Melissa Nass

0:05I'm pleased to introduce our guest today, Dr. Melissa Nass, a graduate of Milton's class of 1995 and now the Director of Health Services at Milton Academy. Dr. Nass, thank you for taking the time to sit down with me today. Let's start by talking about your time at Milton. Can you tell me the story of what brought you to Milton as a student? Sure. I was a day student at Milton Academy and I started here in 10th grade. And I came to Milton because the school that I was attending wasn't really working for me anymore.

0:41I had attended public school my whole life and had been quite a good student. But by the time I got to ninth grade, I was mostly goofing off and not working as to my potential. And my parents thought it was time to look for different opportunities that might serve me better. Is there a particular course or teacher who had a significant impact on you after your time at Milton? I would tell you that Todd Fry taught me how to read, and that is a gift and was really important to me.

1:19I don't think I had been reading literature the way that I did after his class. He was a really important teacher to me. I think Sally Day taught me how to write, and that was also really important to my trajectory. Outside of the classroom, what activities were you involved in during your time at Milton? I was involved in a lot of activities at Milton, but the place where I spent most of my energy extracurricularly was with the peer counselors and with independent student support.

1:53ISS was a group of senior students on campus who were trained to address concerns around suicidality, substance use disorder, and eating disorders. We also did a little bit of work in the area of sexual assault. And that leadership role for me was really important. I learned a lot myself, but also became a real contributor within the Milton community. So that work was important to me. And last question for this section. Every year since the 1960s, Milton Seniors spend the month of May completing a senior project, a full-time commitment to a personal passion and a project of their own design. What was your senior project?

2:40My senior project was volunteering at Boston Medical Center. Boston Medical Center is the safety net hospital in New England. I was lucky enough to get a position volunteering there for my senior project in the Department of Pediatrics. And I had this very meaningful experience while on my senior project that really shaped the rest of my career. I was invited to attend the statehouse with a group of pediatricians to advocate for some money, that was available in the Massachusetts state budget to be allocated for children without insurance in the state of Massachusetts. This is...

3:28Long time ago, where not everybody in the state of Massachusetts had insurance. And I joined a group of pediatricians on their lunch hour at the statehouse. We met with some representatives, and I listened to each of the pediatricians talk about the importance of health insurance in the lives of children. And we were asking for $1 million to be moved into a fund to insure uninsured children. And we learned three days later after meeting with these represent that $3 million.

4:03Had in fact been moved into this fund. And I just thought that these pediatricians were the most powerful people I had ever met. And I decided then and there that I wanted to be one. Wow. And so I chose a career in medicine and in pediatrics very specifically to affect social change. And many, many, many years after my senior project, I became a physician at Boston Medical Center in the Department of Pediatrics. So my senior project was actually important to me.

4:37Yeah, that sounds really impressive. Okay, let's transition to your college experience. So after Milton, you continued your studies at Wesleyan University and Tulane Medical School. How did your experience during undergrad and medical school expand or challenge the values you carried from Milton? I absolutely loved my Wesleyan experience. While there are many similarities between the Milton community and the Wesleyan community, Wesleyan was a bit larger. I was really pushed to grow in different ways.

5:14But I felt very prepared for my work at West. My work at Milton. In fact, some of the textbooks that I used in my science classes at Milton Academy were in fact the same textbooks used in my science classes in college. So I felt very well prepared and jumped right into college. And I'm really excited to share that my son, William, who is a senior this year at Milton Academy, will be matriculating at Wesleyan. Wow, man, that's so amazing. Yeah. Okay, next question. Can you tell us about your journey through higher education?

5:54So after Wesleyan, I was accepted at Tulane Medical School in New Orleans. I was lucky enough to apply for and receive a National Health Service Corps scholarship, which means that the government paid for my full medical school experience in exchange for four years, of work in primary care in a physician shortage area following residency. So I already knew that I wanted to be a pediatrician from the time I was 17, and it was an easy choice for me to make to accept that scholarship.

6:33While I was at Tulane and in medical school, I also got a master's in public health, again, because the work I wanted to do in medicine. Was really in the realm of social change and policy. And Tulane at the time was one of the few institutions in the United States where you could get both degrees in four years. There are many institutions that allow medical students to add an additional year of education to get the master's, but it, Tulane, with a lot of hard work and some intense moments, I was able to earn both degrees.

7:13After graduating from medical school, I went to Brown Hasbro Children's Hospital to do my pediatric residency training. And I was lucky enough to match with a man I had met in my medical school class who went on to be my husband. And following residency, we moved back to New Orleans. Hurricane Katrina had devastated the city in 2005, and they were in great need of physicians. So I was able to fulfill my National Health Service Corps scholarship obligation to provide primary care in a physician shortage area back in New Orleans, which is a spectacular place.

8:00To practice medicine. Thank you. All right. Were there any pivotal moments in your education that helped you decide you wanted to focus your medical career on pediatrics? I think I've always, again, since I was like 17, I knew I wanted to be a pediatrician. I don't think I ever really deviated from that. There are other areas of medicine that were interesting to me, but I was always really drawn to child development and maternal and child health care.

8:32And for somebody who wants to work in public health, pediatrics was an obvious fit for me. Thank you. Okay, so you have had a career for over 17 years of pediatric experience. Your career has spanned from Chief of Adolescent Medicine at Boston Medical Center, Clinical Associate Professor of Pediatrics at Boston University School of Medicine, and you complete your residency at Hasbro Children's Hospital, as you said before. What lessons or takeaways have continued to inspire you in this field?

9:06Well, what I would tell you about my time as an attending in medicine before I came to Milton Academy is that I was always in academic positions. During my time in New Orleans, I was on faculty at LSU. And following my four years in New Orleans, I was on faculty at BU, practicing at Boston Medical Center. And what that means is that I had the opportunity to teach. And I really love teaching, specifically pediatric residents, other folks who really know they are interested in a career in pediatrics.

9:45So that piece has been really important to me, the teaching aspect of my position. Thank you. All right. So since 2021, you have been named Best Top Doctor by Boston Magazine. What does this mean to you? Well, I believe that some top docs are nominated by peers in their field. And in that regard, it is a great honor. All right, now we can talk about curbside care. So a really interesting part of your career has been founding the curbside care program at Boston Medical Center during the COVID-19 pandemic.

10:23This program provides critical care to mothers and infants during the first month after birth in a mobile unit right outside the mother's home. How was the idea for this program conceived? Well, during the COVID pandemic, we saw a 90% drop in our pediatric patient volume at Boston Medical Center. And we thought about it and realized that if we didn't immunize children, we might have a measles pandemic on our hands very shortly. And almost overnight, a generous foundation donated some money to allow pediatrics to start doing vaccination on a mobile unit. And I was put in charge of that project.

11:10And we weren't only seeing children in need of vaccines. We were also seeing newborns who were born to COVID-positive mothers. And the mothers were not permitted to return to the hospital with their newborns, yet their newborns needed care. So we began to start seeing them in the community, outside their homes. And I had this one experience with this mother when I was riding on the unit. While I was examining her baby, she just started crying. She was so happy that we would come to her in this extremely vulnerable period of time.

11:47And I started thinking a little bit about it, that this should be a service that we provide to all new moms, not just moms with COVID. And so I created a proposal to provide care for newborns on the back of a mobile unit at Boston Medical Center. But the important part of the proposal is that we decided to include care for the mothers. Right. So babies have many, many visits in the first six weeks of life. There's a newborn visit, a weight check visit, sometimes a jaundice visit. There's a...

12:25One-month visit. And mothers are supposed to have a postpartum visit following delivery, but 40%, of publicly insured women never return to the hospital for a postpartum visit for themselves. But they do bring their babies into care. And so we started thinking, what if every single time we saw the baby, we also saw the mom? And this is a novel idea for a couple of reasons. The first is that there are huge racial gaps in health outcomes, specifically between white women and black women in the peripartum period.

13:04Black women are three times more likely to die in the peripartum period, are much more likely to have morbidities in the peripartum period. There are disparities around breastfeeding continuation rates, rapid repeat unintended pregnancies, and postpartum depression identification and treatment rates. And so we started thinking, maybe if we brought health care to women in the postpartum period, maybe if they didn't need to navigate transportation back to the hospital or child care in order to seek care for themselves, maybe we could begin to close some of those racial gaps.

13:47And so the program is really a health equity program. We use the prioritization of the baby's health care and the baby's access to the health care system to prioritize and elevate care for women. And so that is how Curbside Care was born. And right as we were running out of funding, somebody published an article about the work that we were doing. Mm-hmm. And the Boston Celtics Shamrock Foundation read this article and reached out to me directly. They had some funding they were hoping to spend in the area of health equity, and they recognized the Curbside Cure program as an opportunity to do so.

14:31And so I'm very proud to say that the Boston Celtics Shamrock Foundation funds our program in full. This is our fourth year of funding. And they've committed for another two years at least. And they've been just spectacular partners in this space. So for Curbs Eye Care, we see patients who've given birth at Boston Medical Center who intend to continue their care at Boston Medical Center and live in the area of Boston. And we see the majority of our patients live in Dorchester, Mattapan, and Roxbury.

15:08And we have many who live in Hyde Park and all of the surrounding Boston area zip codes. But it is a really spectacular service that is quite unique. The care we provide is not supplemental or adjunctive care. It really replaces the visits that women and infants would otherwise have in the hospital. And there really isn't another program in the country that's quite like that. Awesome. So you didn't cover this in your answer just now, but this program is a partnership between the Boston Celtics Shamrock Foundation, BMC, and the Tufts Health Plan.

15:49What was it like to have so much support behind a program that you founded, and what do you hope its legacy continues to be? is a really, that's a great question. The first thing I would say is that the Celtics have really been spectacular partners. They are, running a clinical program is not easy and they are with us in the trenches. They know when our vehicle breaks down and is in need of repairs. They know of our spectacular success stories with patients. They have elevated and shined a light on this really important work, leveraging their visibility in our community.

16:28And that's one of the most important aspects of the partnership. The Tufts Health Plan involvement certainly came through the connection that we have with the Celtics. We've done a number of community events together, which has been really special. So we really owe a great deal to the Boston Celtics Shamrock Foundation. I hope that this partnership continues. The team at Curbside Care really has great vision for expansion of the program. We would really love to expand to include prenatal care for patients.

17:02And we would love to expand the work we're doing to some of the community health centers in Boston. We also have thought about ways to bring care for birthing persons and their babies into spaces that are otherwise just occupied by pediatrics or just occupied by obstetrics in the hospital. So we have great ideas about expansion, but we will need financial support for that expansion. And I hope that the Celtics are part of that future moving forward, but we will likely need the help of others as well. Thank you.

17:38Okay, so your impressive career has now led you to being Director of Health Services at Milton. We are so lucky to have you. What has it been like to return to Milton as an alumna? It has been wonderful coming back to Milton. The first thing is I have two children here. I have a senior and a freshman, and I delight in sharing space with them here in this community and seeing them around campus all the time and their friends, who I'm quite attached to.

18:07But what I would tell you is that I have been a big fan of Milton Academy, certainly since I was a student here and then subsequently as a parent. But now I am included in conversations that occur at the leadership level. And I just am continually impressed by the authenticity, the intentionality. The thoughtfulness of each decision that is made. I have always thought of Milton as a student-centered, nurturing community. But it is pretty spectacular to sit in a room with people making decisions that.

18:51Who continue that legacy. And I just think every day that I'm so grateful that my kids get to be here. Well, what are your hopes for the future direction of Milton's Health Center? Are there any new initiatives or programs that you're hoping to create? Yes, I think that I think this year has been a year of getting my feet under me and becoming familiar with all the policies and procedures that already exist here, working on team building and collaboration with the counseling center and with our athletic trainers.

19:30I am working on enhancing communication about patient care across multiple spaces on campus. I'm working on a project right now around food safety and access for our students with medically restricted diets, working on a project right now to, increase the number of adults who are trained in CPR and first aid on campus so they may be able to respond to student emergencies. There are a number of different places where I feel I can be helpful in this space.

20:04Okay, last two questions. What would you tell your high school self if you could go back in time? That's a really hard question, Sonia. I think that Milton Academy is a wonderfully. Safe space to try on lots and many new hats and to explore lots of different interests. And I think I did that while I was here. And I think doing that was really important. Medicine can be very linear and very tracked. And I'm so grateful for the opportunity to explore lots of different parts of myself.

20:41I think I carried that approach into college and beyond. And I think it's made me actually a better, more well-rounded physician. And so I think that's what I would say to, that's what I say to my kids who are here now is to try everything you can while you can, because it's a community that just presents so many opportunities. To explore so many different interests. And I think it's important to really take advantage of that. Okay. And lastly, what advice would you give to Milton students hoping to study medicine?

21:14I think probably what I just said, it's really important to diversify your areas of interest and your skill set. The humanities are just as important as the sciences in creating well-rounded, successful physicians. So it's important to dig deep in all of those places. The faculty at Milton are just really spectacular. They're the greatest strength of this school. And I would encourage students here to really eat up every moment they have with faculty here.

21:51Okay, thank you so much for having the time.