I was sitting in an organization-wide meeting, sipping my Wednesday latte from June, who runs the little cafe on the ground floor of our office building, when I started to tear up. On the screen, the team from Deeply Rooted was presenting their work within the Philadelphia community: before and after photographs of neglected spaces transformed into something peaceful, something that breathes. There were photos of people working shoulder to shoulder with the communities they were serving, and the passion with which the team spoke was beautiful. What moved me most was the reaching, the idea that care doesn't wait behind a desk for people to find it but goes out to meet them where they are. Watching Deeply Rooted on that screen, I felt enormously grateful to be in that room.

Over the years, I have seen the health care system from many angles, working nights as a patient care assistant while making my way through nursing school; as a nursing student rotating through vastly different clinical environments; as an ICU nurse across multiple hospital systems and cities, including during the early and most brutal days of the COVID-19 pandemic; doing street medicine with the unhoused community in Boston; and eventually as a medical student in both inpatient settings and community clinics. I have also seen it as a family member, sitting at the bedside of a favorite person, understanding in a new and more personal way what it means to need a system to work for you. At every stop, and across every role, I heard the same thing: ideas with nowhere to go, frustrations with no channel for change, people who cared deeply but didn't know where to start. I wanted to be someone who knew where to start. That is what brought me to CHTI, Penn Medicine’s Center for Health Care Transformation and Innovation.

My work here has centered on the OnePenn Breast Oncology initiative, a project built around a beautiful problem: Women are surviving breast cancer at increasingly higher rates, and the system, with all of its multidisciplinary complexity, can struggle to keep pace with its own successes. I spent this year working alongside the most passionate, creative, and thoughtful partners, all gathered around the singular purpose of helping these patients move through their care with less friction and more support. The work was not glamorous. It was emails and meetings and data gathering, incremental conversations and careful navigation. And then the first numbers came back showing that we had decreased the time it took until treatment starts, and I understood that we had actually done something that mattered.

The skills I gained this year I have already begun to carry into the other spaces I work in. I see systems differently, notice where pathways break down, and understand how to bring the right people together to address them.

I entered this fellowship to be empowered to make change. I hadn’t expected that by the end, I’d be certain this work would be a central part of my career. I will miss many things about this year, not least my weekly June-curated latte, along with the banana and the cookie she slips me on the side, but what I am taking with me is something I did not expect: a new lens through which I cannot stop seeing the world, and a deep, settled certainty that the work of transformation is worth doing.

Therese Murphy is a medical student and Master of Bioethics candidate at the University of Pennsylvania Perelman School of Medicine. She has been a clinical transformation fellow at CHTI since 2025.