Veteran Cultural Competency Isn’t Optional in Community Care—It’s Critical
On August 6th, I had the scare of my life. A close family member—a combat Veteran and someone I love deeply—faced a medical emergency that could have easily taken his life. It wasn’t just terrifying because it was unexpected. It was terrifying because, as I watched it unfold from afar, I realized how important Veteran cultural competency is in Community Care, and also, how little existed in the very healthcare system designed to help him.
Before I tell you what happened, let me tell you who he is.
He’s the typical Veteran—highly trained and educated, former combat arms, an officer who led troops into battle. Like many, he transitioned out of the military under circumstances that didn’t allow space for healing. He was out in six months. No rating. No benefits. No support. And no acknowledgment of the wear and tear—both physical and psychological—left behind.
It took eight years of conversations, trust-building, and persistence to finally start talking about VA care, PTS, disability, and job opportunities that gave him back a sense of value and purpose. Eight years.
Then came the call.
He was in the ER—barely able to speak, choking, alone, with something fully lodged in his throat. He had just saved himself from choking to death in front of his daughter and had arrived by ambulance at the nearest Tampa Advent ER hospital. Now, nothing could go down. Nothing could come up. His body was doing its best to keep him from drowning on his own spit, and the only way he could breathe was by coughing and spitting—over and over, every few seconds.
From 8:50 p.m. until after midnight, he struggled in the presence of medical professionals. That’s over three hours in distress, in pain, in a constant state of physical panic that would have unmoored most people. He was taken by ambulance to the closest ER, and they did what they could—their process: administered a muscle relaxer (that didn’t work) and immediately started calling the next hospital that could perform the surgery. They couldn’t do anything else for him. Somewhere in this process, he was labeled “non emergent” because he could communicate and his oxygen levels were technically okay.
What they didn’t see was him, just vitals. They didn't see the Veteran who survived numerous close calls in combat, suffered the loss of men in his command, and friends following, determined to survive a choking incident. They didn’t see the Veteran trained not to panic. The warrior who learned to suppress pain and stay calm in chaos. They didn’t see the PTS diagnosis that made this situation exponentially harder. They didn’t know the culture, and they didn’t ask.
At one point, a staff member came in asking him to get his insurance. I watched him struggle to move. He could barely say two words between spitting into a bag. I yelled over the phone—“He’s a Veteran! He can’t talk. Tell me what you need. I’ll give you the answers.”
Then, he waited- another hour went by.
He told me needed to get off the phone to focus, so I called his VA hospital- the Tampa VA, to ask if he should be transferred to them. They said no, to follow the doctors referral. I said, “I can tell he’s worried about coverage of two ambulance rides,” but I was not reassured. They told me to call VA Community Care within 72 hours. I did—immediately—but it was closed until 8 a.m. the following morning. There are no 24 hour Care Coordinators, not even at the Hospital.
I called the second Tampa Advent hospital to confirm they could treat him since the first couldn’t. The Supervisor was unmoved, almost dismissive. He said they had another case like this from the same hospital an hour earlier—nope, that’s the same person, but they didn’t even know his name.
I called back to the attending ER physician for a timeline update: “Is this still an emergency?” He said it was “semantics”—urgent, just not emergent. He had to follow the process, but the patient needed to be operated on within 24 hours. He is currently stable.
Let me be clear: he. could. not. breathe. If he stopped spitting, he would have drowned on it. I thought about calling an Uber, but worried about any option that took him outside the view—even an unconcerned one—of medical care.
Another hour passed.
At one point, he started texting things that scared me—notes for loved ones, instructions, his will, just in case. He thought he might not make it. He said his goodbyes—yet, he was in a hospital. I sat staring at my phone. I knew what this felt like. I was his next to kin on all his deployments except two. But today, he was not on deployment or in combat, he was sitting in a Tampa Advent ER Hospital- a VA Community Care partner.
I called back the second Advent ER—his intended destination for the surgery—and asked how long will this take. It had been over two and a half hours. I said he is a Veteran, and then was interrupted. The person on the phone told me that he was a Veteran too, and that he worked for the VA. My frustration boiled over: “Then you should know better! You aren’t choking on your spit with something lodged in your throat—call me when he’s on his way!”
I started to think of next steps—I’m lucky because I know them. I’d give them 15 minutes. By the time I called again, he had just arrived. No call, no update—but at least he was there.
The team immediately prepped him for the procedure, in less than 15 minutes he was on his way to the operating room. I rolled down the hallway with him— his one hand holding his phone, the other holding his spit bag. He asked if I could stay with him on the phone, but they said no. When it was time to go, it had just turned midnight—it was his Birthday.
He told me later—after I hung up, they asked him to lay down, but he couldn’t—he told them he’d drown. They settled on sedating him sitting up, and the last thing he recalls is whispering his daughter’s name over and over again as he finally laid down and was put to sleep.
I waited as long as I could, 45 terrifying minutes before I needed reassurance. I was transferred three times, over 15 minutes, with no answer. I got back to the ER nurse and told her I was sorry, but just needed to make sure he was okay.
She asked, “Do you think 45 minutes is too long?”
“What?” I responded. “No—I don’t know how long it should take, when I’ll know, or anything—ma’am, I need to know he’s okay.” She said he was in a different area, and if they weren’t answering, then they were busy. She transferred me once more to a man in Endo who could see he was just wheeled to recovery. He wasn't in the same area, but could see it on the cameras.
It was over.
Thankfully, he survived. Thankfully, they cleared the blockage. Thankfully, there doesn’t appear to be lasting damage, but let me be clear- the system of care failed him because it didn’t know how to care for him.
The Cultural Competency Gap in Veteran Community Care
What I witnessed wasn’t just a lack of bedside manner. It was a systemic failure in understanding what it means to care for Veterans—especially those with invisible wounds like PTS. Community Care providers are often unaware of the unique mental, emotional, and physical needs of Veterans. The VA is doing its very best to expand access through partnerships, but what does access mean without understanding, education, processes, and procedures?
Veterans:
Are trained to minimize pain and stay composed—so they often don’t “present” the way civilians do in crisis.
May experience extreme stress responses, even in “non-emergent” situations.
Carry trauma from deployments, moral injury, and years of service that can resurface in medical environments.
Often fear the financial implications of ambulance rides, ER visits, or non-VA hospital care—which can delay treatment.
Deserve to be seen not just as patients, but as whole people with experiences that shape how they receive care.
What Needs to Change
Mandatory Cultural Competency Training for all Community Care partners.
Integrated Mental Health Flags on care referrals.
Emergency Navigation Protocols that work with the VA.
Compassionate Communication. When someone calls at midnight asking, “Is my family member alive?”—don’t treat it like a customer service issue. Treat it like someone’s life is in the balance. Because it is.
Veteran Community Care Liaisons to advocate and support Veterans and their families.
24 hour VA Community Care hotline.
We Are Lucky
If he had panicked… if he had stopped spitting… if he had laid flat for one minute too long… or coughed the lodged mass up even a tiny bit, we might be telling a different story today.
Instead, we are lucky.
But lucky should never be the standard. Veterans and their families deserve more than that. They deserve a system that sees them, understands them, and is prepared to care for the whole person—not just the patient.
At 8 a.m. yesterday morning, I made sure to call the VA Community Referral line on his behalf—well within the VA's 72-hour notification window to get pre-authorization for his two ER visits, ambulance rides, and surgery. It was a pleasant experience- I rated it a 5 out of 5. Now, we’re praying we don’t have to fight another battle and that the referral goes through. We’re watching every step because we know how fragile the process can be.
I feel frustrated and thankful—frustrated by what happened, but thankful he is okay and to understand this issue and challenge fully, because it’s one I can do something about.
Let’s start with this: Cultural competency isn’t a checkbox. It’s a lifeline. We must ensure training is ongoing and continuous for local clinical care partners who encounter our Veteran and military families. We can 100% activate this at the local level—so when a Veteran walks into a clinic for care and says, “I am a Veteran,” it means something.
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