Resident reignites her passion for surgery through service

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One Hennepin Healthcare resident has transformed the way she provides care. Alexandra Coward, MD, MPH, spent 10 days in Guatemala providing surgical services to a rural community through the nonprofit, HELPS International.

Dr. Coward was inspired to pursue a medical service trip by her interest in public health, surgical development, and service to vulnerable populations. Working at Hennepin Healthcare fueled those interests even more. Paul Stahler, MD, in transplant and trauma, advocated for Dr. Coward to join a service trip – and was successful.

Every day, Dr. Coward and the other providers spent 12 hours performing surgeries on Guatemalans without healthcare access. Dr. Coward said she’ll never forget the long line of patients waiting outside.

“There were more patients that needed surgery than we had time for,” Dr. Coward shared. “We were all acutely aware of that and worked as long as we could. The people waiting had traveled anywhere from one to 12 hours away by car, bus, or foot. Some stayed overnight waiting.”

Many of the services and procedures they provided are easily accessible in the U.S.

“We had people with symptoms from their gallbladder and hernia for years,” Dr. Coward said. “While it’s not a life-threatening diagnosis, it is debilitating. It prevents you from working and participating in daily life. In the U.S., we can fix the problem before complications occur.”

Dr. Coward had to be flexible and creative since the hospital in Guatemala didn’t have all the resources of a U.S. operating room. She gained a greater appreciation for the sheer number of people who contribute to surgery.

“It’s not just the surgeon – you need someone to refer that patient, schedulers, pre-operation, nurses, anesthesiologists, and someone to sterilize the room and equipment,” Dr. Coward said. “It’s all these little things that I wouldn’t normally think about that I was helping with.”

For Dr. Coward, the trip reaffirmed the type of provider she wants to be.

“Patients are coming to me with their own difficulties and struggles, and the healthcare system has not necessarily been kind or accessible to them,” Dr. Coward said. “How can I be a bridge for the patients? How can I help them navigate the system and get the access and compassion they need?”

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Dr. Coward, third from left, expressed gratitude to the Hitchcock Surgical Society for funding the trip and Dr. Stahler for mentorship. She is hopeful more residents will have a similar opportunity.

“Residency is really tough on a limited budget, so I wouldn’t have been able to do this trip without financial support,” Dr. Coward said. “This is what prevents burnout – connecting residents to amazing projects that they can be a part of and be inspired. Reigniting my passion for surgery is going to see me through my final year of residency.”

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