text: The pandemic thrust many women into vise-like leadership positions. The trial under near impossible pressure wasn't limited to people in visible, political roles. Everywhere, people had to make decisions with devastating costs, often to prevent even worse fallout. Leadership skills were tested and discovered, and sometimes it really did feel like walking through fire. Nadine Abdullah was in the fourth year of her five-year term as the internal medicine program site director at Toronto Western Hospital when the pandemic struck. As the site director, she's responsible for every internal medicine resident at the hospital. That responsibility includes their training, but Abdullah also acts as their role model, their advocate, their support system, their cheerleader—and all of it together helps shape each resident's career. She realized the enormity of that role during a pandemic while seated in Toronto's Royal Alexandra Theatre watching the musical Come From Away in early March. She briefly thought, We probably shouldn't be here. Then, she thought, We have to trust in our public health authorities. And then, in the middle of the show, the frantic phone calls started: from residents; from colleagues; from faculty at U of T, through which the residency program is run. Everyone wanted to know what they should do. The next day, everything changed. Abdullah had never thought she was a strong leader; she was terrified.
  
  She wasn't scared of everything she'd have to do as a mother: grocery shopping, home-schooling, getting medications renewed. She knew how to plan for all of that. What scared her was working on the hospital's Armageddon plan: scenarios for one hundred patients, two hundred patients, three hundred patients. "That's a war," she said. Abdullah suffers from multiple chronic diseases, including one that requires she take Trump's purported cure-all, hydroxychloroquine, and she worried about potential shortages of said medication. As someone who is at higher risk, she knew she likely wouldn't survive the virus. Would she have to engage in care that would put her own life at risk? How would she learn about the disease if she didn't? And how would she teach her residents about it? And, more than anything, how would she keep them safe? Questions tumbled through her mind, and she had trouble sleeping, night after night. What about PPE? Would there be a shortage? Had the hospital made a mistake in requiring only surgical masks be worn, not N95 masks? Would they run out of ventilators? At first, after ample consideration, she told her site lead that she didn't feel comfortable working with COVID-19 patients; her own health put her at too high of a risk. Then, she applied the same person-by-person approach to each resident. She answered every call and text to her cellphone. She had socially distanced meetings. As she privately dealt with her own fears, she heard theirs. "No one was treated equally," she told me. "It was all about what did everybody need for them?"
  
  She never told her residents about her own health problems, or let on that she might be more scared than they were. As April advanced, she decided that she no longer wanted to hide from COVID. If her residents were in a position where they might have to look after virus patients, she had to face it, too—no matter the risk. She wanted to show them she could be their leader; she could be on the COVID-19 team. And that first shift? "It was nothing." She felt safe in her PPE. At home, she quarantined in her basement, taking her dinner to the top of the stairs to eat together with, but apart from, her husband and two children. They'd prop up her phone and watch Kim's Convenience together. She began to feel like she was getting a grip on leading through the pandemic.
  
  That new confidence cracked shortly after, in the beginning of May. Around that time, four COVID-19 outbreaks shook Toronto Western, spreading to nineteen patients and forty-six staff members. Hospitals were set to rotate residents, and suddenly none of them wanted to accept anybody who had been working at Toronto Western. Panic set in and a well-intentioned U of T intervened to create its own policies. Unfortunately, the resulting memo failed to properly communicate with hospitals or residents, adding havoc to the mix. On Monday, many residents didn't show up to work, as directed in the memo. Abdullah called a town hall to clarify what had happened, to apologize, and to explain how the hospital and university would move forward together. It didn't go well. Or, as Abdullah said, "It was a disaster."
  
  Emotions ran high. While most residents seemed to understand, several wouldn't accept the explanation and they became aggressive, even vitriolic, she told me. They accused the hospital and program of using residents as human shields. "I can't tell you how I felt I failed," said Abdullah. "I just couldn't control the tears." She did take it personally, and, in her next meeting, offered to resign. Logically, she knew that she hadn't done anything wrong. She knew that she, and everyone else, had made the best decisions they could, given the constraints; other decisions, and mistakes, had been out of her control. At the same time, she also felt like the town hall was a vote of non-confidence; she felt like maybe she wasn't doing a good job after all. But her resignation wasn't accepted. Her colleagues and her own superiors wanted to keep her in leadership. Her own children and her husband told her: we hear you on your daily calls; those residents need you.
  
  When I spoke with her months later, she was still upset and seemed ambivalent about staying in her position. "What people don't understand," she said, "is that we're going through the pandemic, too. We're terrified, too. And we're barely keeping it together." Still, she had kept working with COVID-19 patients, kept helping the residents, and kept wondering if she was doing the right thing, leading the right way, making the best decisions. When it came down to it, like all the new leaders of the pandemic, she had simply kept going, doing it all, even when she wanted to stop.