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The Vietnam War ended more than 40 years ago, but it continues to claim soldiers’ lives. Nearly every spring new names are etched into the black granite walls of the Vietnam Veterans Memorial in Washington, D.C., that pays tribute to the more than 58,000 service members who lost their lives.

Jim McGough is one of them. As a 19-year-old infantry soldier, McGough was with his unit near the Laotian border in 1971 when they came under fire. A grenade exploded nearby, tearing up his feet and lower legs. McGough was taken by medevac to Okinawa, where he underwent surgery, including a transfusion to replace the blood he had lost. Unable to wear army boots after the injury, he was shipped back to the States, where he married his high school sweetheart, Sheryl Isaacson, and they settled down near their hometown of Fort Dodge, Iowa.

Twenty years passed before McGough, who worked in magazine advertising sales, learned that he had , a blood-borne viral infection that attacks the liver and can cause scarring called cirrhosis and liver cancer. The virus only was , and routine testing of the blood supply began shortly afterward. It was about that time that McGough, a regular Red Cross blood donor, learned he had been infected. He’d never been an intravenous drug user or gotten tattoos, common routes of infection, so the McGoughs figured he must have contracted the virus when he had the blood transfusion in Japan.

Veterans are more than as members of the general population, studies have found. The virus is significantly more common among Vietnam era veterans than those of any other service era.

McGough went to a liver specialist, who found no damage. The standard treatment at the time, a combination of the drugs interferon and ribavirin, had debilitating side effects. So Jim and Sheryl, who had two daughters, decided not to do anything.

“We were having a great time,” said Sheryl, now 62. “We’re going, ‘No big deal.’ When you’re young, you’re invincible.”

In his late 40s, Jim started to show signs of liver damage. About that time, he and Sheryl took a trip to the nation’s capital, and visited the Vietnam Memorial. He thought it was magnificent, Sheryl remembers, and told her, “If this thing kills me, I want to get my name added.”

In January 2014, the virus did kill him. Jim had gone through the interferon treatment but couldn’t shake the disease and finally succumbed to liver cancer.

In order to have their names added to “The Wall,” Vietnam veterans have to meet criteria established by the Department of Defense. Many of the 376 names that have been added since the memorial was completed in 1982 are people who died during the war or shortly afterward but whose records were misplaced, for example, or who were overlooked for other reasons. Their deaths of injuries sustained during the war in Vietnam or a defined combat zone. A number of causes of death , including exposure to the defoliant Agent Orange or similar chemicals, illness or suicide related to post-traumatic stress disorder, diabetes, cancer and heart attack.

“They reject far more than they accept,” said Tim Tetz, director of outreach for the Vietnam Veterans Memorial Fund, which founded the memorial and is responsible for adding new names to it.

In McGough’s case, at the bottom of a box in their basement he and Sheryl found a handwritten note from a nurse in Okinawa ordering a blood transfusion for Jim the day after he was wounded. That was the documentation they needed to prove his disease was service related so he could qualify for veteran’s disability benefits. Later, after his death and a lengthy application and evaluation, adding McGough’s name to the memorial also was approved.

In addition to Jim McGough, seven names were inscribed in 2016. There’s not much room left to add more names, Tetz said, at least not long ones. There’s space for one more long name, he said, fewer than 20 medium-length names and a basically unlimited number of short ones. It’s an issue that the National Park Service is wrestling with, according to Tetz.

In 2013, the first of a number of pricey new drugs was approved by the Food and Drug Administration that in as little as eight weeks with few side effects. Yet the price tags for a course of treatment, which can exceed $84,000, created financial challenges for programs like the Veterans Health Administration. But with additional financial support from Congress, the VHA has reduced the number of vets who are eligible for treatment from 145,000 to 71,000, said Dr. David Ross, director of the HIV, Hepatitis, and Public Health Pathogens Programs at Department of Veterans Affairs.

It was too late for McGough, though, who died just weeks before the drug came on the market.

“I can hardly bear to watch those commercials,” said Sheryl. “It’s just heartbreaking.”

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