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Recently I returned to the New York City World Trade Center Health Program after a dismal experience with the national 9/11 program. Everyone at the program in NYC made re-enrollment a breeze, in spite of the program now being overseen on the federal level.

During my intake appointment for psychological support, the nurse asked what I have a hard time with.

“Decisions,” I answered. “I have a hard time making decisions.”

“What kinds of decisions?” she elicited.

“Like what to eat for dinner.”

“Do you get confused, or just blank?”

“Just blank.”

I love when a health professional is able to help attach words and descriptions to my mental illness. I get blank. Sometimes I get overwhelmed, and sometimes I’m just blank. It’s like my circuits overload and my engine shuts down.

Unfortunately, this blank state happens much too often, especially when it’s time for dinner. For mornings, I developed a routine to help start my day: toast and coffee. After that, sometimes I eat a heartier breakfast. Lunchtime usually consists of leftovers, whatever my company serves, or something easy like pasta. But when dinner comes, after my brain has already been exhausted by a day of work, I’m without an idea, without desire, and without memory of what’s in the kitchen. I’m just blank. On days when I’m by myself, I usually don’t eat very well at dinnertime.

Today I did make a decision. I decided to prepare more vegetables that will store in the refrigerator for several days and eat grains, couscous, or noodles with it. Now the decision needs to become an action, which means I must execute a plan. This also is often difficult for me. A plan for eating meals at home that isn’t takeout requires a shopping list and a trip to the store. Often I pull out a piece of paper and pen and think of only one or two items. And then when I get to store, I get overwhelmed, or I relive 9/11 (or the morning after?). Shopping becomes an obstacle to overcome. Penny helps me get through the store, but it still takes me more effort to shop than normal with segueing blank states at every decision point. In American grocery stores, there are too many decisions to be made. It would be better for me to shop in Berlin Wall–period Eastern Bloc countries, where oftentimes necessities were scarce and there were no choices except buy it or don’t buy it.

I have an idea. Decision cards. I could put things I like to eat on index cards with ingredients lists on them. And then on days that are hard for me, I could blindly pick a card. Execution of the decision would have to go onto a pre-written checklist. 1. Pack wallet, keys, shopping list, and bag. 2. Go to the store and buy ingredients. 3. Go straight home and prepare meal.

Let’s see if that works.

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