Living Without Certainty

What caring for an ageing dog taught me about chronic illness, healthcare, and learning to live in the meantime

Chronic illness is rarely dramatic.

It doesn’t arrive like an emergency. It doesn’t demand immediate action. More often, it settles quietly into someone’s life and stays there, shaping days, decisions, and identity over time.

What makes it difficult is not always the symptoms themselves. It’s the uncertainty that comes with them.

In healthcare, we are trained to look for clarity. A diagnosis. A treatment pathway. A follow-up plan. And when those things exist, they are profoundly helpful. But many people live in the space where they don’t. Where tests are inconclusive. Where symptoms fluctuate. Where the plan is to “monitor”, “review”, or “see how things evolve”.

From the outside, that can look like inaction.
From the inside, it can feel like standing on unstable ground.

Caring for my dog through an acute vestibular event sharpened something I already knew professionally but felt viscerally as a carer. The distress wasn’t driven by the illness alone. It was driven by not knowing what to expect, and by having responsibility without a clear narrative to hold onto.

That experience mirrors what many people with chronic health conditions live with every day.

They are told what they don’t have.
They are told things are “stable”.
They are told to come back in six months.

And in between, life continues.

People still have to work, parent, care, decide, cope. They still have bodies that feel unfamiliar. They still wake up every morning inside the same unanswered questions.

Uncertainty is not neutral. It has physiological consequences. When the nervous system doesn’t know what is coming next, it stays on alert. Sleep fragments. Pain amplifies. Fatigue deepens. Anxiety isn’t a personality flaw in this context. It is a reasonable biological response to unpredictability.

What often gets missed in chronic healthcare is that information and understanding are not the same thing.

A patient can leave an appointment with accurate information and still feel completely lost. Understanding requires context. Pattern. A sense of trajectory, even if that trajectory is uncertain.

People don’t always need reassurance. They need orientation.

They need to know what is likely, what is possible, what would be concerning, and what can be safely lived with. They need to hear what tends to improve, what may fluctuate, and what adaptation actually looks like over time.

Without that, many people turn elsewhere. Online forums. Social media. AI tools. Not because they distrust clinicians, but because they are trying to build a coherent story that helps them function.

This is not a failure of intelligence or resilience. It is a survival strategy.

Healthcare systems are under extraordinary pressure. Time is short. Clinicians are stretched. Burnout is real. None of this is controversial. But it is precisely in these conditions that communication becomes more important, not less.

Clear, anticipatory explanation does not add time in the long run. It saves it. It reduces repeat consultations driven by fear rather than deterioration. It improves adherence. It protects clinicians from carrying distress that does not belong to them.

Most importantly, it helps people live in the meantime.

Living with uncertainty does not mean giving up. It means learning how to hold life without constant resolution. Animals are extraordinarily good at this. They do not project forward in the same way humans do. They respond to what is happening now, and they adapt when the ground shifts.

Humans struggle more. We are meaning-making creatures. When meaning is absent, we invent it, often catastrophically.

One of the quiet responsibilities of healthcare is to help people not invent the worst story.

That doesn’t mean offering false certainty. It means naming uncertainty honestly, while also naming what tends to hold steady. It means saying, “We don’t know yet, and here is what usually happens in the meantime.” It means acknowledging fear without amplifying it.

Chronic care is not about fixing everything. It is about supporting people to live well enough, safely enough, and with dignity, even when answers are incomplete.

That requires skill. It also requires humanity.

Caring for another being, whether animal or human, teaches this quickly. Responsibility sharpens attention. Love makes uncertainty heavier, but also clarifies what matters.

What I took from this experience is not a criticism of healthcare, but a reminder of its power. Words shape physiology. Explanations regulate nervous systems. Orientation is a form of treatment.

People can live with a great deal of uncertainty.
They struggle much more with being left alone inside it.

You can read the earlier reflection, When the World Spins by clicking here