The “SOME PEOPLE” Essays
Waiting for Healthcare in the United States by Justin Merriman | Edited by Kimberly J. Soenen April 14, 2025
(Spirit Walker, a fifth-generation descendant of Chief Black Hawk, waits for healthcare at the Remote Area Medical pop-up clinic in Wise, Virginia. Photo by Justin Merriman.)
As I drove into Wise, Virginia, a small town in the coal fields of Appalachia, I had no idea what I would find at the Remote Area Medical Clinic (RAM). The nonprofit organization travels the country delivering healthcare to impoverished, isolated, and underserved people who have no access to hospitals, clinics or adequate health insurance.
As I looked around the dark parking lot, across the vast field of cars and people, it was hard for me to believe this is America—the land of plenty. With the nation engaged in a never-ending debate on healthcare, this place felt like the epicenter of it all.
Here, Spirit Walker, a fifth-generation descendant of Chief Black Hawk, sits in the cinder block animal stables at the Wise County Fairgrounds in Virginia, waiting to be seen by a doctor. His shoulders hunched, hands on his knees, he wears an “I Love Jesus” baseball cap with an American flag pin on it. Sheets hang from clothespins, providing a thin veil of privacy between him and the more than 2,000 other people who traveled from 15 states seeking free medical care.
Today, the fairground doesn’t host rodeos, livestock auctions, flea markets or pageants; instead, it is the location of the largest pop-up healthcare clinic in the United States.
RAM started as a conflict zone triage clinic and soon recognized the United States approach to medical care creates conflict-like conditions across the country so they scaled. Now RAM offers vision, veterinarian care, dental and Primary Care.
“I’m 55 years old. I’ve tried to get Obamacare. For me, it would be $800.00 a month. There’s no way to afford health insurance and there’s no way to live without it,” says Murleen Smith, of Big Stone Gap, Virginia, who has made the trek to RAM for four years now. Murleen says she counts on the clinic. “Basically, you wait all year for this healthcare clinic to come around.”
Each morning, long before the sun crests the surrounding mountains, families line up at a gate with a numbered ticket in hand, waiting for their chance to enter. For many, this is their only chance to see a doctor, get much needed dental work, or get fitted for glasses.
The parking lot becomes a campground, where many spend the days sleeping in their cars, in tents, and on the bare ground. I joined them as I slept in my own tent on the edge of the field.
My camera catches glimpses of people’s faces as they stand in line in the dim light of cold mornings. It is surprisingly quiet. The exhaustion of waiting weighs heavily in their eyes.
ABOUT
Justin Merriman is based in Pittsburgh, Pennsylvania and is a founding member of American Reportage, a collective of documentary photojournalists specializing in comprehensive storytelling of the American experience. Follow his ongoing work here and @justinmerriman.
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