Gymnast Simone Biles took home the all-around title at the world championships for the fourth time.

Biles, 21, strangely struggled in the competition on Thursday in Doha, Qatar, only days after tweeting she’d put off having a kidney stone removed until after the competition.

In any case, in spite of a fall on the vault, a fall on the balance beam and stepping out of bounds amid her floor practice schedule, Biles still pushed through with her #BlackGirlMagic with 1.693 points – the biggest edge of the triumph of her four titles.

Morgan Hurd, also from the U.S., took bronze, while Mai Murakami of Japan won silver.

Notwithstanding the all-around, Simone Biles, who came back to the game this Summer, led the U.S. team to gold.