I was lying on my rack in a crowded tent in Afghanistan, watching an old episode of Project Runway on my computer. I rested my hands on my chest and felt something unfamiliar through my shirt: a lump in my left breast that had seemingly appeared overnight.

It was hard, immobile, and painless. As a nurse, I knew these were red flags, but I thought I’d wait until I was scheduled for rest and recovery five months later to have it checked out.

I didn’t want to go on a medical evacuation that might disrupt operations or my teammates’ already-scheduled leaves. So I stayed focused on caring for service members while repeatedly checking the lump, hoping it would disappear, move, or change.

I had long put others first. My mother often said that I insisted on carrying my baby sister everywhere, changing her diapers, and treating her like a doll. After back-to-back deployments to Iraq and Afghanistan, I felt that I should remain deployed and keep caring for service members. My priority was to support the people around me and stay focused on the mission, not myself.

The author in Afghanistan in 2010. She was awed by the beauty of the mountains. (Photo courtesy of Ellen Schimmels)

Teamwork, selflessness, discipline, and accountability were ingrained in me. I wanted to look out for others, but it went deeper than that. The thought of being seen as someone who was “trying to get out of” an obligation or “not being focused on the objective” was heartbreaking; it would mean I wasn’t devoted enough. I wanted to prove my commitment to the Army and to my military duty.

The military suited me. I thrived in an environment that rewarded hard work, meticulous attention to detail, and relentless productivity. Yet those same qualities also reflected a stubborn perfectionism and a deeply rooted belief that I was never quite enough.

I learned early in life that doing for others earned affection, value, and a sense of belonging. My family didn’t have much. While that fostered humility, it also left me feeling embarrassed and inadequate. At school, I worried that other girls would notice I was wearing their castoff clothes that my mother had found while rummaging through yard sales.

That sense of “never enoughness” followed me throughout my deployments and military career. People-pleasing and putting others first became my mantra, but over time, self-sacrifice slowly evolved into self-silencing. I began to define my worth by what I could do for others, and in the process, my identity beyond selfless caretaker faded into the background.

I didn’t tell anyone about the lump for months. I didn’t want anyone to dissuade me from where I believed I needed to be. I worried that leaving would be akin to admitting I wasn’t strong or dedicated enough.

Fortunately, a friend convinced me to have the lump evaluated. A portable ultrasound revealed a solid mass. Within days, I was evacuated to Camp Dwyer, then to Bagram Airfield, where I waited to leave the war zone. Departure was delayed multiple times until I was finally transported to Germany more than a week later.

Unfortunately, the delays left me with plenty of time to ruminate. With little else to keep myself occupied, I asked if I could help at the clinic. Even as a patient, I still wanted to feel useful. Without the ability to perform my duties, I was surprised by how quickly my sense of value diminished.

I was also worried about how surgeries, chemotherapy, and radiation would affect me physically and impact my ability to have children. I was 36 years old and had planned to start a family after returning from Afghanistan. I wanted to preserve my breasts and asked for a fertility preservation consultation to discuss what this process could do to my body.

My oncologist, a young captain, put his arms out and motioned with his left hand and said, “This is your cancer.”

Then he directed me to his right hand. “This is everything else: your career, your dogs, your husband, the child you want to have.”

Ellen Schimmels visited friends in Milwaukee in 2011 about three months after completing her chemotherapy treatments. She had tried to continue working even when her cancer treatment included both chemotherapy and radiation. (Photo courtesy of the author)

He looked back at his left hand. “This is all I care about,” he said.

At the time, I thought it was the cruelest thing I’d ever heard. I didn’t consider his priority to save my life. Of course, my priority was not myself. I was concerned that my unit in Afghanistan didn’t have enough resources without me. I worried about my ability to remain on active duty and continue to serve my country. And I feared that treatment might take away my ability to nourish a baby.

I had spent so much time putting the mission and others first that I didn’t know how to prioritize my own needs. I fought against being placed in the Warrior Transition Unit because I wanted to continue working while undergoing treatment. I struggled to understand that focusing on my recovery was not a failure to serve.

Eventually, I was allowed to return to work—bald, my skin a grayish hue from chemotherapy, and visibly unwell from the ongoing radiation treatment. I wore wigs and makeup to redirect any concern people might have for me so I could focus on patients.

Ellen Schimmels served more than two decades before retiring. At her retirement ceremony in 2020, she gave the flag to her daughter, Kenley. (Photo courtesy of the author)

Shortly after completing cancer treatment, I became pregnant. But my body was not ready, and I miscarried. I knew I had so much love to give to another human being, yet I began to question whether wanting to become a mother was selfish. I worried that motherhood would interfere with my ability to give the same level of commitment to the people and service that had always mattered so much to me.

Fortunately, I was ultimately able to conceive through IVF and gave birth to a baby girl.

I retired from the Army after more than 22 years and am still trying to find my place. In the five years I’ve been a civilian, I’ve had more jobs than I did during a similar span of my military career. Today, I teach nurse practitioners and treat veterans, roles that allow me to continue serving in meaningful ways.

The paradox of being a woman in the military lies precisely in these contradictions: being nurturing and caring, yet strong and mission focused; being willing to sacrifice for others, but worthy of care, too. Cancer hasn’t stopped me from being the person who gets things done.

But I continually strive to find balance between productivity and purpose, between feeling useful and inconsequential, between caring for others and tending to my own needs. I am still learning who I am beyond the mission, and that being enough isn’t achieved through service and self-sacrifice.

This Reflection from The War Horse was edited by Kim Vo, fact-checked by Jess Rohan, and copy-edited by Mollie Turnbull.

JoEllen “Ellen” Schimmels is a clinical professor at Emory University, a therapist for the Group Psilocybin-Assisted Therapy for PTSD study at the University of New Mexico, and a clinician at Hear to Help. She has also worked in the outpatient mental health clinic at the New Mexico Veterans Health Administration. Her 28 years of nursing experience include 23 years of active duty service in the Army, with combat tours in Iraq and Afghanistan. She shares her life with her husband and cherishes her role as mother of two bright, enthusiastic children and stepmother to two amazing boys.