Therese Murphy

Interviewer: From outside of healthcare, most of us don’t really know what future doctors actually do in medical school. Could you tell us a little bit about what you are learning in medical school as a student?

Therese: Currently I am in clerkships, so I am out of the classroom and I am spending most days of the week in the hospital. I’m learning everything from the science behind how we treat certain conditions to how to have a difficult conversation, how to tell someone that their mothers has cancer and how to work within a medical system that inherently does not prioritize people. How to make sure that you are giving good quality care to those who might be underinsured or uninsured and how care might differ between groups of people, even if that’s not the intention. 

The first couple of years of medical school are very science heavy, learning everything about the human body, medications, and about all the incredible science that we’ve discovered. But the clerkship time adds onto that learning. It’s definitely scientific, but “yes – and these are humans,” “yes–and how are you working within this to synthesize all that you’ve learned to try to help the person in front of you within a complex system.” I think that is something that no one can master, but we can all try our best to be students of it.

Interviewer: What has been your favorite part of medical school so far? 

Therese: Honestly, my favorite part so far has been rounding with the team on the patients. I think it’s really fun to have everyone, in a nerdy way, talk about what’s going on, what the studies have said, what’s our plan. And then go in there and communicate all of that in a completely different way, in layman’s terms, to someone about their loved one and build that bond and personal connection. And then later to go back in the afternoon, after rounds, saying “how are you doing?” “how did you feel about that conversation?” “Do you have any follow-up questions?” Those relationships have been really special.

Interviewer: Because you were a nurse before transitioning into medical school, do you feel there has been a distinct shift in your perception of medicine, how to care for people, or even what health means? 

Therese: You know, I think that it’s been fairly seamless just because I had a good understanding of the difference in roles and how you are a specific piece in a puzzle. I knew my piece was going to change and what that was going to look like. But some things have stuck with me. For example, as a bedside nurse I spent a lot of time physically touching people. In the ICU, too, a lot of the time it was my hands that were bathing you, feeding you, crushing up your medications, and that is something that I knew would change but it’s been very “real.” 

Once I’m in a position as an attending on the team, and I’m having a difficult conversation, I decide if I should sit down and hold someone’s hand or whatever I choose to do. It’s harder as a medical student because you’re just one of eight people in the room. There was one moment I remember in particular my first week of clerkships. We were having a really difficult conversation with someone. I’m standing with my hands behind my back, just aching to go give this person a hug, but that’s not the position I’m in and that’s not my role at that moment. So I’ve had to brainstorm, “how can I also bring those things that I loved as a nurse to these patients?” And so, like I mentioned, going back in the afternoon and seeing my patients.  Then I hold their hand  or ask them if they need help with xyz. That’s been part of the transition that I’ve regularly noticed. It hasn’t been bad, it’s just figuring out how this is going to be different and how do I work with it.

Interviewer: As a med student, as you're being taught and learning, what do you think the education and structure of medical school is telling you about what it means to be healthy? 

Therese: I think the focus of med school, specifically, is a lot of learning scientific facts and trying to learn new scientific facts or what we think the facts are. And at times that tends to reduce being healthy to numbers and statistics. 

For example, I took two shelf exams yesterday (standardized exams). A question might be, if you should start a statin on somebody at X age with X condition with X LDL. If the LDL is 69 you don’t start it. If it’s 70 you start it. So some of those hard cut offs can make it feel like you’re reducing things to boxes. We need that in order to standardize good care, but in the student environment you are very limited to those definitions of health. And I noticed it’s easier when you’re the practicing physician. I’ve observed someone sayings, “yeah maybe your cholesterol isn’t at that cut-off, but through shared decision making, we think that it’s actually best for you to start it now.” I think there’s so much room for exploring your patient’s view of being healthy, what they want, and their goal. Do they want to take medication everyday? Those are easier to explore when you are the provider. When you are a student your ability to do this is reduced as you are still being taught.  

Interviewer: Just for you, what does it mean for you to be healthy? 

Therese: It’s two-fold for me. 

I think that I want to be able to do things that bring me joy. And I know that is going to change throughout my life. Right now, that might be running a marathon. That might not always be something my body is going to be able to do. And that might change, maybe it’s that I can walk down to the Bingo hall. Being healthy is just being able to do the things that bring me joy and being open to the changes that will have to happen throughout life. 

And also, way way way more frufru and qualitative. But I think waking up everyday, really excited for your feet to hit the floor and do whatever you’re doing that day. That’s health to me. If you have that, all the other pieces of a traditional  view of health like diet and exercise and those other things will fall into place. Because if your feet hit the floor and you are pumped about what you’re doing, you’re going to want to take care of yourself because you’re going to want to keep doing it. 

Thank you, Therese! 

-Culture + Health LAB Team