It was the coldest of December afternoons in 2020 and heavy clouds were rapidly approaching – a viral storm of COVID on the horizon and what was predicted to be a tsunami of a second wave. 

I had just been appointed as clinical director for mental health in the Merthyr Cynon Valley within Cwm Taf Morgannwg Health Board – the area with the highest COVID infection rate in Wales. This hadn’t been in my original game plan; taking on my first senior management role at the height of the worst health crisis facing the NHS in living memory. I remember thinking, 'what on earth am I doing? This is madness!' I also recall feeling scared and excited at the same time. That nagging question kept returning, 'who am I to take this on?'

Once my panic subsided at the enormity of the task, I still questioned whether I had the skills this job would demand of me during a pandemic of unknown proportions. 

If anyone was to ask me what four decades of living with a major physical difference has given me, I would answer ‘strength and resilience’. Aged 17, shortly before entering Liverpool University Medical School, I was diagnosed with bone cancer and underwent an above knee amputation of my left leg.

Since then, I have used a prosthetic limb and more recently, a wheelchair to mobilise. I have faced multiple relapses, undergone several major surgeries and more investigations than I care to remember. On that December day, facing the dark hour of the storm, I knew I would need an enormous amount of strength and resilience to lead my department through what was ahead. 

What else would I need to take on this enormous task? Creativity and flexibility for sure. Living with challenges to my mobility, I have had to possess a chameleon-like adaptability to getting around. Artificial legs, crutches, and wheelchairs are amongst the more traditional methods. However, I have also used tricycles, tandems and kayaks to reach hard to access places. I have even been known to swim like a mermaid to a remote beach when walking has not been an option.

Living with difference is the birthplace of creativity and flexibility. I knew as I faced overflowing wards, significant staff absences and COVID outbreaks – all of which would test me and my team to the very limits – I would need to use these skills, which proved to be invaluable in adapting to the unique challenges created by COVID.

Compassion and empathy were vital in the task ahead of dealing with stress, trauma and burnout amongst staff. Did I have enough to ride the huge wave of distress coming my way? To any healthcare professional wishing to experience a deeper understanding of compassion and empathy, I would recommend a spell spent on the turbulent seas of suffering and sickness.

When we’ve known what it is to feel helpless, frightened and overwhelmed by uncertainty ourselves, we acquire unrivalled compassion and empathy to understand others similarly placed. This insight made me more confident that I was already equipped with everything I’d need to be an effective leader in such a crisis.  

Finally, courage. When the hurricane hits, it takes bravery to believe that ‘this too shall pass’ and to inspire others to believe it too. To stand firm through the destruction and to know that a brighter, calmer day will rise requires fortitude. Could I muster this? Not only for myself, but for those who may doubt the hidden depths of their own mettle?

My mind took me back to an equally dark winter’s day when I was told by my orthopaedic surgeon that I had a highly aggressive form of bone cancer. That my leg would be sacrificed, and my body ravaged by chemotherapy. That I might not see my 18th birthday.

'You will need extraordinary courage, little lady,' my surgeon told me, 'but I believe you can do it'. Facing the inevitable fear of living with cancer and the challenge of becoming and remaining a survivor has taught me to be a woman of courage. I can endure dark hours; I can withstand storms. 

I look back on the last 15 months since I was appointed as clinical director, and the waves that have swamped our entire department, our whole health board, our whole country. We have been fearful of sinking and terrified of drowning, but we are coming through this. We are still here.

The flood waters may carry the debris of exhausted staff and a mountain of work ahead. We may be weary and bashed about, but we can be proud with our stories of strength and resilience. We can learn from our need to be creative and flexible. We can honour the accounts of those who have demonstrated deep compassion and empathy and be inspired by tales of remarkably heroic acts and courage at horrific personal cost. 

If I could turn back the clock and change history, if I could trade resilience and creativity, empathy and courage for perfect health and escape my teenage trauma, I wouldn’t. Surviving cancer and living with difference gave me the strength for this extraordinary time in my career. For it is in the darkest hour of the storm that our strength is born. 

Mary is a consultant psychiatrist and clinical director of mental health at Merthyr Cynon Integrated Locality Group