Altogether, McCain was held as a prisoner of war in North Vietnam for five and a half years, nearly five of them after his refusal to accept the out-of-sequence repatriation offer. His wartime injuries left him permanently incapable of raising either arm more than 80 degrees. For his actions as a POW, McCain was awarded the Silver Star Medal, the Legion of Merit, three Bronze Star Medals, another instance of the Navy Commendation Medal, and the Purple Heart Medal. He also gained an appreciation, from experiencing the mutual help and organized resistance of the POWs, that his earlier individualism needed to be tempered by a belief in causes greater than self-interest.
