Shadow Me Next!

When Care Means More Than Medicine | Dr. Nekaiya Jacobs Pratt, MD

• Ashley Love • Episode 36

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What happens when a physician notices something seemingly small but deeply meaningful missing from patient care? Dr. Nekaiya Jacobs Pratt, a pediatric critical care physician, transformed hospital culture by addressing a gap that affected her patients with textured hair.

During the isolating days of the COVID-19 pandemic, Dr. Kay found herself questioning her place in medicine. The emotional weight of caring for critically ill children had always been balanced by the joy of seeing them recover, but something was missing. When she noticed hospitalized children with textured hair weren't receiving appropriate hair care products, she took matters into her own hands, literally. She began bringing products from home and braiding patients' hair on her days off.

This personal mission evolved into something remarkable: a hospital-wide initiative providing culturally appropriate hair care products across six states and a children's book called "The Magic Bonnet" that serves as her "love letter" to this work. The impact runs deeper than appearance; it fundamentally changes how patients experience care and how providers see their patients.

"When patients feel seen and they feel like you are not just the lab result or the CT scan...they participate in their own healing," Dr. Kay explains. Through education involving mannequin heads with various hair textures, she's transformed a hushed subject into an opportunity for connection. Healthcare providers who once avoided conversations about different hair types now confidently advocate for their patients' hair care needs.

Dr. Kay's message resonates beyond pediatrics: "Bring your whole self to work." By embracing our unique perspectives and lived experiences, we address healthcare disparities and provide care that honors patients as whole people. Her story reminds us that meaningful change often begins with noticing what others have overlooked and being brave enough to do something about it.

Join us for this inspiring conversation about finding purpose in medicine, the power of cultural competence, and how small acts of dignity can transform healthcare from the inside out.

For more about Dr. Kay

> please visit her at www.heyitskaymd.com

> and check out her book The Magic Bonnet

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Ashley :

Hello and welcome to Shadow Me Next, a podcast where I take you into and behind the scenes of the medical world to provide you with a deeper understanding of the human side of medicine. I'm Ashley, a physician assistant, medical editor, clinical preceptor and the creator of Shadow Me Next. It is my pleasure to introduce you to incredible members of the healthcare field and uncover their unique stories, the joys and challenges they face and what drives them in their careers. It's access you want and stories you need, whether you're a pre-health student or simply curious about the healthcare field. I invite you to join me as we take a conversational and personal look into the lives and minds of leaders in medicine. I don't want you to miss a single one of these conversations, so make sure that you subscribe to this podcast, which will automatically notify you when new episodes are dropped, and follow us on Instagram and Facebook at shadow me next, where we will review highlights from this conversation and where I'll give you sneak previews of our upcoming guests.

Ashley :

Dr Nakia Jacobs-Pratt is a pediatric critical care physician who doesn't just show up for her patients she advocates for them in ways that truly transform care. During the height of the COVID-19 pandemic, she started noticing something that many overlooked Hospitalized children with textured hair weren't receiving the basic products they needed to care for their hair. It may seem small, but to the kids and families she serves it meant everything. Fueled by her own frustration with the emotional weight of medicine during that time, dr K took initiative. She brought products from home. That time Dr K took initiative. She brought products from home, braided hair on her days off and created something that's now become a system-wide movement across hospitals in six states.

Ashley :

In this episode we talk about her path to medicine, the emotional intensity of caring for critically ill children and what it means to bring your whole self, culture, identity, lived experience and all into the hospital room. Dr K is living proof that meaningful change in healthcare often starts with noticing the small things and being brave enough to do something about them. Please keep in mind that the content of this podcast is intended for informational and entertainment purposes only and should not be considered as professional medical advice. The views and opinions expressed in this podcast are those of the host and guests and do not necessarily reflect the official policy or position of any other agency, organization, employer or company. This is Shadow Me Next with Dr Kay Jacobs-Pratt. Dr Kay, thank you so much for joining us on Shadow Me Next. This is going to be an incredible conversation because you are an incredible person, so thanks for being here, thank you.

Dr. Kay:

Thank you for having me.

Ashley :

Before we dive in to the incredible way that you're not only providing life-saving medical care to your patients, but making them feel cared for, which is just incredible, I would love to talk about how you ended up in medicine in the first place. So go back to the beginning with us. Did you always know you wanted to be a doctor?

Dr. Kay:

No, I didn't. I didn't always know that I wanted to be a doctor. I am really blessed to have had parents who exposed me to a lot of different things. I played the piano, I danced, I played sports, did all of the things and I knew I was really good at science, just kind of naturally gifted at science Not so much at math, but I could get by and I didn't know where I was headed. But my parents really were like you know what, do your thing, you'll figure it out.

Dr. Kay:

And I thought for a really long time that I was going to be a dancer. I love dance, I still love to dance. And for a bit of time I'm like yeah, this is what I'm going to do, I'm going to be a rockette, this is going to be phenomenal and I'm going to be on a billboard. And then here we are now In college I was like you know, I'm going to major in science because I enjoy biology, and that led me to marine biology, because that was like the thing to do at that time and I quickly realized I didn't really want to be on the water, those types of things. I got motion sick really fast and I had to like pivot yet another time, and that's when I found medicine through some really great mentors and I mean, it has just been a journey and I am so happy that all those pivots happened.

Ashley :

That's incredible. I love that story, you know, and the marine biologist who doesn't want to be a dolphin trainer marine, but at some point right that was a requirement, dr K.

Ashley :

Tell us how, tell us how school was for you, and let's let's focus really on medical school, but not just that, schooling all the way through, because a lot of pre-health students I've talked to recently one of their primary reasons for avoiding medicine is the length of schooling. So to become a medical doctor, it's an extensive amount of studying, right, and it doesn't just end after med school, which is four years. It is much longer, as you know. Tell us about that, yeah.

Dr. Kay:

You know, when you decide you want to pursue medicine and I'm just going to speak from the physician perspective, because that's what I do you have decided to be a lifelong learner. So I always encourage people who are considering this to think of it as milestones, but that you never stop studying, you never stop growing, you never stop learning. It's just a continuum of life. So once you have accepted the fact that you will forever be a student in some capacity, then it's a much better pill to swallow, or easier to swallow, because it's a lot of schooling and it's not easy. There will be times that you stumble, there'll be times that you have to start over, and that's okay. That's my journey as well too.

Dr. Kay:

I didn't go straight through to medical school After I was done with college. I didn't do well on the MCAT. I took it again and didn't do any better. So I actually entered a post-bac program which I which was phenomenal and exactly what I needed to do Did excellent in my post-bac program and matriculated into medical school, did great in medical school, made it through and was like you know what I want to do pediatrics and just decided this continuum of learning was going to be what it was, but up until getting into residency it was not easy. There were a lot of hard days. There are a lot of really great days, and the day I finally accepted that you will forever be studying, you will forever be in a book and you will forever be humbled, it was the day I really said you know what Sit down and study like? That's reality and you chose this and it's a really, really great career.

Ashley :

I love the way you framed that, because you're absolutely right. If you look at it like it's a continuum, if you look at it like it is a true journey and not really one with the beginning of medical school and end of medical school, beginning of residency, end of residency, beginning of fellowship, so on and so forth, it's all working towards where you're at right now, which I would imagine. Where you're at right now, as incredible as it is, there probably is still a next step for you, and maybe you are right now as incredible as it is, there probably is still a next step for you, and maybe you are starting to think about or have thought about that next step. That's a really great way of thinking about it. Thanks for sharing that. That's perfect Now. Right now, you're practicing in pediatric critical care medicine, which is just it's sick kids.

Dr. Kay:

Yeah, it's very sick kids, very sick kids. And this is a strange space in medicine sometimes because people who haven't really been there have a hard time fathoming a child being that level of ill. And that's the space I exist in those kids anywhere between a few days old up to 18 who are in the hospital with a life-threatening illness. That's my bread and butter.

Ashley :

Wow, how do you navigate the emotional weight of caring for those children? I mean, you seem like the most vivacious, beautifully sold, happy person. Thank, you. And you see some tough stuff. I mean people on their very worst days, and not just theirs, but their children's worst days. How do you manage that?

Dr. Kay:

It's so interesting that you say that, because if someone had to ask me to just give a one-liner of my job, it is that I meet families on their worst day. A child is ill and that kid feels that, and the parents feel it. No parent would not switch places with their child, so to them it is their worst day, regardless of the level of illness that that child is facing. I could be dealing with a kid next door. That is in a very different position, but it doesn't matter, because each and every room that I go into for that family it is their worst day, and that can be tough.

Dr. Kay:

But I try to remind myself of that, even when I'm like my most tired self is that these people are depending on me to show up at my best self and that every day I go to work, a child gets to live. If I don't do this job, if others in this field don't do this job, then that isn't the case. So every day that I get up out of bed and I say you know what? This is what I've been trained to do and I'm a great vessel to do it is a day that someone gets to take their child home and to me that is beautiful. In med school I knew very quickly I was going to do pediatrics. Like very fast, I thought I feel for these kids they don't deserve what's happening to them and I want things to be better for them. And I just knew that you know I was going to do P's.

Ashley :

I didn't know I was going to do ICU medicine but I speaking as a healthcare provider who can't possibly fathom a life in pediatric critical care, it is so nice to hear you say I understand how sick these kids are. I understand that these parents are so upset. I would be upset if this was me. But I have the training, I have the experience and I have the tools to make a difference and help these kids and keep these kids alive. So I think a lot of times people look at especially physicians and think they're superheroes. These things don't phase them, they're just. This is a job, this is what they do and it's really, it's a calling. I mean you, you feel like this is where you belong and it's where you've worked towards.

Dr. Kay:

It is truly a calling and the amount that I care is just. It's so interesting. I was in a super stressful situation recently and shortly after it kind of settled down, my aura ring said did you just work out? And I thought to myself I mean, I felt like I did, but that reaction of having the high heart rate, being nervous and scared, just as the parents were to say I have got to fix this now, is real and the fact that I still get to feel that at work really just shows me that I still really care and I love what I do.

Dr. Kay:

Each day that someone gets better or I get to see a kid leave the hospital, I'm just like this is why I'm here and that feels really good. That's why when people ask me, like you know, are you exhausted or tired? Sure, I work day shift and night shift and I'm up at 2 am sometimes, but the feeling that I get when that kid waves at you and you know that that was not the kid that came in is just I mean, it's priceless. There's nothing like it.

Ashley :

It just fills your cup all the way back up, you know when you see something like that. I love it. Tell us, if you can, what does a day gosh? What does the day in the picky look like? Is it? Is it always sad?

Dr. Kay:

No, no, it's it's. Some days are sad I won't sell it as not sad some days, but for the most part it's really, really awesome. So we start the mornings with, you know, finding out from our team members how the night was, if I'm on a day shift and we sit, we talk about all of the patients and our plans and thoughts for the day. We go around, we do family-centered rounds and we talk to the families about this is what I'm thinking, this is what I want to do. I'm blessed to be at a hospital where I have residents and fellows, so it's really great to like give them some autonomy, to make some decisions and some moves. And then I start to see the patients and weigh in on the things I think we should do differently.

Dr. Kay:

And then, after that, begins the fun things. We get new admissions, we get to do procedures which is why I went into ICU, because I absolutely love using my hands and love doing procedures and then we tie up things, we take care of things, we fix things, we change medication plans, and then there's always that unknown, because you plan your day out, but it's the ICU. Anything can happen at any given time. And so when the overhead page comes and someone says they need me stat somewhere and I have to go. That's the excitement that I enjoy and that comes in spurts and waves and it feels good and your adrenaline gets up and you go and you do all the things that you've been trained and you know how to do and it's just a lot of fun. So I would say that it is fast-paced, you think a lot and if you love physiology, it's like the perfect place for you.

Ashley :

Oh, that does sound very exciting. I'm selling it. I'm selling it. You mentioned something that I want to touch on just for a minute Family-centered rounds and on any time you're working with a pediatric patient. I can't imagine there is anything much more important than this. Tell us what that means and how that might be different from just rounding like we hear about on TV and in the textbooks and things like that, yeah, family-centered rounds really re-centers the focus on the actual family and the thing about when a family's in the ICU.

Dr. Kay:

There's that feeling of helplessness and it comes because you have someone come in that says your child is sick with X, whatever it may be, and these are the things that we need to do to get them better. And as a parent or a family member, what else do you say? But okay, you don't really feel like you have equal parts in what happens next. Many times You're taking the information you aren't really processing it because it's kind of a trauma response, right? If I asked you three days later if you remember my first conversation with you, you're going to say no, I don't. You came in, you said bad things and that's all I have, and you said this is what we had to do and I trusted you and you did it and we got better and that's great.

Dr. Kay:

But family-centered rounds reminds families that they are equal parts of the team. We rely on our parents and our family members so, so much and it is our time to honor that, to involve them in the conversations, to allow them to hear what we're saying as the medical team, so we may come by your room and say, hey, we're going around now We'll pull whatever. Family members are participating in rounds and the team talks about everything. The nurse gets to talk, the resident talks, the fellow talks, the pharmacist, physical therapy Everyone gets to say this is how the child is doing and get on the same page, come up with care plans and hear from the family and answer questions. So I think Family Central Rounds really just reroutes the care in actually the family and it reminds us that the patient is a human.

Dr. Kay:

During COVID man we moved so far away from that which we had to. That was just the nature of the beast. But it was easy to take a face off of the patient when all you're doing is looking at the paper of what's happening. But when you stand at that door and you see the family, it really reminds you that these are people and we have to weigh that into all of our decisions.

Ashley :

We have to weigh that into all of our decisions.

Ashley :

That was beautifully stated and you're absolutely right.

Ashley :

I think we can get bogged down in the data points and the billing codes and the diagnoses and what's next, et cetera, and then you just have to pause and recenter and look at the bed and look at the parents, the other family members that might be in the room.

Ashley :

The patient is a human. You said that, and and this is just such a perfect segue because, dr K, you mentioned so many of the things that you do medically on the day to day and yet, in the middle of all of this, of all of the chaos of getting paged, of running to rooms, of doing procedures, et cetera, you noticed something about your patients and their care that maybe wouldn't have its own diagnosis code, or perhaps there's not an actual prescription that you would write for, but you found a prescription for it and I'm going to hold it up, and it is this absolutely incredible book, incredible book called the magic bonnet, and this, this is care that you have given, given not just to your patients, but to other patients and to parents and to clinicians. I've learned so much reading this as an adult and as a clinician, even working in dermatology, which is hair, skin and nails, you know. So tell us a little bit about, tell us a lot of it about this.

Dr. Kay:

I would love to, because it's such a fun part of what I'm doing right now, but I feel like I got to go back to the backstory of how I even landed at the book, and it was honestly during COVID. I feel like you know, in Golden Girls, when Sophia says picture it Sicily, I feel like that, picture it COVID 2020. And medicine was hard for me.

Dr. Kay:

We started you know, Healthcare Heroes, here's your discount, all the things. And that held me over for a small amount of time and I slowly found myself moving into that feeling of isolation. It was those drives in the morning where and I live in Chicago a normal drive you encounter thousands of cars. You don't remember them. During COVID it was the same people. I remember vividly a blue Mazda, every morning that I saw same person and I remember one morning I didn't see her. Then the next morning, the next morning I didn't see her and I remember praying, thinking I hope she's okay because it was that few of us going somewhere and I'm like we.

Dr. Kay:

It felt so lonely and in that I started to question medicine. I had questioned what I was doing, why I was there, why no one told me when I said I wanted to do ICU that I would need to be prepared for this particular moment and it was hard for me and I really needed to recenter myself in medicine. And I found something super personal to me, which was hair, and said you know what this is important? And I started to look around and saw that there's not a lot of people in the hospital that look like me. I've known that in my journey and our patients don't have a big voice in that sense. So when I started to see children with hair like mine suffering from baldness or not having their hair taken care of because we didn't have the proper products, I said, you know what I'm going to bring in the right stuff. So I started ordering travel size things off of Amazon and I would come in there on my days off and do hair braids, all of these things. And the kids just loved it and I loved it and it was what I needed. It's what I needed.

Dr. Kay:

And one day the hospital said, hey, we got a patient satisfaction survey and we love what you're doing, we want to support it. And I said, okay. And they said what do you need? And I said, oh, I need money, I need products. And fast forward to two years later, we developed a whole product line that is available across our entire healthcare system. So six states of products for people with hair like mine bonnets, shampoo, conditioner, all the things. Bonnets, shampoo conditioner, all the things and it has just been I mean, it makes me teary-eyed to even like think about coming from during COVID. Like how do I get out of medicine was a thought I had so often to now being like oh my gosh, like you are medicine, this is you. You are medicine to this, and the book is my love letter to that work, and that is what the root of the book is.

Ashley :

And what a beautiful love letter it is. It really is it. Just it touches on so many things that are so fantastic. You mentioned, when you were describing family centered rounds. You mentioned the care team. All of the people that are involved in the care team. They're in this book, you know. You've mentioned them. You've mentioned, oh gosh, every patient that comes in, that comes in through your ICU, is unique, and you've mentioned unique preferences and hairstyles in this book that patients might have.

Ashley :

You know, it's just everything in medicine. You can take it and apply it to this. In non-medical terms. It's something that a child would enjoy reading. It's something I deeply enjoy reading, and I think it's just such a testament to the ministry that you were, were and now are still serving these families and their children. I'm sure you have taught so many people in the hospital where you work about this sort of thing too. Tell me what that means to you. I mean, there's huge cultural gaps in healthcare. We know that but just in seeing people as well, tell me a little bit about that and how we can do better.

Dr. Kay:

This is probably one of my favorite things to talk about when it comes to hair and I love talking about it because this whole, all of this work, really showed me the importance of talking about hair and understanding people's identity. Like hair is just kind of a figure in the world of who we are as people, or a part of our identity. When I started this project, one of the first things I did was a needs assessment and in that needs assessment I asked people. I said hey, how comfortable are you with other hairstyles? And people were like not at all. I asked people could you name this hairstyle? Nope, not at all. And they said I said how do you feel about approaching a patient who has different hair than you do? They were like oh, I just wouldn't, I would avoid it or I would wait until someone brought it up.

Dr. Kay:

And as I started to find out and talk to people about like why is that the case, I really learned that hair is so personal that we almost swung the pendulum to a direction where people said you know, don't even ask me about my hair, don't touch my hair, these types of things and that led to people not even trying to understand hair and one of my favorite stories is there's a nurse who came to me and said I'm so glad you're doing this work.

Dr. Kay:

Can I ask you a question? I said sure, and she said what is your hair? And I thought I've been here for five years and you never felt comfortable asking me about my hair. We have gone to you know dinner together, we have been in a coat together, all these things. I have sent you know your children Christmas gifts and I'm like you never felt open, like I was open enough for you to talk to me about hair, and she was just like you know. I felt like it was culturally not appropriate to talk to you about your hair. And that was the day that I said you know what? We're going to change this, we're going to fix this right now.

Ashley :

Now Dr K and I did not have the opportunity to discuss a quality question, but this kind of bold, thoughtful action that Dr K is demonstrating brings up an excellent interview question that you might hear during one of your pre-health professional school interviews. Can you share a time when you noticed something that wasn't working and took action, even if it wasn't your responsibility? Keep listening to hear how Dr K demonstrated this when she brought hair products to her hospital and turned a personal act of kindness into system-wide change. Keep in mind that there's more interview prep, such as mock interviews and personal statement review over on shadowmenextcom. There you'll find amazing resources to help you as you prepare to answer your own quality questions.

Dr. Kay:

I started bringing in mannequin heads and different types of weaves and things like that for people to understand different textures of hair, and the amount of people that walked up to that cart that said, I have been waiting to feel this type of hair was mind-blowing. And we went from people saying I don't know about different types of hair to people passing their hair quizzes, to people saying I want to be a curly hair champion, I want to tell other people about this work and I mean it's just like completely full circle. So I love the education portion of it because it has made me personally feel closer to my team and it makes me feel like they have another piece of me. That is so, so important.

Ashley :

We did. We have made these conversations taboo, which is where we're talking so much about how other things are becoming less taboo and how to approach. You know discussing obesity with a patient and abuse with a patient and things like that, but you know there is no different.

Dr. Kay:

Exactly, it's no different, no different. So to see people go in and talk to a family and say, hey, I see, how long have you had your braids in? Do you want a bonnet? Things that I know that they would have never done before it's just amazing to watch someone advocate for their patient's hair when someone's coming to take out the EEG leads and they're like no, you actually can't take the leads off of this type of hair. That way. It's just. I mean I don't have to do anything anymore. I mean they beat me into the room now and I'm like this is great.

Ashley :

I love that. That's incredible. That is really incredible. And, dr K, you will have to confirm. But I would imagine that a lot of these kiddos that leave the hospital, yes, they're going to remember getting poked. They're not going to remember how many times, but what they might remember is, hey, that. But what they might remember is, hey, that nurse knew about my braids. That white nurse knew about my braids. She knew what locks were. She knew how I needed to care for my. I can't, oh my God. The teenage girls that are in there must just, they must just feel so seen. Why is it important for patients to feel seen in medicine right now, especially our young ones?

Dr. Kay:

Yeah it's. I mean, it's so important when patients feel seen in medicine right now, especially our young ones. Yeah, it's so important when patients feel seen and they feel like you are not just the lab result that you got back or the CT scan that you got back and you're taking care of them as a person. They participate in their own healing.

Dr. Kay:

And I tell people all the time there's but so much medicine I can give someone. That body has to give back and a body that can't give back can't survive, because if that was the case, no one would ever die right. But your body has to give back and in order to give back, that body has to trust you. It has to trust that you see them and it has to believe in you. And people do not believe in you if they think that you don't know who they are, if they feel like you just treated them like another person, you don't understand them, you can't relate to them. All of these things and that's true because literature shows us I mean, there are so many healthcare disparities, there's so many different ways that we can do better for people in medicine, and all of that is rooted in knowing the people who we serve, and this is a major part of that who we serve, and this is a major part of that.

Ashley :

And you know, that's not just applicable to our youngest patients, that's applicable all the way throughout their entire life, from from womb to tomb. So they say you know, it's literally everybody in between. Thank you for seeing that and thank you for being so bold as to step in and say you know, I can do this. Somebody needs to. It's going to be me. What would you say to encourage other people to kind of step into these places where they might see an issue and they might be very well equipped to deal with it, but perhaps they're just they're, they're pausing. What would you tell them? How would you encourage them?

Dr. Kay:

just they're pausing. What would you tell them? How would you encourage them? I would say you're not just a number and sometimes, when you're in a huge team or a huge system or a huge world of medicine, you feel like you know, oh, maybe I'm just a body or I'm a part of this team and you're not. You're not just a number. There is value in who you are. There is value in your lived experience. There's value in your opinion. It's up to you to put yourself out there and to give it a shot and try. People deserve your try, because if you don't and we don't ever see what comes out on the other end you don't know how many people you could have helped.

Dr. Kay:

So I would say that don't see yourself as a number, don't see yourself as a worker bee. See yourself as a part of the change, because that's why we went into medicine. We want to help people live better lives, and that requires us to be the people that we are. If we all just contributed what we learned from a book, it would be the same thing. I read the same chapter you read, so we know the same thing. What makes us different is what we contribute as ourselves. So bring your whole self to work, not just Netter's Anatomy, not just your physiology book Like bring your whole self to work, because that is the essence of what we do, that's how we change the world and that's how we move the needle in the direction it needs to go.

Ashley :

Yeah, Dr K, that's a beautiful, beautiful way to end this. Thank you for what you do. Thank you so much for this book, the Magic Bonnet. You can find it on Amazon. Where else can we find you? How else can we support you and what you're doing?

Dr. Kay:

Thank you for that. I'm on Instagram. I'm at heyiskmd, so like heyisk, which is how I answer the phone in the hospital. Everyone asked me how I came up with this name is because when people call to pick you up, I'm like heyisk. That's just my tagline. It became a thing, so it's heyiskmd on Instagram. You can also find me at my website, which is wwwheyiskmdcom, and all of my contact information is also there.

Ashley :

Thank you so much and I will link all of that in the show notes below. Dr K, you are such a gift to medicine and it has been such a pleasure having you on Shadow Me Next today. Thank you so much for joining us.

Dr. Kay:

Thank you for having me. This has been wonderful. I so appreciate you.

Ashley :

Thank you so very much for listening has been wonderful. I so appreciate you.

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