There are moments in life when the identity you have carefully built over decades is interrupted so abruptly that you are forced to ask who you are when the familiar parts no longer function the way they once did.

For physicians, identity often begins early. We learn to attach meaning to competence, endurance, reliability, and service. We become the person others call when decisions must be made, when systems feel uncertain, when emotions must be managed quietly in the background while work continues. Medicine rewards steadiness. It teaches us to move forward even when life behind the scenes is complicated.

What it does not always prepare us for is what happens when our own body changes in a way that alters how we move through the world.

Navigating physical disruption

Several years ago, my life changed in a way I could not have fully anticipated. I underwent a right below-the-knee amputation. The physical recovery was demanding, but what surprised me most was not the pain or the rehabilitation itself. It was the immediate awareness that the body I had relied on without thinking had become something I now had to consciously negotiate every day.

Simple things required strategy. Balance required attention. Fatigue carried a different meaning. The ordinary became deliberate.

At the same time, life did not pause. There were still professional decisions to make, employment uncertainty to navigate, financial obligations to manage, family responsibilities to carry, and difficult transitions unfolding all at once. There was no isolated space where adversity existed apart from responsibility. Everything happened together.

Reconstructing identity through adversity

What I learned during that season is that adversity reveals leadership more honestly than titles ever do.

Before that experience, I understood leadership largely through performance, decision-making, responsibility, communication, and the ability to remain composed under pressure. Those things still matter. But adversity exposed another layer: Leadership also requires the ability to reconstruct yourself when circumstances have altered the conditions under which you once performed with ease.

That reconstruction is quieter than many leadership conversations acknowledge. It is learning how to enter rooms while carrying visible and invisible adjustments that no one fully sees. It is accepting that competence may now require adaptation rather than speed. It is resisting the temptation to equate changed capacity with diminished value. It is understanding that authority is not weakened by vulnerability when vulnerability has been disciplined by reflection.

Medicine often celebrates resilience, but resilience is frequently misunderstood as returning to who you were before difficulty occurred. In reality, some experiences do not return you to a previous version of yourself. They require you to become someone more intentional.

Sustainable leadership through pacing

I returned to work with greater clarity about what truly matters in leadership. I became more attentive to how people carry burdens privately while still appearing functional publicly. I became more aware that not every strong professional voice is untouched by hardship. In fact, some of the most thoughtful leaders are those who have had to rebuild quietly while still showing up responsibly for others.

Adversity also changed how I understand pace.

Medicine often rewards acceleration, more productivity, more availability, more output. But physical recovery taught me that sustainable leadership is often built through pacing, not force. There are seasons when strength looks less like speed and more like disciplined endurance.

That lesson has influenced how I lead now, how I mentor, and how I think about physician development more broadly. Too often we teach physicians to pursue credentials, promotions, and external markers of advancement without giving equal attention to the internal work required to sustain identity through disruption.

Yet disruption comes for many physicians in different forms: illness, caregiving, burnout, divorce, grief, disability, moral injury, career transitions, or private disappointments that never appear on a curriculum vitae.

The question is not whether adversity belongs in leadership development. It already does.

Bertina Marie Hooks is an internal medicine physician.