This article argues that Omar El Akkad’s debut novel, American War (2017), offers insight into the possibilities of trauma fiction in the twenty-first century. American War is analyzed as a case study for the trauma novel of the twenty-first century—a literary exploration of future and ongoing trauma, rather than a text “working through” a past event. The novel offers as well an unrelenting image of the cost of refusals of care in the early twenty-first century, the last decades in which the impending disaster might be averted. Queer affect theory inflects trauma studies in ways that allow us as readers to describe trauma that is systemic and ongoing; it also allows us to articulate the disproportionate effects of climate trauma on certain human communities, the physical and mental toll of such effects, and the necessity of bearing witness to climate trauma’s causes and consequences in ways that not only create space for but also call forth interventionist action.