You sound like you have a vision, at least a partial vision, in your head. I don't use patterns (I study them and decide how I'd like to copy them and no one would ever relate what I have created to the one I copied!). I use graph paper (prefer velum) and put in the geese the way I "see" them. Obviously they are flying over ...... so that gets sketched in. And geese like water, so maybe a lake needs to be there... and bit by bit the picture comes to life. Then I resketch because I need to reproportion the sizes, etc. By the time I get to this point I am so anxious to begin that it just happens.
Of course, when you work on a quilt this way it takes on a life of it's own and you can't be held responsible for how it comes out. I took a "viewers choice" first place at a very large fair with a NW Native American totem bear one year. It is hard to take credit, but I did follow the vision (I couldn't stop byself). This is my favorite way to make a quilt and I do it for someone specific each time. When I just "do" it, the quilt is never completely satisfactory.
For those who need quilts I find fabrics in my stash I loved once and don't so much any more and dig around until I find the "perfect" mix and make the quilt top, usually geometric, perhaps simple squares. I think of who might get that quilt and the fact that I have so much and others have so little (think after a hurricane!) I find myself pouring myself into the making.
Hope this helps.