The Best Laid Plans

I am a planner. I check menus before going to restaurants. I investigate parking options for every new place before I go. I need to know what to expect and what to bring to accommodate my condition. I’m not pathological about it – new technology and medication affords me a measure of flexibility -- but I was medically raised in an environment where rigid routine was the healthiest path. Which I didn’t follow, of course, but the lessons were learned.

It’s a natural state of mind for chronic and autoimmune patients. There is such a high level of uncertainty to many of our conditions that planning is a way to help us wrest a little bit of control back from conditions that afford us very little. We need to know where we will be and what will be around us in every situation because if our conditions flare up, we need to know that we can be safe and take care of ourselves. Even so, we know that even with all of our planning, we may be unable to get through an event successfully, but we have to try.

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As it happens, planning is a natural state for the bulk of humanity. Recently, I was catching up on episodes from CBS Sunday Morning. One from about six months ago had a segment on planning and how COVID-19 had cancelled everyone’s ability to plan. During the segment, the experts that Susan Spencer interviewed pointed out that the lack of planning was feeding much of the anxiety that has risen to such great heights over the last 16 months. Humans have a unique ability to visualize the future and planning allows us the illusion that we have some sort of control over our futures. The pandemic has forced all of us to acknowledge that what we do to control our futures may be in vain.

As I listened, I realized that my experience during COVID seems to be much less psychologically traumatic than many people’s. At first, I thought it might be my streak of introversion. I have always been ok on my own for long stretches, and I made enough calculated risks to see friends that I didn’t feel as thrown off as I might have.

Yes, that was part of it, but a small part. There are lots of introverts who are struggling.

The larger part was that for decades I have not known my future. I always dreaded the perennial interview question, “Where do you see yourself in five years?” Because who knows? Every time I tried to make long term plans back then (that question is usually for younger workers), I seemed to develop some new condition that required an adjustment in my plans, so while I continued to plan, “what’s the point?” always sat in the back of my mind.

The nature of chronic conditions, and one of the hardest things to manage, is unpredictability. Many of us develop and can recognize patterns our bodies fall into with our conditions, but we know from experience that 1) that does not stop our bodies from deviating from those patterns without notice, and 2) your body changes every once in a while, causing the need to adjust medication and routines. Both of these circumstances can destroy plans in the short- and long-terms.

So, when COVID came along, the sudden and lasting change in lifestyle wasn’t as jarring for me as it would have been if I were healthy because it felt like just another wrench in my plans. Granted, this was on a much greater scale than I had experienced before, but it felt like yet another shrug and adjust moment. And in that, another silver lining to a lifetime of difficult medical circumstances.

I’m sure not every chronic and autoimmune patient feels the same way, but I hope at least some do. There were lots of elements that have caused increased stress and anxiety during the pandemic – higher risk of disease for those with chronic conditions, a stalled economy, high unemployment – but for once I can say that my conditions prepared me for one of the biggest. It’s no longer a traumatic experience when my best laid plans go awry.