THE COST OF BETTER CHOICES
The Cost of Better Choices
I didn’t fail to choose because I was careless.
I failed to choose because I was trying to choose correctly.
An air fryer with ten modes.
A CCTV camera that also runs on solar power.
Phones with endless configurations.
Robot vacuum cleaners that promise intelligence.
I didn’t buy most of them.
Not because I didn’t need them but because the number of options quietly overloaded me. Repairing my old phone had a lower cognitive cost than choosing a new one. This wasn’t minimalism. It was exhaustion.
The same pattern repeated elsewhere.
I couldn’t buy a watch for my brother. The options were endless, the standards invisible, and the fear constant: What if there’s a better one I’m missing?
When my other brother finally bought it, I felt relief not because the decision was made, but because the responsibility was no longer mine.
Buying gifts became another trap. Too many choices meant no single choice felt sufficient. Once, I bought two gifts instead of onenot out of generosity, but to quiet the anxiety that I might have chosen wrong.
These are small decisions.
They reveal a large problem.
When Choice Escalates Expectations
We are taught that more choice equals more freedom.
What we are not told is that more choice also raises the bar for what counts as an acceptable decision.
The pattern became impossible to ignore when I tried to buy a bed .I knew nothing about beds. All I knew was that my back hurt, my studies were intense, and sleep had become non-negotiable. What I encountered was not help,it was a taxonomy.
Orthopedic support.
Multi-layered foam.
Spring-loaded bases.
Beds that promise warmth in winter and cooling in summer.
Beds that claim to align the spine, distribute pressure, optimize recovery.
I did what choice culture trains us to do.
I researched.
The more I read, the clearer it became that this was no longer about sleeping.
It was about choosing correctly.
But every feature came with a price that exceeded my budget.
And every budget option now felt compromised not bad, but inferior .I hadn’t even made a decision yet, and regret had already entered the room .In the end, I didn’t buy a bed .I repaired my old cotton mattress instead rearranged the cotton, tried to make it softer. It was still hard.
And now it felt harder than before not just physically, but psychologically.
Because I didn’t just sleep on a firm bed.
I slept on the knowledge that better options existed.
When options are limited, “good enough” feels reasonable.
When options multiply, “good enough” starts to feel like failure.
The question silently shifts from “Is this fine?” to “Is this the best?”
And “best” is a standard defined only in hindsight.
Every additional option adds not just possibility but pressure.
Choice and the Internalization of Blame
Here’s the part we rarely admit.
When things go wrong in a world of limited choice, we blame circumstance.
When things go wrong in a world of abundant choice, we blame ourselves.
If I regret a decision now, there’s no external excuse left.
I had options. I researched. I chose.
So regret doesn’t land as disappointment it lands as self-indictment.
Choice turns misfortune into personal failure.
When the Stakes Became Real
This logic didn’t stop with objects.
College choices broke me.
This wasn’t choosing a phone or a gift.
This was choosing a future.
Every option had trade-offs. Every trade-off felt irreversible. Every irreversible decision felt like a test of intelligence and worth.
If I chose wrong, I wouldn’t just lose an opportunity.
I would become the person who chose wrong.
For two years, I’ve regretted decisions not because they failed but because better ones might have existed.
Not known better ones. Imagined ones.
Choice, Medicine, and the Burden of Responsibility
This is where the paradox becomes dangerous.
Modern medicine offers unprecedented choice:
multiple investigations, multiple guidelines, multiple treatment pathways, multiple “correct” answers.
On paper, this is progress.
Psychologically, it relocates uncertainty almost entirely onto the clinician.
When options were few, outcomes were attributed to disease severity or limitations of tools.
Now, when outcomes are poor, the question is immediate and brutal:
Did you choose the right test?
Did you escalate early enough?
Did you miss a better option?
The existence of alternatives retroactively criminalizes judgment.
Guidelines multiply not to reduce uncertainty but to document that choices existed.
And when something goes wrong, responsibility has a clear address.
Decision Fatigue Is Not a Personal Failure
Clinician burnout is often framed as a failure of resilience.
This is inaccurate.
What clinicians experience is decision overload in high-stakes environments with delayed feedback and irreversible consequences..
Every decision carries opportunity cost, documentation burden, medicolegal exposure, and moral weight.
Paralysis, defensive medicine, over-investigation,guideline worship these are not pathologies.
They are adaptations.
The Unequal Geography of Choice
As Barry Schwartz argued, the problem with choice is not just how much of it exists—but where it exists.
In low-resource settings, lack of choice destroys welfare.
In high-resource settings, excess choice erodes it.
Adding options to already choice-saturated systems does not improve outcomes.
It escalates expectations and amplifies self-blame.
Conversely, introducing basic, meaningful choice education, diagnostics, treatment into deprived settings restores agency and dignity.
Choice has diminishing returns.
Medicine ignores this at its own cost.
Ending
We don’t need more options everywhere.
We need better distribution of choice.
Less where it has become noise.
More where it still means survival.
Medicine doesnt need infinite choice.It needs well-designed constraint.
Constraint that:
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Protects judgment
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Normalizes uncertainty
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Distributes responsibility realistically
The opposite of good medicine is not limited choice.
It is responsibility without support.
Until we acknowledge the psychological cost of excess choice, we will keep mistaking burnout for weakness, overthinking for incompetence, and regret for error.
And clinicians will keep asking themselves the most corrosive question of all:
“What if I had chosen differently?”
DISCLAIMER:
This is not an argument against evidence-based medicine, clinical guidelines, or the expansion of access to care. Choice saves lives when it creates possibility where none existed.
It is an argument for recognizing that choice, beyond a point, carries psychological and moral costs that are borne disproportionately by individual clinicians and that good systems must acknowledge and share.
One idea I keep returning to after publishing this:
ReplyDeletedissatisfaction today is often not caused by bad choices, but by imagined alternatives.
The mere visibility of “better” options most of which we never needed and could never afford—quietly erodes satisfaction with reasonable decisions.
We don’t suffer because we chose poorly.
We suffer because we were taught to imagine endlessly.
We are told to live in the moment, but constant decision-making makes that impossible.
When every moment demands evaluation, comparison, and justification, the present is no longer lived it is managed.
Kindha meedha oopu ma ramya madam toppu..🔥🔥🔥
DeleteThis is not a story about indecision.
DeleteIt is a story about how modern systems turn judgment into liability.
What is needed is not to remove choice, but to put proper limits. Systems have to understand that uncertainty is normal, not a personal flaw. Every decision will not have a perfect answer, and expecting perfection only adds pressure. Responsibility should be shared, not silently dumped on one person. If this does not change, decision fatigue will keep being seen as weakness, and burnout will keep being blamed on individuals instead of the system that caused it.
You can’t fix the system, so stop trying to outsmart it. The only thing you really control is how much of yourself you give to a decision. Before you even start, be clear about your limits. How much time will you spend? How much money can you afford? How much mental energy are you willing to burn? Once you hit that limit, you stop. Not because you found the perfect answer, but because the decision isn’t worth more of your life.
DeleteTake something simple like buying a bed. Decide you’ll spend one evening on it. Pick three options that fit your budget and choose one. Don’t keep scrolling reviews for weeks, hoping some final sentence will remove all doubt. That moment never comes.
After you decide, hold yourself to only one standard: was this a reasonable decision with what I knew at the time? Not whether a better option exists today. There will always be a better option. If the new bed helps you sleep better than before, that’s enough. You don’t need the best bed in the country to justify your choice.
While researching, stop the moment you understand the trade-offs. When buying a phone, once you know that one option gives better battery at a higher price and another saves money but sacrifices performance, you already know what matters. Anything beyond that isn’t helping you decide. It’s just feeding anxiety.
Regret doesn’t mean you messed up. Feeling uneasy after choosing a college, a job, or even a gadget doesn’t prove the decision was wrong. It just means you’re aware other paths existed. That awareness is uncomfortable, but it’s normal.
One practical way to survive this is to create simple rules for yourself. For gifts, decide in advance that you’ll buy one thoughtful item from a fixed category, like a book or a watch, and that’s it. No second gift. No safety net. For career decisions, make a rule that once you choose, you won’t reopen the decision for a year. Rules feel restrictive, but they protect you from putting yourself on trial over and over.
Even after big decisions, doubt will show up. You choose a college or a clinical path, and months later the “what ifs” start. That doesn’t mean you chose wrong. It’s just the cost of acting in a world where certainty doesn’t exist.
When that pressure hits, call it what it is. This isn’t indecision. It’s decision overload. The goal isn’t to feel calm or perfectly sure. The goal is to keep going without letting a system built on endless options turn normal human judgment into self-punishment.
Thank you for this thoughtful response. I agree that many people end up creating personal rules and limits simply to survive inside systems that overload judgment.
DeleteMy concern is that these individual strategies are often mistaken for solutions, when they are really workarounds. They help people cope, but they don’t address why so much responsibility and uncertainty are concentrated on individuals in the first place.
The goal of the piece wasn’t to reject personal limits, but to ask why they’ve become necessary so often and why decision fatigue is treated as a personal failure rather than a predictable outcome of system design.
That’s exactly the problem.
DeletePersonal rules and limits are not real solutions. People use them only to survive. Kooti kosam koti kashtalu — just to manage daily life, people already carry too many burdens. These rules are not created because they are ideal, but because the system leaves no other choice. When a person has to control and limit their own thinking just to function, it shows the system is already out of balance.
The real issue is not that people are bad at deciding. The issue is that modern systems expect people to think endlessly, predict perfectly, and take full responsibility alone. When this doesn’t work, the blame goes to the person. Decision fatigue is seen as weakness. Burnout is treated as a personal problem, not a system problem.
This wrong framing matters. If we think the issue is personal strength, the solution becomes meditation, time management, or being more “strong.” But if the issue is system design, the solution is different: fewer unnecessary choices, shared responsibility, and support for judgment. Only this actually reduces harm.
So yes, personal limits help people survive. But the fact that survival itself needs so much effort is the real message. The piece is asking why this struggle is treated as a personal failure instead of feedback that the system is poorly designed.