As I contemplate retirement from clinical practice as a general surgeon, something I’ve been doing for over 41 years including residency, I’ve been having some unsettling thoughts.

Like many physicians, I’ve tried to stay somewhat emotionally detached from my patients. You must maintain some distance in order to be able to make tough decisions and to keep on doing surgery for so long.

I have written in a previous blog about the effect of complications on the psyche of a surgeon, realizing of course, the patients and their families suffer even far more than I do. I’ve always taken complications personally, but lately I’ve been more acutely aware of this issue.

As I reach the end of my career, I find myself empathizing more and more with the plight of my patients, especially since many of them have somehow become younger than I am.

There are things you don’t think about when you are 40 or even 50 years old. I find myself making a long mental list of diseases that I hope I never get. Lately, I’ve been pondering a real conundrum. Which is worse, growing old and becoming demented with a body that still has many miles left on the odometer, or having the body break down and remaining lucid enough to realize what a mess you are in?

I haven’t settled that issue yet but I’m leaning toward dementia as long as I’m pleasant. Unfortunately having been a cranky bastard for pretty much my entire life, I think I’m more likely to be a disagreeable if dementia sets in, so maybe the sound mind/unsound body option would be a better deal for my family. Too bad they don’t get to choose. Nor do I.

I would prefer neither. In an attempt to postpone physical deterioration, I’ve been exercising regularly and am in the best shape I can ever recall, including when I was in high school.

If you’ve been following me, you know that for mental gymnastics, I’ve been blogging about three times a week for the last two years. I plan to continue writing for long as I can coherently put two sentences together.

Perhaps it is the end of summer that has made me melancholy. Or possibly it’s realizing that very soon the way I have defined myself for the last 41 years will no longer apply. Let’s look at the bright side. At cocktail parties, people who used to ask me for medical advice will probably think twice knowing that I’m retired. Instead maybe they’ll start asking when does “its” take an apostrophe.

“Skeptical Scalpel” is a surgeon blogs at his self-titled site, Skeptical Scalpel.