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#WomenOfPenn: From the Operating Room to Desert Storm, and Back Again

The following post is part of a year-long online campaign highlighting #WomenofPenn. The campaign, developed by FOCUS on Women’s Health and Leadership and Penn Medicine Communications, promotes the work being done by women at Penn Medicine and aims to inspire early-career women in academic medicine through the examples of successful women role models.

Women of Penn

In the fall of 1990, Paula Crawford-Gamble RN, MSN, CAPT, NC, USN (Ret), walked away from her decade-long nursing career at the Hospital of the University of Pennsylvania to fulfill a lifelong dream: joining the Navy Nurse Corps. Four weeks later, with virtually no military training, Crawford-Gamble landed in Saudi Arabia, where she was expected to help set up a 1,000-bed hospital for those injured during the Persian Gulf War.

Her sink-or-swim training during Desert Storm led her to become the first Navy reservist to earn Aircrew Wings, qualifying her to serve as an aircrew member on board military aircraft. Later, she led the Medical Department as a captain aboard the U.S.S. George Washington (CVN-73), a U.S. Navy Aircraft Carrier. She also served as a flight nurse with Marine Aircraft Group 49, in the Navy Operational Medical Institute (NOMI), and as Reserve Executive Officer and Commanding Officer of Portsmouth Naval Hospital. With the Marines, Crawford-Gamble helped to design and operationalize Joint EnRoute Care, a program to promote a streamlined mode of medical transport for the injured warrior.

Now, Crawford-Gamble is back at Penn Medicine. She is using 25 years of experience in the armed forces to lead Penn’s Veterans Care Excellence Program (VCEP). As VCEP Liaison, Crawford-Gamble aids in the recruiting, training, and success-building of veteran employees at the Health System, as well as ensuring that veteran patients receive optimum care.

Olivia Cook, a senior in Penn’s School of Nursing, will begin her own career as a Navy nurse this spring. As battalion commanding officer for Penn ROTC, Cook is accustomed to leading, and she is looking forward to her time in the Navy Nurse Corps.

In celebration of Veterans Day, Cook sat down with Crawford-Gamble to talk about her path from the operating room to the battlefield and the lessons learned along the way.

Q (Cook): What were you doing prior to joining the Navy, and what made you decide to enlist?

A (Crawford-Gamble): I was working as a nurse at Penn for about a decade on the heart team as well as the trauma team, and I was really influenced by the pioneers I worked with. I was scrubbing for an admiral, and so many other renowned men and women surrounding me at Penn had served in the military. But, most importantly, it was my dad, a solider in the 3rd Armored Division in World War II. He was at the Battle of the Bulge and Omaha Beach, and I always wanted to follow in his footsteps.

Another one of the main reasons I joined the military was that in nursing school, I took care of three Marines at the naval hospital. Two of them were in hammocks because their extremities were amputated due to experiencing traumatic injuries in Vietnam. One swore that if the helicopter had been there 45 minutes sooner, he would have legs. They made me promise I’d join the military. That was another reason I joined.

Once I got my orders to be mobilized, I thought, “I hope I’m ready.” The training they gave me was only about three to four weeks before I deployed. It was because of my time at Penn that the Navy felt I was ready and experienced enough to be mobilized and caring for our warriors without much military training. I was honored.

Q: You said you had the necessary clinical experience, but did you have anything that prepared you for war?

A: Everyone in the OR, once they find out you’re being mobilized, they all give you words of wisdom to try and prepare you, but it’s very different once you get over there. It was truly an eye opener.

Once we arrived in Saudi Arabia, when we were ready to go into the hot LZ [landing zone], all of a sudden, two F-18s rode on either side of our aircraft, and we hear over the loud speaker, “Don your masks! Don your masks!” You put your mask on, and you start hyperventilating. And we landed, and then recon was down at the base of the stairs directing us to go into these little busses, and we were getting fired upon. And I was thinking, “Wow. It’s starting.” Ironically, the war hadn’t even technically started yet. But really, it had. It was a “Welcome aboard” that you’ll never forget. And it’s a culture shock. But you have a job to do, and you just do it.

Then, we get to our compound, and the next day we had to build our 1,000-bed hospital. It took us seven days, and that is where I met Admiral [Karen] Flaherty, who is now director of the Philadelphia VA. Meeting someone in that challenging of an environment, you get to know each other very well.

Because of my nursing experience at Penn, they soon pulled me from that hospital and put me in a joint unit. We lived on the north end of the narrow strip where two F-18s would take off and land every 20 minutes. We had what we called a casualty processing unit, made up of Army, Air force, and Navy. It was challenging enough just trying to learn the Navy, and now, all of a sudden, you’re learning the Air Force and Army’s methodologies, too.

Q: Did your initial employment set the stage for all the operations that you wanted to be a part of?

A: It’s not that you love war, but you love what you do. It was an incredible experience for me being pulled to different military units and learning many different operational platforms. As a Navy nurse, you have the ability to be versatile. They may need you on the tanker side one day, and the SEALs may need you the next day. You get pulled into a lot of different units and you need to know what their needs are and how to take care of them.

When I got back from Desert Storm, I went to flight school and I got my Wings through the Air Force. I was the first reservist to do that. Because of my experience and what I wanted to do, I felt I needed to do that, and I also wanted to get a position with the Marines.

[From the time I met those Vietnam Marines veterans as a nursing student], my thrust was to be a part of developing better systems for injured care, and I had the opportunity to do that by going to flight nursing school. As a Navy nurse, it’s a dichotomy in a sense, you’re having to fight and defend yourself in war while caring for the injured.

Q: Did you ever feel like you faced challenges as a woman in the military?

A: Desert Storm was paramount for women. It was a time when women were filling manpower gaps, so their wartime roles were expanded on many battle platforms. The challenge of being accepted into nontraditional roles is difficult, but achievable.

Women also faced many hurdles when they returned home, since the Department of Veterans Affairs was not prepared to care for the number of women veterans. Now, state VA departments have met that need, with innovative clinics and referral programs for multiple specialties that women require. However, the challenges that women in the military and female veterans face are still vast. We need specific care for them. We’re just starting to do that now.

Q: Did your early interactions with your two patients who were Marines influence where you went with the rest of your career and your current work with the VCEP program?

A: Penn Medicine has always supported the military in one way or another. The challenges that those two Marines presented to me were — and still remain — a driving force with me and the VCEP program. I get to meet veterans with common issues who come to Penn Medicine to work, as well as those who come to Penn Medicine to be taken care of. Our aim is to really promote streamlined care, as well as helping them develop their careers, and also to promote a supportive culture for their families.

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