Fair enough, I suppose. I do have a 'gal' that can pack up and leave, as she happens to be the mother of my children. I did figure location into my reasoning, but to limit yourself to 1 or 2 programs, you must have a pretty good indication that you will match at one or the other, I would assume.
As far as 'being on the edge', I have yet to meet a practicing anesthesiologist who relishes 'being on the edge'. Many enjoy complex and demanding cases, like excitement, etc. but being on the edge implies that you are one step from disaster at all times, and I dont know anyone, anywhere that realistically seeks that out.
As for neurosurgery, all of those bastards are miserable. I decided I didnt want to be miserable. I hope you dont take what I said personally, it just seems foolish to apply to 19+ programs that you would never go to (because of location) and rank 1 or 2. I imagine that you will get a spot at 1 or 2 and so it wont be an issue, but if you dont are you prepared to go through the match again next year (not always easy to get a PGY-2 spot) which would waste a year, or will you change careers?
Im sure youve thought all this out, so I wish you the best.