Tessa Richards was a BMJ editor who championed patient involvement in the journal. In 1983, when she joined the BMJ, patients were just extras and their photos were often published without consent, even nude with a black eye patch, which proved ineffective at masking identity. By 2023, when she left, the journal had a patient editor, a patient advisory board, and more than 1,000 patients and public reviewers. Patients are now involved in all parts of the editorial process. Richards led the patient engagement strategy and ensured its implementation. She created a set of articles emphasizing that patients are equal partners. The transformation it carried out was gradually taken over by other magazines. She achieved this through indomitability and finding ways where there seemed to be none.