I never thought of myself as athletic growing up.

I wasn’t particularly good at team sports.

I swam competitively in a summer club, kept swimming into adulthood, and then, at thirty-four, decided I wanted to see if I could finish an Ironman.

I did.

Back then, a hundred-mile bike ride on a Saturday wasn’t remarkable.

It was just what the training schedule called for. Sunday was usually a long run.

The week was organized around whatever came next, and I ate a ton of peanut butter pretzels from Trader Joe’s on my way from the office to workouts.

Every now and then I’ll see someone out on a road bike and think, I remember that life.

What’s interesting isn’t that I miss it.

I don’t.

If you offered me that life back exactly as it was, I don’t think I’d take it.

Training at that level wasn’t just exercise.

It was time. It provided a framework for my life outside of medicine. It was saying no to other things so I could say yes to that one thing.

It was 2008 when I completed Ironman Wisconsin.

And then, life moved on.

Work took over. Then almost twenty years of practice. New responsibilities. Different priorities.

I don’t look back and think I chose poorly.

But I have found myself wondering about something else.

How much of who we used to be do we intentionally leave behind…

…and how much simply slips away while we’re busy living?

I think about that because I hear versions of it in the clinic all the time, even when nobody says it directly.

A man comes in because of urinary leakage after prostate surgery. Somewhere in the conversation I’ll ask what he doesn’t do anymore because of it.

The answers are rarely about the leakage.

They’re about trips that never got planned. Golf with friends that no longer happen.

Grandchildren he no longer gets down on the floor with because standing up has become complicated because he leaks urine when he does.

A man comes in because of erectile dysfunction.

What he’s often mourning isn’t the erection.

It’s the version of the relationship that slowly disappeared around it.

Those conversations have made me notice something in myself.

I don’t want to be thirty-four again.

I don’t need another Ironman.

But I also don’t want to confuse the life I chose with the things I simply stopped choosing.

Those aren’t the same.

Some things deserve to be left in an earlier chapter.

Some don’t.

The trick, I think, is knowing the difference.

It’s easy to blame age for everything because age is always present.

But sometimes it’s a bad knee that could be treated. Or sleep apnea that’s never been diagnosed.

Or forty pounds that arrived so gradually they started to feel inevitable.

Sometimes it’s fear. Sometimes it’s habit. Sometimes it’s just that “later” quietly became five years and then twenty.

I don’t have a grand conclusion.

Only an observation.

The older I get, the less interested I am in trying to become a younger version of myself.

I’m much more interested in making sure I don’t accidentally become a smaller one.