As a kid, one of Alexandra Zdonczyk’s favorite activities was discovering and observing small creatures in her backyard, and in streams and tidepools. She envisioned herself growing up and studying insects, birds or marine life. In high school, she became fascinated with human biology and imagined careers in medicine. Even so, Zdonczyk never saw herself as an eye doctor.
“I entered medical school not knowing about ophthalmology,” said Zdonczyk, who will soon earn a medical degree and a master of science in clinical investigation from Washington University School of Medicine in St. Louis. “I’ve never worn glasses. I had no personal perspective on how vision impairments can affect quality of life or stymie brain development and function, especially in kids.”
She stumbled upon ophthalmology by way of another passion: advocating for health equity. An associate dean alerted her to a research project examining health disparities among children with strabismus. Colloquially known as crossed eyes, uncorrected strabismus can cause irreversible vision damage and developmental problems leading to poor academic performance, physical disability, relationship struggles and reduced employment prospects.
Together, ophthalmology and health-equity advocacy have uncovered a third passion for Zdonczyk: St. Louis. She moved here from Atlanta nine years ago to attend Washington University. In July, Zdonczyk will begin her residency in ophthalmology at Barnes-Jewish Hospital. “I feel at home in St. Louis,” she said.
Why are you interested in ophthalmology?
I enjoy the combination of ocular anatomy, performing surgeries, and the one-on-one relationships developed during patient care. It’s exciting to have such a tangible effect on people’s lives through surgery, and relatively quickly. You do a cataract surgery, for example, and when you take their eye patch off the next day, the patient is suddenly blown away, sometimes, in tears by the impact of better vision on their lives. For everything we do, we depend so much on our vision. Being able to help preserve people’s vision can be so life-changing. For pediatric ophthalmology, you can alter the trajectory of a child’s life.
How can clinicians address health disparities as a part of patient care?
It’s impossible for health-care providers to get through a working day without encountering issues of access to care for their patients. It can be really frustrating when you have medical therapies, such as a prescription, that scientifically have been shown to help a specific condition, but your hands are tied if your patient can’t afford the medicine or if they can’t access it. Or if they cannot come to follow-up appointments because they lack transportation or their job won’t let them take off for a few hours. Follow-up, even after hours, is important, as is offering resources for services such as transportation to the medical center.
The research I worked on examining health disparities among pediatric patients who underwent surgeries to correct strabismus showed significant variations in follow-up care. Kids from lower socioeconomic backgrounds were less likely to have follow-up appointments. So, if, for whatever reason, a child was having postsurgical issues and was not able to see a doctor, then the child ends up in the same place as where we started. They might even develop irreversible visual impairment as a result of amblyopia, also known as “lazy eye.” The lifelong impact is immense. Children can suffer lifelong vision impairment if strabismus is not properly treated.
As a Latina, I also see many examples of health inequities among native Spanish speakers. St. Louis has a small but growing Latino population; however, a lot of providers don’t speak Spanish. These language barriers can have a major impact on health care. It’s important for people who are bilingual, like me, to go into the community, form relationships and develop trust, and help recruit and mentor students from all backgrounds to form a health-care workforce representative of our patient population. Many of our patients share stories about how they immigrated here that remind me of my friends and family and motivate me to help address gaps in their care.
Why stay in St. Louis?
I love St. Louis. In addition to the wonderful mentors I’ve been grateful to learn from at WashU, I’ve formed lifelong friendships here. I’m excited to say that some of my best friends are also staying here for residency and that my partner and I will continue to live and work here. I think the combination of local and global influences, all within a 20-minute driving radius, is really fun. St. Louis has many ethnically distinct and historical neighborhoods that I love exploring during my free time. Sometimes you can feel like you’re in a different country. Lafayette Square feels like it’s the turn of the century. The area around Cherokee Street offers delicious, authentic Mexican food. Cahokia Mounds, in Illinois, is fascinating.
But there’s also a dark underbelly to some of these neighborhoods that, historically, were created because people were only allowed to live with other people of the same race or ethnicity. It’s a double-edged sword in which certain social structures have helped preserve the area’s amazing heritage, but, at the same time, it’s continued to perpetuate the divisions we have such as the Delmar Divide. St. Louis is a microcosm of the whole nation, but, here, I feel like I can make a positive impact on people’s lives.
Education: Earned undergraduate degrees in biology and Spanish at Washington University. Slated to complete a medical degree and a master of science in clinical investigation in May.
Employment: Will begin a medical residency in ophthalmology at Barnes-Jewish Hospital.
Favorite St. Louis activities: “All the amazing festivals! Some of my favorites are ‘Festival of Nations’ in Tower Grove Park and the ‘Fiesta in Florissant,’ a Hispanic festival.”
Favorite place to get coffee: Brew Tulum in the Delmar Loop. “It has really good spicy Mexican-style coffee and this spicy cacao drink called “Xococoatl.”
Favorite exhibit at the St. Louis Zoo: The six aviaries that comprise the Bird House and Garden. “My mom and dad love birding, and I grew up traveling to different places to go bird-watching.”
Favorite place to enjoy nature: “Oh, tough choice. There are so many. I love Castlewood State Park. One that I discovered recently is Klondike Park near Missouri wine country. It has a beautiful, sandy beach area. The sand is so pristine. It feels like an actual beach.”
Best place to get a taco: “My partner is Mexican, from the Rio Grande Valley in south Texas, and he believes that El Morelia Super Mercado offers the most authentic tacos. The place is a Mexican grocery store in north St. Louis County. They serve you tacos, with a little baggie of toppings. It’s casual and so delicious.”
See here to read about this year’s Class Acts at Washington University.