The Foreign Service Journal, July-August 2023

THE FOREIGN SERVICE JOURNAL | JULY-AUGUST 2023 49 Indeed, as far as I know, our case was the first to crack open the department’s rigid position on world- wide availability for career candidates and their family members. Upon settlement of our case, State ended its long-standing policy of requiring that applicants’ family members receive Class 1, worldwide-available medical clearances and uncoupled the hiring of new Foreign Service applicants from the medical clearance status of family members. For me personally, that earlier settlement meant that I could begin a career as a Foreign Service officer that would otherwise have been barred to me. A Long Trek We reached that point only after a lengthy trek through bureaucratic proce- dures and emotional highs and lows. Fulfilling a long-held dream, I passed the Foreign Service oral assessment in September 1994 and began the entry process, including the security clearance and medical examinations for myself, my spouse, and our daughter and son. Both children were born with congenital cataracts and had developed glaucoma as a result of corrective surgeries. Their glaucoma was well controlled with eye drops, and our pediatric ophthalmologist was confident we could safely manage overseas. State’s Bureau of Medical Services (MED) disagreed, however, and in February 1995 determined the children were Class 5, unavailable for worldwide service. (At the time, preem- ployment candidates and family members could receive either Class 1 or Class 5 medical clearances; Class 2, post-specific clear- ances, were available only to currently serving officers and dependents.) The decision surprised and disappointed us. We began a lengthy appeal process but met resistance at each stage fromMED and the recruitment office of the Bureau of Human Resources (HR, now the Bureau of Global Talent Management). It was frustrating to know that the same officials who were so dead set against us would work hard to accom- modate us if I were already serving. Some officials implied or outright accused us of being poor parents for trying to take our children abroad, despite the fact that we already had spent a year in the Soviet Union with our daughter in the mid-1980s on a scholar exchange. Oth- ers expressed concern about the potential costs to the department because of our children’s conditions. The first step was informal consultations between our ophthalmologist and the assistant medical direc- tor (AMD) at State, then between my wife and me and the AMD. He was not persuaded, accusing the chil- dren’s ophthalmologist of having a “cavalier attitude” toward their conditions. We followed up with letters from other prominent pediatric ophthalmologists endorsing our plan. When that didn’t work, we requested a review of the MED decision by the Employ- ment Review Committee (ERC), a panel of nonmedical State officials, who also denied our request, in March 1995. Despite the ERC denial, things seemed to look up when the AMD contacted the ophthalmologist MED regularly consulted. I was told that he “enthusiastically” endorsed our proposed treat- ment/monitoring plan. The AMD would re-present our case to the ERC with a positive recommendation and was “very optimistic” about the outcome. Just before the meeting, however, his perspec- tive again soured. He told us that in the current political environ- ment, in which downsizing at State was the order of the day, the ERC was more likely than in the past to weigh my potential value as an FSO against potential problems with the children. His assessment of the ERC proved correct, and we received another denial in June 1995. The Carter family, Moscow 2000. COURTESYOFPAULCARTERJR.