time before and the period after the photographs came out.
So the torture has not defused time bombs, but it also turns out to be
extremely counterproductive in terms of strategy and intelligence. The
memos leading up to the debate about torture--the Yoo memos [arguing
that the Geneva Conventions did not apply in Afghanistan], for
example--are a classic example of lawyers chasing topics in a formal,
legal sense when they know nothing about the topic itself. Because of
the way those memos were structured, the permission for torture was
given without any substantive discussion about whether it would work,
or what the drawbacks would be of implementing it.
And so we wound up, really, with a nightmare. If you go read the
Chinese response to our human rights report on China this year, it's
amazing. The U.S. State Department, in its annual review of human
rights, accused the Chinese of secret detentions, deaths of prisoners,
unfair trials, blah blah blah. And the Chinese said, any nation that
has suspended international law has no right to criticize any other
CP: Is there any research, or have you given any thought, to the long-term effects of torture on the torturers?
Miles: I've tried to find it. There's some interesting data, two
major sets. First of all, the general level of PTSD [posttraumatic
stress disorder] among soldiers is pretty high. [Psychiatrist and
author Robert Jay] Lifton did some work looking at the special
psychological damage done to people who participated in atrocities, in
a book called Home from the War. It was a study of those vets
who threw their medals over the White House wall. There's also an
interesting paper I found which suggests that levels of PTSD in
returning veterans are higher in soldiers who have killed than in
soldiers who have just been in battle conditions. Interestingly enough,
they're especially high in people who commit atrocities. So I think
there's good reason to believe that we will bear an extra burden of
psychological disability, with all the social consequences of that, in
the many people, from physicians to guards, who were involved in this
When Congress shut down MK Ultra, MK Search ran for another six or
seven years. It was essentially a successor program. [Then-CIA director
Richard] Helms ran it. He destroyed the original papers to try to
suppress the names of the universities that cooperated in the original
research, but the findings of the MK Ultra and the first part of MK
Search were published in a memo that's available online. It's called
the Kubark Intelligence Manual. It flat-out says that torture doesn't
work. Then, in 1997, an Army counterintelligence memo summarized the
conclusions of the rest of MK Search. It said that force is a poor
technique. Plus there's countless documents that I found by
interrogators saying, we're getting junk out of torturing these people.
The FBI people were just horrified. The FBI's an interesting
organization, because although there were various individual dissents
by senior intelligence people who knew that this was a messed-up
procedure from the get-go, it was only the FBI that, as an institution,
fought the Army tooth and nail. It's very amazing.
CP: How was the FBI even in this dialogue?
Miles: It turns out this is a very complicated operation. What's going on is this: The SEALs and the CIA basically got the
operation in Afghanistan. The Navy, Army, and CIA are in charge at
Guantánamo. Iraq is essentially an Army/ CIA operation. The FBI's role
is to look at particular prisoners where there is evidence they know of
some activity on U.S. soil. It's not an international policing role.
But they would get called in to certain cases.
The FBI people saw the abusive techniques the Army was using and they went nuts. They went nuts.
First they offered to retrain the Army people because they thought they
were so messed up. They took them up to their own center and tried to
retrain them. They sent Miller a memo stating at length exactly why
what he was doing was illegal as sin. They finally wound up telling
their people, "Anytime you see a departure from our policy standards
for interrogation, you are to immediately dissociate yourself from the
interview and leave the site and have nothing to do with it." They
essentially broke away, because they couldn't get the Army to change.
One absolutely spectacular thing--there was this guy down in
Guantánamo, and the FBI said, let us talk to him for a couple of days.
Their technique is rapport-building. They talked to him, they got
information out of him, and then the Army people came in with their
characteristic thing: We think you FBI guys are wimps, and you don't
really know how to squeeze these people. So they worked him over for a
couple of days and they couldn't get any more out of him. They admitted
as much right away. The FBI guys wired this back to headquarters, but
also said it wasn't going to make any difference, because these people
in the Army were committed to their strategy. I have to tell you that
if anybody's got a white hat in all this--at least the Guantánamo
operation--it's the FBI. That shocked me.