Silent Storms: Toxic Exposure and the Hidden Burden on Veterans

06-08-2025

By Dr. Howard Friedman MD | Veteran | U.S. Army Medical Corps | Internal Medicine | HHOM LLC

He fought for his country. Now he fights for breath. The battle didn’t end overseas—it lingers in every inhaled memory of smoke and silence

Silent storms from battles past,

Drift in dust and toxic cast.

Invisible wounds, the lungs can’t see,

Linger on through memory.

But truth will speak, and light will show—

What every veteran must know.

—Dr. Howard Friedman, MD

The Immune System: Our Sentinel and Saboteur

We are alive today because of the remarkable vigilance of our immune systems. This system—intricate, tireless, and uniquely individual—serves as both our protector and, at times, our greatest threat. While the immune system defends against infection, its dysfunction is often the hidden trigger behind chronic, non-infectious diseases.

Just as no two fingerprints are alike, our immune responses are shaped by a lifetime of genetics, experiences, and exposures. And yet, when faced with toxic assault—from Agent Orange to burn pit smoke—the immune system responds in familiar ways: inflammation, hyperactivity, and ultimately, collateral damage. What begins as a defense can become a prolonged attack, leaving behind a trail of chronic illness.

From respiratory conditions to autoimmune diseases, from neuropathies to malignancies, the common thread in many post-deployment syndromes is inflammation—sparked and sustained by environmental exposure. This blog explores how similar exposures can trigger vastly different conditions in different people, depending on the uniqueness of their immune system.

Agent Orange: A Legacy Still Felt

During the Vietnam War, Agent Orange was sprayed across jungles as a defoliant. Veterans were told it was safe. Later, many began developing alarming health conditions. Rather than investigate, the VA initially denied the connection. It took persistent advocacy and undeniable evidence for the truth to surface.

The result was the Agent Orange Registry—still active today—and a growing list of presumptive conditions. But what most don’t realize is that Agent Orange wasn’t the only herbicide used. Others were sprayed, but veterans who served in Vietnam are presumed exposed to Agent Orange, regardless of which specific compound they encountered.

We now understand that toxic exposure can lead to complex, cascading health effects. Conditions like Parkinson’s Disease can be connected to secondary disorders such as sleep apnea. Depression may accompany or worsen a cancer diagnosis. Kidney failure may follow multiple myeloma. The human body doesn’t compartmentalize these struggles; neither should we.

Thanks to the PACT Act, there’s been a long-overdue expansion in how the VA handles toxic exposure. The law enhances eligibility for VA healthcare and recognizes many more conditions as presumptively service-connected—not only for Agent Orange but for other exposures including burn pits.

Burn Pits and the Post-9/11 Era

In Iraq, Afghanistan, Kuwait, Somalia, and other conflict zones, the military used open-air burn pits to dispose of nearly everything—trash, plastics, electronics, medical waste, and even ammunition. The result? Clouds of toxic smoke inhaled by countless service members.

For years, these exposures were ignored. Slowly, patterns emerged: rare cancers, severe respiratory illnesses, and autoimmune disorders affecting previously healthy soldiers. The VA now acknowledges this through Toxic Exposure Screening and the Airborne Hazards and Open Burn Pit Registry.

The PACT Act also mandates screening and expands presumptive coverage for veterans exposed during the Gulf War and post-9/11 conflicts. It's a start—but for many, it's too little, too late.

The Hidden Burden of Delay

What do Agent Orange and burn pits have in common? A decade or more passed between exposure and recognition. For many veterans, that delay means symptoms dismissed, diagnoses missed, and benefits denied.

Not every veteran will develop the same conditions. That’s the burden and the challenge. Our immune systems react differently—some over-respond, others break down. And unless a condition is common enough to be added to a presumptive list, the burden of proof falls squarely on the veteran. That’s a weight no one should have to carry alone. This isn’t just a medical issue—it’s a family issue. Delayed diagnoses, financial strain, and emotional trauma ripple through marriages, children, and communities.

What to Ask for at Your VA Visit

If you served in Vietnam, the Gulf War, or anywhere in the Middle East or Africa, you must request a Toxic Exposure Screening at your VA visit. This is now policy, and you are entitled to it.

Bring a written list of your symptoms, deployments, and service history. Ask for referrals to specialists. Do not minimize your experience. Every cough, every ache, every unexplained symptom matters. And above all—your provider should listen.

Final Message

Every veteran swore an oath to serve and protect this country. That oath must be returned—with respect, evaluation, and care. Early detection can save lives. Information leads to advocacy. And no one should navigate this alone.

At Howard’s House of Medicine, we believe in listening deeply, investigating thoroughly, and standing with veterans in their fight for recognition and treatment. Whether it’s helping you understand your condition, writing expert medical opinions, or advocating for VA benefits, we are here for you.

Let this blog be more than information. Let it be a call to action.

—Dr. Howard Friedman MD

Board-Certified | Internal Medicine | Veteran | U.S. Army Medical Corps

Founder of Howard’s House of Medicine (HHOM LLC)

https://www.hhomllc.com

Frequently Asked Questions

Q; Why don’t all veterans exposed to the same toxins develop the same illnesses?

A:Because no two immune systems are exactly alike. Genetics, age, prior health conditions, and even stress levels all shape how your body responds. One veteran might develop chronic respiratory disease; another, autoimmune issues; a third may feel fine for years before symptoms emerge. Toxic exposure acts as a trigger—but how that trigger plays out depends on your body’s unique biology.

Q: What is the PACT Act and how does it help veterans with toxic exposure?

A: The PACT Act expands the list of conditions presumed to be service-connected due to exposure to burn pits, Agent Orange, and other environmental hazards. It mandates Toxic Exposure Screenings at VA visits and broadens eligibility for benefits and care. Importantly, it shifts part of the burden of proof off the veteran’s shoulders—acknowledging the scientific connection between deployment and long-term illness.

Q: What should I bring or say during my VA visit to be taken seriously?

A: Come prepared. Bring a written summary of your service locations, known exposures, symptoms, and how long they’ve been going on. Be specific—don’t downplay fatigue, joint pain, cough, memory issues, or mood changes. Ask directly for a Toxic Exposure Screening and request referrals if needed. You’re not exaggerating—you’re advocating for the care you’ve earned.