The Cooled and the Cooked: Veterans and Extreme Heat in America

8-25-2025

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

Two Americas, one uniform: veterans divided by access to cool air or relentless heat

The sun does not ask if you can pay,

Its furnace burns the night to day.

Some rooms are cooled, their silence kind,

While others scorch the weary mind.

A nation split by heat and wealth,

One side in shade, one losing health.

---Dr. Howard Friedman M.D.

Introduction – The New Fault Line

There’s a new line running through America. It isn’t marked on a map, but you can feel it when you step outside in July. On one side are the cooled—those with steady income, central air, and the means to buy relief from the furnace. On the other side are the cooked—veterans living on fixed benefits, families working two jobs in warehouses or kitchens, the elderly in apartments where the only fan is the window itself.

Heat has always been part of summer. But this is different. Nights no longer cool the body. Days stretch beyond human tolerance. And for those with chronic illness, PTSD, or service-related injuries, the thermostat isn’t just about comfort—it is about survival. Veterans know this well. After years of serving in extremes, they come home only to find the battle continues in a quieter but no less dangerous form: a rising temperature that divides us into who can afford to heal and who cannot.

Section 1 – Heat as an Inflammatory Stressor

Heat is not just a number on a weather map—it is a biological insult. The body works within a narrow range of temperatures; once crossed, every system strains. Veterans already living with hypertension, heart disease, diabetes, or sleep apnea are pushed further toward the edge when the air will not cool.

Physiologically, heat acts like an accelerant. Dehydration thickens the blood, raising strain on the heart. Cortisol surges as the body interprets relentless heat as a stressor. Inflammation spreads through joints, vessels, and neural pathways. Sleep, the body’s primary repair system, is disrupted when nights never drop below 80 degrees. What begins as fatigue can escalate to arrhythmias, strokes, or sudden death.

For veterans, the risks are multiplied. Many take medications—beta-blockers, diuretics, antidepressants—that blunt the body’s ability to regulate temperature. PTSD and sleep apnea worsen when heat denies rest. Injuries that already limit mobility leave some unable to reach a cooling center or even open a window. What the nation calls a “heat wave” is, for these men and women, another deployment into hostile territory—only now the enemy is the climate around their own homes.

Section 2 – Economic Disparities: Who Gets Cooled, Who Gets Cooked

Heat does not strike equally. It magnifies existing divides. In one neighborhood, homes hum with air conditioning, backup generators stand ready, and bottled water stacks high in the pantry. A few miles away, windows are sealed with plastic, fans move hot air in circles, and families ration electricity because the bill is already overdue.

Veterans are often caught in this gap. Many live on fixed disability payments or pensions that leave no margin for higher utility costs. The choice becomes cruel: cool the room or buy groceries. Those still working often find themselves in warehouses, kitchens, or construction sites—jobs where “hydration breaks” are spoken of but rarely honored, and protective gear makes heat feel like armor in August.

The working poor face the same reality. Apartment complexes without central air, crowded shelters, and long bus rides across baking asphalt leave the body without reprieve. These are not just inconveniences—they are exposures. Just as Agent Orange or burn pits were exposures of one era, extreme heat has become the slow-acting toxin of this one.

And so the country splits: one side cooled, the other cooked. Survival is increasingly determined not by resilience, but by resources. The divide is not theoretical—it is measured in hospital admissions, in funeral notices, in the quiet suffering of those who sweat through the night while others sleep beneath a steady stream of chilled air.

Section 3 – A Call to Awareness and Policy

Heat cannot be treated as background noise—it demands attention. When I was in the Army, we had a MOP system. Depending on the temperature and humidity, we were ordered to stop, hydrate, and recover. In the civilian world, that system doesn’t exist. Instead, outdoor workers—especially in the South—are ruled by the almighty dollar and the myth that heat “toughens you up.” The truth is the opposite. Heat doesn’t build resilience; it strips it away. It activates inflammatory pathways, drains fluid from organs, and pushes the body toward collapse. Heat stroke is not toughness—it is failure of protection.

Yet compassion is denied in the name of profit. Summers grow hotter, nights stay warm enough to steal sleep, and still the divide widens between the cooled and the cooked. Neither party seems willing to name the crisis. Agencies remain quiet, the government stays quiet, the cooled live in silence, and the cooked have no voice.

Cooling and hydration are not luxuries. They are as vital as clean water, breathable air, or essential medication. Hospitals know this—when air conditioning fails, patients are evacuated. But in the community, relief is optional. Cooling centers exist, but how does a farmworker or warehouse worker sit in one and still keep a job? What happens to the food supply when laborers collapse in the fields?

Veterans, once sent to war, now face another battle—this time with heat. PTSD, diabetes, heart disease, sleep apnea—all are worsened when the body is cooked. The truth is visible to anyone willing to look: survival in the heat should not depend on your bank account. Awareness must come first, but awareness without policy is abandonment. Access to cooling is public health. It should be public policy.

Conclusion – Cooling as Medicine

The cooled and the cooked is not just a metaphor—it is a living divide shaping health, survival, and dignity in America. Veterans know better than most that the body cannot be pushed past its limits without consequence. Heat is not about toughness; it is about biology. It inflames the body, steals sleep, strains the heart, and magnifies disease. What stands between survival and collapse is not willpower but access—access to air that cools, water that hydrates, and systems that care. These are not luxuries, they are medicine. Just as we would never withhold antibiotics or oxygen, we cannot afford to treat cooling as optional.

If we can begin to see cooling as part of public health, then we can close this divide. Veterans, the working poor, and every citizen deserve more than silence in the face of rising heat. The future will be measured not only by degrees on a thermometer but by the compassion we choose to extend.

The furnace rises, the night won’t rest,

A country split by who is blessed.

One side in shade, the other burned,

A lesson written yet unlearned.

Cool air heals where silence failed,

Compassion speaks where heat prevailed.

---Dr .Howard Friedman M.D.

Frequently Asked Questions:

Q: Why are veterans especially vulnerable to extreme heat?

A: Many veterans live with chronic conditions such as hypertension, diabetes, or sleep apnea. Heat amplifies these conditions, disrupts sleep, and increases inflammation. Medications often blunt the body’s natural cooling ability, turning what should be “just a hot day” into a real health threat.

Q: How does heat exposure reveal America’s economic divide?

A: Cooling isn’t evenly distributed. Some households have central air, generators, and the means to keep the temperature down. Others ration electricity, rely on a single fan, or face impossible choices between food and utility bills. For veterans living on fixed incomes, this divide can be the difference between health and hospitalization.

Q: What can be done to address the problem?

A: Awareness must become action. Heat needs to be recognized as a public health issue. Policies ensuring access to cooling centers, workplace protections, and utility support are essential. Veterans know better than most that survival depends on preparation—our nation should apply the same principle to protecting those at risk in extreme heat.