“We are all children in the face of illness—scared, ignorant, and impulsive—and we should be treated as such.”

So says Mark Attiah, a student at Perelman School of Medicine, University of Pennsylvania, in a letter that was published in the Journal of the American Medical Association last week. His article’s premise: Adult acute care facilities should take a page from the design standards applied to children’s hospitals. Attiah was inspired to write the piece after completing rotations at both types of hospitals. The kinds of elements he encourages—warm and cheerful lighting, family-centered spaces, single patient rooms—aren’t new to the healthcare design audience, even in adult spaces (even if they’re not yet as widespread in reality). But still, it’s nice to have this point made in JAMA for all the medical world to ponder.

But what really struck me about Attiah’s very thoughtful perspective is a story he relates about a young patient (“Elise”) with a severe chronic disease, which requires her to endure long hospital stays on a regular basis. First diagnosed at age 17, Elise began getting treatment at adult facilities when she turned 18.

“It was unpleasant,” she said to me about her first stay in an adult hospital. “There are no activities—there’s nothing to do!” She told me that during her lengthy stays in the children’s hospital, she was doing something every day: from arts and crafts to games to even a hospital prom. These activities were set against a backdrop of gorgeous artwork, of course. … [T]he plain surroundings and lack of things to do in the adult hospital suddenly forced her to grapple with this illness by herself—unless you count the sights and sounds and smells of the three other people she now had to share a room with. … [H]er parents weren’t allowed to be at her bedside through the night, something they were able to do before. What troubled Elise most, though, was the actual medical team. “They weren’t as happy to be there.”

Elise’s story puts a face on the often-repeated idea (and research-backed findings) that patients, family, and caregivers are all left wanting when the care environment doesn’t support them in a truly human way, which can affect patient outcomes. But more than that, Attiah uses Elise’s story and his own observations to make the point quoted at the beginning of this article. He adds, “This rite of passage from the child to the adult patient underscores the tacit assumption that adult patients have developed a certain hardiness: a stiff upper lip that renders a reasonably pleasant environment … unnecessary.” But the truth, he says, is that “without help, most people, regardless of their age, aren’t naturally good at being patients.”

Is this accurate? In some ways, yes, there’s a “stiff upper lip” attitude that I myself can adopt now, which I never had much luck with as a child. But does that mean I’m naturally a good patient? Well, no. The fear and butterflies and need for distraction are still just under the surface the entire time.

It’s common practice for architects and designers to put themselves in the shoes of their clients and the people who’ll be using the space as they work through their projects. In healthcare, whether the patients are adults or children, it might help to imagine those shoes as Stride Rites.