Alexes Hazen had no plans to become a surgeon when she graduated from college with a history degree in 1987. But while serving as a Peace Corps volunteer assisting with medical care in Honduras, she realized her passion for helping others could be translated into a career in medicine. She returned to the States, entered a post-baccalaureate program in medicine, and went on to earn her medical degree and train as a microsurgeon.
She had been on staff in the Wyss Department of Plastic Surgery at NYU Langone Medical Center for 23 years when the new department chair, Dr. Eduardo D. Rodriguez, arrived and recruited her to join and help assemble the medical center’s new face transplant team, who recently performed the most complex face transplant to date. The recipient, Patrick Hardison, was a volunteer firefighter who had experienced extensive, disfiguring burns in the line of duty. Preparation and training for the transplant would be intense, requiring more than a year of grueling hours, scrupulous attention to the tiniest details, marathon practice sessions, and a team of more than 100 specialists. “Since I had been at NYU Langone for so long, I was able to bring together colleagues across various disciplines at the medical center to join our team.”
In selecting Hardison for the surgery, Dr. Hazen was part of a team of specialists who traveled to Hardison’s hometown of Senatobia, Mississippi, to make sure he had the necessary support system intact to care for him upon returning home after the transplant. The team met with his local doctors, his pharmacist, and his family to ensure everyone was prepared. “In fact, the team’s psychologist and I met with the patient’s children, who are still young, to answer any questions they had about the procedure and to help prepare them for this monumental transformation.” This leave-no-stone-unturned due diligence distinguishes face transplant procedure in the U.S. and abroad — in China, a recipient without the vital, vigilant support system died because he failed to take his post-transplant medications.
For their seven practice runs, Dr. Hazen and the other six surgeons on the team got up at 4 a.m. on Saturdays, traveled from New York to Pennsylvania, and practiced the procedure on cadavers for 12 hours straight. The team of craniofacial and microsurgeons, all used to being the person in charge in the operating room, had to work seamlessly as a team, each person fulfilling his or her role to ensure that the surgery went off without a hitch. Each time they performed a practice surgery, they’d get better and faster, and in the way of all teams who work together so intensely, they became close, a tight-knit unit dedicated to the immense undertaking of giving someone an entirely new face. “In addition to everyone knowing their roles, we met as a team after each session to review the rehearsal procedures, to discuss what worked well and if there were any areas of where enhancements could be made. It was a great opportunity to fine-tune each step.”
During the surgery, Dr. Hazen was the crucial liaison between the donor and recipient operating rooms, shuttling back and forth, ensuring both surgeries were proceeding according to plan. “We were so well coordinated that the first part of the surgery had a difference of only 12 minutes from the time that we anticipated that portion of the procedure to take,” said Dr. Hazen. She also served as backup for each of the other surgeons, filling in whenever one of them got tired. This meant she had to know everyone else’s roles perfectly, like the actor who understudies all the lead characters in a play, ready to go on and perform flawlessly at a moment’s notice.
Participating in the face transplant has changed the way Dr. Hazen looks at her surgery practice. “Now that we have seen what is technically possible, doors will open for other challenging situations.” And she sees big things for the field of reconstructive surgery in general. “Patrick had to go through 70 surgeries over the course of 14 years before the transplant,” she said. “My hope is that people with facial injuries — be they burns or gunshot wounds — will one day not have to go through those initial surgeries and will go right to having a transplant.”
As the only female member of the transplant team, Dr. Hazen encourages women who want to get into surgery to pursue their dreams. “It’s hard. It takes a lot of work and a lot of time. It’s a sacrifice. If you want a family, if you want to get married or have children, it’s possible, but it’s hard,” she says. “Find mentors — not necessarily women, but people you can rely on and support you. You need a strong supportive family, whether that’s your parents or your partner or your sibling. You need people who support you and help you not to get discouraged.”