When the Exam Room Feels Like a Sensory and Social Pop Quiz

You made it. You're in the exam room. The victory of arriving is huge. But now, a new challenge begins. The questions to check in at the front desk, the wait to hear your name called, the paper crinkle sound on the exam room table is suddenly as loud as thunder. The fluorescent lights buzz and flicker, casting a sickly glow. The smell of antiseptic makes your nose start to burn and run. More questions from the medical assistant, but now with dates and details you can't remember. You're already on sensory overload, and the doctor hasn't even walked in. You forgot your questions and the reason you came!

Then when the doctor walks in the social-emotional pop quiz you didn't study for.

• Question 1: "How have you been?" (Do they want the truth or the polite script?)

• Question 2: "Rate your pain on a scale of 1-10." (What does a 6 feel like? )

• Question 3: "Did you follow the instructions from the last visit?" (I didn't do the referral!)

• Question 4: Rapid-fire instructions about a medication or a test.

** AWKWARD MOMENT ** while I wait for them to type on the computer

Your brain is doing double-duty: trying to process words, manage your sensory environment, recall what you wanted to ask, monitor your tone and eye contact, and interpret vague questions, all of which induce a low-key panic. It's exhausting. It's why you might leave and realize you forgot to ask your most important question.

What’s Real: This is a clash of cultures: the neurodivergent nervous system meeting the high-efficiency, neurotypical design clinical environment. Research shows that alexithymia (difficulty identifying feelings) and interoception differences (trouble sensing internal body signals) are common in neurodivergent folks, making those "simple" questions profoundly complex.

Pointers to get what you need from the visit:

• Bring a Buffer. Noise-canceling headphones or earplugs until the doctor enters. A fidget tool in your pocket.

• Bring Your Notes. A literal, physical list of your concerns and questions. Hand it to the doctor if speaking feels hard. Say, "I wrote this down so I wouldn't forget."

• Use Direct Language. It’s okay to say: "I need you to speak slowly." "Can you please give me written instructions?" "I have trouble with pain scales; can I describe it instead?"

• Visit Summary Notes: The electronic medical record creates notes of the visit. Ask for these to be printed and reviewed with you before you leave.

• Take an Advocate: Bring someone who helps listen and navigate the visit with you can be incredibly helpful and save you a lot of time while reducing your anxiety.

• Debrief. Afterwards, go to your car or a quiet corner and just breathe. Your body just ran a marathon. Text a friend who gets it. You did the hard thing.