Choice is a funny thing. On one hand, it is something I work towards. I want to be unique. I wear my hair differently than Jim. I buy different shoes than Topher. I have a different job than Krista. And so on.

This desire for self-expression is felt by many of us, and it leads to a society that places a high value on free will and liberty, or, in other words, choice. This choice is all around us. A simple trip for food creates multiple decision points and each decision point requires choosing between many different options. Assuming dress, time of day, and mode of transport are already in place, one must decide whether or not to visit the grocery store or a restaurant. The grocery store decided, there are then countless other decision points through which one must past, consciously or unconsciously, in order to leave the store with even the smallest basket of essential items.

If hundreds of choices have to be made before I can leave the grocery store with a carton of milk, then I must have to consider thousands or tens of thousands of choices before I decide to end my marriage or before society endorses a particular system of government. But this is not the case. Ironically, when it comes to answering some of the most complex and important decisions in our lives, we are often blind to choice and we feel that we must make one of only a few options. A husband considers whether or not he will leave his wife after finding her in bed with someone else, so too the average parishioner decides between belief in God or atheism and the average voter selects the Democratic or Republican candidate. Non-binary perspectives such as moving to an open relationship, an evolving belief in God, and starting or supporting a group that promotes an alternative system of government are often not considered.

As a resident in psychiatry, I am having to process painful, complex, and intense experiences on a regular basis. I make decisions that profoundly impact the lives of others. Each time a patient cries in front of me as I break the news about involuntary admission I continue to learn the consequences of my decisions. As I make these choices I feel next to helpless; I can feel myself frantically searching for dry ground.  The sky is dark and the sea is rough. The salt burns my eyes. I see a couple small spots of land, but I can't make out anything else. I'll go for that one;  if I can't control the storm, then at least I can choose from which piece of earth I will weather it.

Psychiatrists often do everything they can to make it to a spot of dry ground in this torrent sea of complexity and emotional pain. We cling to it. Only after many waves continue to beat down do we realize that our unfortunate spot of land is made of sand; it is wasting away with each movement of the sea. Then it disappears; we are left to be tossed blindly to our next temporary refuge.