2025

I recently accepted an opportunity to work in a new clinical setting. I now spend one day a week at a harm reduction site that serves people who are currently using or have used drugs within the past 12 months.

To my surprise, I’d passed by the nondescript brick building housing the site countless times. Clients come in to a room known as the “exchange”—a large space where they can make a cup of coffee or a bowl of oatmeal, grab some snacks, trade used needles or pipes for clean ones, or pick up a hygiene kit or a new T-shirt. Social workers make the rounds to assist folks with these tasks; as the clinician, I meander and chat with the clients, introducing myself as a doctor and offering to help them with any medical questions.

“Wait here,” Dr. X said. “Someone will come and set up your next appointment and give you a copy of your lab results.” So I sat down on one of the plastic chairs, took my Kindle out of my purse, and waited and waited in the exam room. The staff must be busy, I thought.

No, that title is not a misspelling of Chicago’s baseball team, the White Sox, but the germ of an idea that started with literal white socks. When I was a teenager, kids could be critical. Heaven forbid if you wore white socks with blue slacks, like blue jeans. Oh, the horror!

Thankfully, time marched on, and recently I was sitting in an exam room with my husband, wearing blue slacks and white socks. A health-care professional walked in, and she was wearing blue scrubs and white socks. That exam room visit led to a hospital stay for my husband. As I was sitting in the hospital waiting room, I noticed that all of us in one corner of the space were wearing blue slacks and white socks. How refreshing.

I should have paid attention to Red Flag Number One, which was having to provide my insurance information four times. Twice is normal—once when making the appointment and again when you show up for it. Four times is excessive; that was my first clue.

I also blew past Red Flag Number Two, which was the most dark, dismal, uncomfortable waiting room I’d visited in years. Patients were crammed into uncomfortable chairs with little to no space between them. Everyone in the room looked stressed and unhappy.

Forty-five years ago, during a sabbatical at a solo practice in a rural village in Wales, I learned to push back against office conformity.

The British National Health Service (NHS) had a prescribed set of colors for exam room furniture that they undoubtedly bought in bulk and provided as part of their support for general practitioners. Most offices I visited during my nine months with the NHS had standard-issue exam rooms.

It was long enough ago that I can’t recall why (did I change jobs? did my doctor stop taking my insurance?), but I was forced to find a new ob-gyn. Anyway, this would be my first female doctor, which promised to make the annual visit more comfortable.

Indeed, “comfortable” seemed to be the byword of her practice. The tastefully appointed waiting room with its soft lighting, vintage botanical prints, and soothing pastels looked more like a Laura Ashley living room than a conventional doctor’s office. There was a nicer than usual selection of magazines, too, I noticed. I sank appreciatively into a cushy floral armchair to wait my turn to meet my new doctor.

Follow the blue brick-patterned rug to Elevator G. Press the button for the tenth floor. Stop at the check-in sign. Wait behind the do-not-cross-this-line sign. Finally, it’s your turn. They strap a white bracelet on you—after you recite the secret passwords: Greta Garbo. 9/18/1905. 3135331.

Then you sit. You bury yourself in your phone, trying not to drink in all the misery around you. Everyone has something. Everyone is waiting. Everyone sits with their head bowed. Three seats down a guy is snoring—rip-ragged, chain-sawing, full-out snoring. No one wakes him.

Several days a year I’m what’s known as a Standardized Patient. An actor. A fake. A learning tool for beginning medical students. From interacting with me, they learn to communicate with “real” people in a medical setting.

Now seventy, I still remember the moment I walked into an exam room, in my thirties, prepared to help someone, and suddenly realized that this was my happy place. To greet someone, close the door, sometimes shake hands, then sit down on my rolling stool and share my brain and heart to solve some puzzle, using science and art, whether listening, touching, teaching or questioning. Very grateful to be accepted and needed, and learning from everyone.

Lisa Ramey
Peterborough, New Hampshire

I’m not sure which is worse: a physician’s exam room or a dentist’s office. An exam room is eerie in its silence, while the demonic whine of a dental office drill sends a shiver down my spine. But ultimately it may be the exam room, despite its potential to diagnose whatever diseases may be attacking my body, that scares me more. Its instruments evoke pain, its sterility the nothingness of death.