It is useful to think of Walker’s life in three distinct phases that connect but do not overlap in simple ways.
The first phase was professional: the long effort to establish herself as a physician, from medical school in the early 1850s through the failed joint practice, the volunteer service, and the eventual contract appointment in 1863. This phase was defined by the gap between her qualifications and what institutions were willing to give her based on those qualifications. She had the same medical training as her male classmates; she was treated differently at every institutional point from the failed practice to the Army bureaucracy to the Patent Office Hospital chain of refusals.
The second phase was service and advocacy: the Civil War years and the subsequent decades of writing and lecturing on women’s rights, dress reform, suffrage, and the legal argument for women’s pre-existing constitutional right to vote. This phase was defined by her public presence — the distinctive figure in men’s formal clothing with the Medal of Honor, making arguments in public forums about the conditions of women’s lives. It was the phase in which she was most visible and most influential, and also most controversial.
The third phase was institutional: the 1917 rescission, the two years of continuing to wear the medal until her death in 1919, and then the decades of dormancy followed by the 1977 restoration. This phase was defined by the gap between the institutional record and the actual facts of her service — a gap she refused to acknowledge during her lifetime and that was eventually officially closed after her death.