Unless you mean that whenever you choose something, there's something else you leave behind
Yes, that's essentially what I mean; I don't mean the minor sort of stuff where you invest resources in pursuing a certain aim, but situations where you come to a fork in the road you're travelling and you have to go one way or another. In the context of the story it means that House's choice meant oblivion and the price was the loss of his personal history, which is major shit. Wilson choosing to save his friend's life meant losing his only friend, which is the same choice Stacy made years earlier. The consequences may have been obvious to House, Wilson and Stacy at the time, but it's on an entirely different level than speaking a language with an accent, which may be somewhat unsatisfactory, but hardly the stuff that makes angels weep. (I also can't find it in me to truly shed a tear at the thought of you having to give up literature in order to study maths, but that may just be my total lack of empathy. It could also be the fact that I made pretty much the same choice, but consider it one of the minor watersheds in my life ...)