An Amputee Wants to Be a Military Nurse

choi

Gish Jen's essay, though published inline at nytimes.com on Apr 29, 2024, was not published in print until today: May 5, 2024 (at the section of SundayReview, at page P 4).

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Dave Philipps, Losing a Foot Didn't Stop Her Until She Attempted to Enlist. New York Times, Apr 28, 2024, at page A1.
https://www.nytimes.com/2024/04/ ... annah-cvancara.html

Quote:

"Flat feet, for example, stopped being disqualifying during the Vietnam War. More recently, childhood asthma and some mental health disorders ceased to be red flags.

"While there is no specific rule barring amputees from serving, in practice, that caution has meant routinely rejecting amputees.

"the military allows amputees to serve, it just doesn’t allow them to join.   Lose a leg, or even two, to an injury while in the service, and the chances are good that you can stay. The military routinely invests years in rehabilitation and expensive surgery for those service members, makes exceptions to fitness standards and finds niche jobs that they can perform — all things that the Defense Department cites as reasons it would be too burdensome to allow amputees to join.

My comment: You can stop reading when you reach quotation 3.
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Hannah Cvancara’s dream is to become a nurse in the military, and she has been trying to achieve that dream for more than a decade. But every time she applies, she gets rejected.

It’s not that the 28-year-old couldn’t handle the job. She is working now as an emergency department nurse at a civilian Level II trauma hospital in Spokane, Wash., tending to bleeding car accident victims, drug users in fits from withdrawal, children in the throes of seizures and whatever else comes through the doors.

And it’s not that she can’t meet the fitness standards. She can do double the number of push-ups required, and has finished the timed 1.5-mile run with minutes to spare.

The issue is that Ms. Cvancara has only one foot and gets around on a prosthetic. So the military will not let her join.

“I’ve proven I can do the work — now I just have to convince them to let me do it,” she said with a somewhat weary smile as she left her hospital at dawn after a recent night shift. Her stethoscope was still draped around her neck, and she was wearing raspberry-hued sneakers — comfortable enough for a 12-hour shift and, as she noted with characteristic emergency-medicine dark humor, good at camouflaging blood stains.

The U.S. military has always screened recruits rigorously to weed out any who might not be able to perform. In some ways the standards have evolved over time. Flat feet, for example, stopped being disqualifying during the Vietnam War. More recently, childhood asthma and some mental health disorders ceased to be red flags. Despite stunning advances in prosthetics, though, the military still looks on amputees the way it did in the days of flintlocks and cannonballs.

The military says it must be cautious about anyone who might not be able to do their job under harrowing circumstances. While there is no specific rule barring amputees from serving, in practice, that caution has meant routinely rejecting amputees.

Ms. Cvancara, who pronounces her surname “van-CAH-rah,” is determined to change that. She recently applied to the military once again, to join the Air National Guard. And in case she is rejected once more, she is working with her representative in Congress, Cathy McMorris Rodgers, to pass a bill called the Hannah Cvancara Service Act that would create an exception to allow amputees to join the military as medical personnel.

Not that Ms. Cvancara feels she needs an exception.

She was born with a deformed lower left leg that was amputated when she was in diapers, and has worn a prosthetic for so long that she feels it is part of her body. She grew up in an outdoorsy family, and learned to love backpacking and snowboarding. In school she was on the swim team and played varsity volleyball. She has climbed wilderness peaks in the Cascades, surfed in the Pacific and competed in the Miss America competition.

“My whole life, no one ever told me I couldn’t do anything I wanted to, until I tried to join the military,” she said. “I don’t want to be treated like I’m special. I just want to be treated like everyone else.”

Military recruiting commanders do not appear poised to let that happen.

That doesn’t mean there are no amputees in the military. In a perplexing bureaucratic twist that seems lifted straight out of “Catch-22,” the military allows amputees to serve, it just doesn’t allow them to join.

Lose a leg, or even two, to an injury while in the service, and the chances are good that you can stay. The military routinely invests years in rehabilitation and expensive surgery for those service members, makes exceptions to fitness standards and finds niche jobs that they can perform — all things that the Defense Department cites as reasons it would be too burdensome to allow amputees to join.

Many troops who lose a limb while in the service eventually return to full duty. Soldiers hit by roadside bombs have deployed again with artificial limbs. Amputees have gone on to serve as Navy divers, Marine snipers and Army post commanders.

The injury doesn’t have to be service-related. Two Air Force officers lost legs in recreational boating accidents, and another lost a hand while renovating her kitchen. All three returned to duty as pilots, and were held up by the Air Force as inspiring examples of grit.

“They’ll support you if you show you are willing and able to do the job,” said Brian Beem, an Army cavalry scout who lost a leg to a roadside bomb on his first deployment, to Iraq in 2006, then served for another 12 years. On his second combat deployment, to Afghanistan, he packed a spare leg in case of emergency.

If a one-footed nurse can meet the standards and wants to join, he said, why not let her?

“I learned in my Army career, I would much rather have someone beside me who is a little banged up but is motivated, than someone who doesn’t want to do the work,” he said.

Each military branch has general medical requirements that are applied to all recruits, whether they plan to be clerks or commandos, according to Beth Asch, a senior economist at the RAND Corporation who studies military recruiting. But there is a growing awareness among policymakers that the one-size-fits-all approach may not be optimal.

“Ultimately, people have to be fit for service — but what does it mean to be fit to serve?” Ms. Asch said. “Do we really need to apply the standards for the infantry to a finance person or logistics person, or a nurse?”

While the military has held the line on admitting amputees, it has loosened standards recently in several other ways, in an attempt to fill recruiting shortfalls. Recruits can now be older and score lower on aptitude tests than in the past. And more waivers are being granted for recruits’ medical conditions, prior misconduct or drug use, and tattoos. About one in six recruits now gets some sort of waiver.

Ms. Cvancara has a hard time understanding why she is not one of them.

Her father was an Air Force doctor, and she knew growing up that she wanted to follow him into military medicine. When it came time to apply to college in 2013, she looked into an R.O.T.C. scholarship that would pay for her training. An Air Force recruiter told her that her prosthetic made her ineligible.

That was rejection No. 1.

She trained to be a civilian nurse, and by chance worked the clinical hours required for her degree at the Naval Medical Center in San Diego. After getting her nursing license in 2020, she applied to join the Navy, confident that she had already shown she could do the job.

She aced the physical fitness tests, passing the swim test both with and without her prosthetic, and then applied for a medical waiver from Navy Recruiting Command. Several months later she received a brief message on Navy letterhead saying, “Subject applicant does not meet established physical standards.”

Rejection No. 2.

The military personnel bureaucracy is risk-averse, and no one wants to be the first to let an amputee in, said Katherine Kuzminski, who studies the military and society at the Center for New American Security.

“They don’t want to do it because they have a culture of not doing it,” she said.

“The military’s main objective is lethality, and they want to stay focused on that. The question is whether, in this day and age, a person who in the past might have been a burden may now help maintain that lethal edge.”

Ms. Cvancara expects a decision on whether she’s accepted by the Air National Guard in the fall.

A spokeswoman for the Air Force said she could not comment on individual applicants but voiced caution about the ability of amputees to serve.

“Personnel, including nurses, must often be ready to deploy on short notice to various environments, including combat zones or areas with limited medical facilities,” the spokeswoman, Rose Riley, said in an email. “The Air Force would consider whether an individual with a below-the-knee amputation could function effectively in such settings.”

She added that the Air Force “would need to evaluate how well the prosthesis performs under different conditions, including its durability and the individual’s ability to perform necessary maintenance or adjustments.”

If Ms. Cvancara is rejected again, it will be by a branch where a pilot who lost a leg in a hunting accident went on to fly missions in Afghanistan, and a special operations pararescue medic who lost a leg in Afghanistan now trains other elite medics.

If the Air National Guard doesn’t accept her, she hopes lawmakers will step in. Ms. Cvancara recently spent a week on Capitol Hill, knocking on lawmakers’ doors to lobby for the bill with her name on it.

“I want them to see that I’m not a risk to the force,” she said. “Let amputees have a chance. Let us show you that we can be an asset.”