Seventy-five minutes for the women. Fifty-nine for the men.

Today’s letter

Two lines to have ready before the waiting room

It is almost one in the morning and the television in the waiting room is on mute. A woman sits in the third row with her coat balled up and pressed against her right side, because pressing helps a little. She has been doing math for an hour: how bad this is out of ten, whether seven is too high a number to say out loud, whether the nurse at the desk will decide she is making a fuss.

On Friday, Gallup and the organization Pivotal put a number on that hour. They asked 5,200 American adults about the last five years of medical care, and 51 percent of the women reported a bad experience against 39 percent of the men. The most common one, named by a third of the women, was a provider making their symptoms or their pain seem smaller than they were.

“Am I making too much of this?”

She is not a complainer. She sat through the first three hours at home with a heating pad, told nobody, finished the dishes, and drove herself over at midnight because it had gotten worse instead of better. Every woman I hear from has some version of that drive.

So she did the thing she was taught to do, which is to be a good patient. She kept her voice level and said it was probably nothing, maybe a six, sorry to bother anyone on a Wednesday night. Then the hours went by, and she read the waiting as evidence: if it were serious, somebody would have hurried.

Here’s what gets me.

None of that was her fault. The waiting had already started before she opened her mouth.

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Let me show you how I know. Not with my opinion, and not with a survey, but with a hospital that went back through its own records.

Doctors at the Royal Melbourne Hospital pulled every adult who came into their emergency department with stomach pain during one month in April 2024. That came to 708 people: 416 women and 292 men. Four out of five of them were given something for the pain while they were there.

Then the team looked at the clock instead of the conversation. Not what anyone said, not how anyone rated themselves… just the minutes between the front door and the first dose.

What they found

Royal Melbourne Hospital, 2026. Walker et al., Emergency Medicine Australasia.

The women (75 minutes)

Middle wait from arrival to the first dose of pain medicine, across 416 women.

The men (59 minutes)

Same month, same department, same complaint. A gap of 16 minutes, and the women were also about half as likely to get the injected dose instead of a pill.

A records review, so it shows a pattern linked to sex, not a cause.

In other words, two people walk in holding the same part of their body, and the one who is a woman sits about a quarter of an hour longer before anything takes the edge off.

Her patience had nothing to do with it. Yours does not either.

So why does the clock run slower for her?

Triage runs on a fast read of who looks sick. A woman in pain is more likely to sit still, to apologize for taking up a chair, and to answer with a hedge instead of a number, and studies of emergency care suggest all of that is linked to being scored as less urgent. The scoring takes about a minute, at a desk, and the number that comes out of it sets everything after it: the chair, the hour, the dose. Nobody at that desk decides she is exaggerating. The system reads calm as fine, and it has been reading women that way for a very long time.

She never stood a chance at that desk. Neither did you, I’d bet.

That’s the part no one says out loud… the advice she keeps getting is to speak up for herself, and in that same survey, 42 percent of women said they have already had to do exactly that, against 26 percent of men.

Try this today

Write the two lines now, in your notes app, so they are sitting there the next time something hurts enough to go in. Line one is the number: what it is right now out of ten, and the worst it got today. Line two is what it stopped you doing, in plain words: could not stand up straight, could not drive, woke at four and stayed awake. At the desk, read both lines out before anything else, then ask for one plain thing: something for the pain while you wait. If an hour goes by, say the number again to the next person who comes past.

A number and a limit are the two things a triage desk is built to act on.

Promise me you’ll try it today? Saying it out loud is half of what makes it stick.

I’m in. I’ll try it today →

The two lines work for a plain reason, and it is not confidence. A triage score gets built out of things that can be written in a box, and a number plus a limit is the shape that fits in the box.

Most women get there in the end. She gets seen, somebody finally looks properly, and the thing gets taken care of. What it costs her is the hour in the chair and the story she tells herself while she sits in it.

There’s still time for you. Not to turn into a different sort of person at the desk, just to walk up to it with two lines already written.

So the next time you are counting minutes in a plastic chair, wondering whether you should have made more of it…

It was never your fault.

— Cole

P.S. Longest you have ever sat waiting with something that hurt, in hours? Just the number, hit reply. I will tell you tomorrow where most of the answers land.

Most people take vitamins to protect their health.

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