"I had my questions ready… and then I remembered them in the car on the way home."

If you’ve ever walked out of a doctor’s office only to realize you forgot to ask the one question that really mattered, you're not alone. In fact, you're in excellent, overwhelmed company.

For patients living with chronic illness or complex symptoms, this is a near-universal experience. You go in prepared. You've rehearsed what to say. Maybe you've even written things down. But somehow, during the appointment, your thoughts scatter. You freeze up. Or you get so focused on answering the doctor's questions that you lose track of your own.

This isn't a personal flaw. It’s not anxiety. It’s cognitive overload and executive dysfunction.  Not from ADHD, PTSD or trauma - from having chronic illness itself.

Executive Dysfunction Isn’t Just for ADHD or Trauma

Executive dysfunction is often associated with ADHD, PTSD, or brain injury. But studies increasingly show that chronic illness itself can impair executive function.

A 2025 study in Brain Sciences found that people with chronic musculoskeletal pain had measurable difficulty with memory, attention, and task switching, even without any neurological disease (Patel et al., 2025). Another 2020 study in Frontiers in Psychiatry highlighted how cognitive load under stress can impair working memory and focus, especially during emotionally charged tasks like medical visits (Vance et al., 2020).

This is why executive dysfunction and cognitive overload are closely linked. These two concepts reflect two sides of the same coin: executive dysfunction is the symptom (e.g. frozen memory, scattered thoughts), while cognitive overload is the triggering state, where the brain’s bandwidth is exceeded under stress. Overload is a state that often triggers executive dysfunction: especially in people whose cognitive reserves are already taxed by chronic illness.

In plain terms? Chronic illness makes your brain tired. And trying to advocate for yourself while managing that cognitive fatigue is incredibly hard.

The Cognitive Load of Being Sick and Strategic

Let’s be honest: navigating the medical system while managing chronic symptoms is a full-time job.

When you live with chronic illness, you’re already expending mental energy on:

• Monitoring symptoms and tracking flare patterns
• Managing medications, appointments, and follow-ups
• Interpreting complex lab results or research on your own
• Anticipating how to explain yourself quickly and clearly to a provider who may be short on time

Then comes the actual visit and suddenly you’re expected to:

• Stay calm and coherent
• Advocate effectively without sounding confrontational
• Ask the right questions in the right order
• Decode medical language in real time

That’s a cognitive juggling act. And it happens on top of pain, fatigue, brain fog, and the emotional toll of being repeatedly dismissed or misdiagnosed.

So when your brain goes blank or you forget to ask something critical, it’s not a personal failure: it’s cognitive overload in action.

Why You Remember It in the Car On the Way Home

During your appointment, your brain is:

• Translating symptoms into medical language
• Trying to make a good impression
• Managing stress and potential power dynamics

All of that uses up working memory and mental bandwidth. But more importantly, it pushes your nervous system into a state of high alert: what we often call "fight or flight."

In that stress state, the brain prioritizes short-term survival and de-prioritizes reflection, recall, and higher-level thinking. So when the doctor says, "Any questions?" your brain might actually suppress the very thoughts you prepared.

Only later, when you’re back in the car and your body begins to feel safe again, does your brain start coming back online. That’s when the questions finally resurface.

This is not because you're unprepared. It’s because your brain was protecting you from overload in the moment.

What You Can Do

If this happens to you, you’re not alone and you’re not doing anything wrong. But there are ways to make the cognitive burden of navigating appointments feel a little lighter; and to give your brain the structure it needs to stay grounded.

1. Use a prep worksheet and bring it with you.

Don’t rely on your memory alone. Write down your top 1–2 concerns ahead of time, along with any key symptoms, patterns, or questions you want to ask. Paper doesn't forget under pressure. Bonus: this shows your doctor you’re organized and engaged, even if you don’t feel that way in the moment.

2. Bring a support person even if they’re just moral backup.

A trusted friend or family member can help you stay on track, ask something you forget, or simply take notes. If no one can join you, jot down key points right after the visit ends, while the details are still fresh.

3. Tell your doctor what you wrote down.

You can say: “I brought a few notes so I wouldn’t forget anything; do you mind if I show you?” Most providers will appreciate the clarity. You’re not being difficult, you’re being thorough.

4. Ask for documentation: especially if something gets brushed off.

Even if a symptom doesn’t seem actionable to your provider, you can say: “Can we document that I brought this up today?” That small moment of validation can matter later: for you, or for future providers reviewing your chart.

5. Plan for a follow-up proactively.

If your questions don’t all get answered or something big gets left out, ask: “Would it make sense to schedule a follow-up to go over the rest?” This takes pressure off the current visit and acknowledges the complexity of your care.

6. Be kind to your brain after the visit.

Don’t expect yourself to “bounce back” immediately. Give yourself some decompression time after medical appointments. Journal, nap, talk it out, or simply do something comforting. This is recovery, not indulgence.

You deserve care that makes room for your real, human brain: especially when it’s doing its best under complex conditions.

Free Tool: Doctor Visit Prep Worksheet

To make this easier, I created a free printable worksheet to help you:

• Organize your symptoms and top concerns
• Track patterns over time
• Prepare questions ahead of time (so you don’t forget them in the car)

[Download the worksheet here]

You are not scattered. You are not difficult. You are doing a hard thing in a hard system. And you deserve support that sees the whole picture.

Dr. Goodwin is a board-certified family physician and chronic illness patient. She creates tools and content to help patients navigate healthcare with more clarity and less stress.