Venetta Symonds started full-time work for the Bermuda Hospitals Board 40 years ago today as one of the first black radiographers at the King Edward VII Memorial Hospital.

Her ambition back then was not to become chief executive officer of the entire organisation — but that is the position she attained in 2012 after she rose through the ranks.

She admitted as she prepared to retire at the end of this month: “It’s emotional every day now.”

Mrs Symonds said her relationship with the healthcare quango went back to 1975, when she worked as a file clerk over the summer break from school.

She added: “I’m happy. I’m really, really happy, but at the same time it is so hard.

“There is nothing that I am planning on doing on August 1. I refuse to box myself in right now. I’ve been on this path since I was 17.

“I want that first day to happen. People say ‘oh, you are going to be so upset, you are not going to be able to check your e-mail, you are not going to be connected to BHB’.

“That might be so, but I just want to feel it. I just want to understand what that feels like.”

Mrs Symonds is the fourth woman chief executive of the BHB.

She has stayed in the job longer than any of her most recent predecessors — and longer than most hospital CEOs anywhere.

Mrs Symonds said: “I remember reading once when I was at the three-year mark that hospital CEOs don’t normally last any more than three years. I thought ‘wow, OK’.”

The quango she heads up is the second-largest employer on the island, with 1,800 staff, and she led the hospital redevelopment project which saw a $247 million acute-care wing open in 2014.

She said: “Thank goodness I obviously have an appetite for complexity.

“Hospitals ... they are cited as probably being one of the most complex organisations to manage and the reason why I think I stayed, regardless of how difficult it gets ... and maybe why I’m still here after 45 years, is that the bottom line for me is care and quality.”

Mrs Symonds said that when she first joined the X-ray department at KEMH as a 17-year-old intern there were no black radiographers.

But John Swan, then the BHB chairman and later to become Premier of Bermuda, established a policy to Bermudianise the hospital that year.

Sir John wrote in an end-of-year report that the “key to a community hospital is community participation” and that if Bermudians were given the opportunity to enter healthcare services then “we will one day have hospitals that we can truly say are run by Bermudians”.

Mrs Symonds’s potential was spotted fast — she was asked if she was interested in a career in radiography and if she wanted to apply for a scholarship from the board.

As a pupil studying A levels in English, physics and biology, the idea appealed.

She won the scholarship to study for a two-year associate’s degree in the United States and then asked for financial support for another two years to gain a bachelor’s degree — but the education sub-committee at first rejected her request.

Mrs Symonds has related how a committee member asked her at a meeting if she thought she needed the extra qualification because she would be coming back as CEO.

She told the woman: “I don’t want to be the CEO, but if I don’t get my bachelor’s degree I’ll never have the opportunity.”

She said it was possible now to “unpack” the woman’s remark in the context that there were “pockets in this hospital back then that were not integrated and certainly weren’t encouraging to non-white Bermudians”.

But it did not deter her or her father, Norris Pearman, a hard-working mechanic who was with her at the meeting, and between them they persuaded the committee to continue the $2,500-a-year scholarship for the needed two years.

Mrs Symonds said: “I took it as a barrier. There was something derisive, there was something about it that just didn’t feel right and it made me, at that time, take a position and made my dad take a position that ‘no, you don’t discourage a young person from wanting to do more’.”

Mrs Symonds recently found the quote from Sir John in Randolph Williams’s book 100 Years of Care in Bermuda and realised that, although other Bermudians led the hospital before her, she was perhaps the first to benefit from the Bermudianisation policy.

She said that the “solid upbringing” she had with her father, housewife mother, Ilis, and two older sisters, Marva and Donna, was the bedrock on which she built her career.

Her parents instilled in them all a strong work ethic and continued to support her as a working mother after she married her husband, Carlos Symonds, in 1987 and had two children, Marcus and Natasia.

Mrs Symonds said: “I’ve been married for 33 years and had my children while I was setting up the CT scan at KEMH, which was a big milestone in my professional career.

“I’ve probably had to hire babysitters once or twice because my parents, my husband’s parents and my family, my sisters, were there.

“Having support and being able to give yourself permission to not feel guilty and use your supports, that was a big part of it.

“Without them, I wouldn’t be here. It wasn’t about compromising my parenting, because I’d had really good role models for parents.”

She summarised the work ethic they gave her as: “If you are in a role, how do you add the most value?”

Mrs Symonds added: “It’s not really about what other people think so much as it’s your own critical insight and your own evaluation. For me, at the end of this month, it’s really what do I feel about how I’ve added value at BHB.”

But Mrs Symonds said there were many others who helped smooth her path to the top.

She explained: “The black individuals in the hospital, there was this movement. There had to be a movement to help you through.

“I sit here on the heart and on the shoulders of so many individuals. I’ll never ever be able to thank everybody who I need to thank for being here today.”

She added: “It wasn’t like being the CEO was my ambition. I probably never would have thought of it if the lady didn’t say it to me.

“It was always about — because my entire family is like this — if you put your heart and soul into it, then what happens is then you get promoted because you are adding value.

“But that path has been tortuous. It hasn’t been a straight path. There has been a lot of hard work along the way.”

She moved from radiography to become an administrator 20 years ago, at the same time as she was studying for a master’s degree.

Mrs Symonds said: “I became a chief operating officer and I had to do that transition and I said ‘you know what, any negativity that comes or that I sense, I was going to use it as energy to help me to go higher’.

“So instead of disintegrating and going away, when I come up against challenge, I actually walk into it. I think it has helped me.”

About 70 per cent of the BHB’s professional staff is non-Bermudian, but Mrs Symonds said the majority of employees were Bermudian — and that made a difference.

She said: “There is something about understanding culturally what’s going on here. I have a really, really good team.

“My executive team is exceptional. We have a really good blend of both because you need the external knowledge. You just need a blend of so many different experiences and that’s what we have right now.”

She said being responsible for the hospital care of everyone in the country was “daunting” and she took that responsibility “really seriously”, especially as a Bermudian.

Mrs Symonds added: “I’ve had two children here myself. My mother passed away here.”

She said a “liberating” moment in her career came when she realised she did not have to know everything and could build a team of experienced professionals to “collectively deliver”.

The BHB hit the headlines for the wrong reasons at times over her tenure, including court cases involving medical malpractice and former employees who sued the board.

Mrs Symonds said: “It’s difficult when things don’t work from a patient perspective. It’s sad and extremely difficult and it’s also difficult when you have employees and things don’t go the way that they want it to go.

“So all of those things take something from you. For me, how I deal with it is, OK, we are going to learn and we are going to get better because we don’t want to repeat an issue that’s not positive.

“I’ve been a part of the change at BHB that moves us into being a learning organisation. We are still on that journey.”

The board recently released salary information for its entire executive team after an earlier refusal.

Mrs Symonds’s half-a-million dollar annual salary has been public since 2016.

She said she was proud to have led the quango as it became more transparent but chose not to read criticism about her compensation from some people because, “I’m human, it hurts”.

Mrs Symonds added: “What has been a challenge to me is not having the opportunity to share ... that it’s not like someone just gifted me and I was on this slide that took me from file clerk to CEO and I was just able to go down the slide without any bumps.

“It’s been a really difficult, hard road and I’ve travelled the road with the best of intentions doing the best that I can.

“The board has over the years made decisions ... I didn’t hire myself. I didn’t pay myself.”

She questioned if there was a “glass ceiling” that meant she could be featured on the front page of the newspaper for decades for her contributions to the BHB yet “all of a sudden, it became about the money”.

She asked: “Where is the focus on the value? There’s got to be a discussion more on value, on the one hand, and what does Bermuda want for its young people. Is there a ceiling? I don’t know. Should we be competitive with the rest of the world?

“I’m not saying that I don’t understand where the questions and where the concerns come from. I completely understand that, it’s just the context. But isn’t that always the case?”

But Mrs Symonds said she was focused on the positive as she prepared to stand down.

She continues to mentor and advise young people who joined the BHB and may train to become an executive coach in the autumn.

But she said nothing was set in stone and her first priority would be to take a break, focus on family and “see what life is like”.

Her parting message to staff was that she appreciated everything they had done — not least over the Covid-19 pandemic — and was proud of the team she has led.

She also thanked the public and the board for their support.

Mrs Symonds added that she was thrilled that, as she prepared to leave, her daughter would join the BHB.

Natasia Symonds recently returned to Bermuda after nine years abroad, where she achieved an undergraduate honours degree in Canada, a graduate degree in physiotherapy in Britain and gained healthcare experience in the UK.

Mrs Symonds said: “I am so proud that as I hand the leadership baton back to BHB later this month, Natasia is joining BHB as a physiotherapist.

“I am very proud that Natasia and I will overlap for one month and that in some small way I will continue with BHB, vicariously through her.”