Swiftly, painlessly, and old.

I remember what George said and vowed that rather than let Alzheimer's take me, I would take it. I would live my life as ever to the full and die, before the disease mounted its last attack, in my own home, in a chair on the lawn, with a brandy in my hand to wash down whatever modern version of the "Brompton cocktail" some helpful medic could supply. And with Thomas Tallis on my iPod, I would shake hands with Death.

I would like to die in good health, at an old age, in a house on a mountain that looks out over the ocean, dreaming about everyone and everything I have had the impossible good fortune to have loved. Maybe Ralph Stanley is singing “Angel Band.”

Over two weeks, in a pleasant fug of palliative morphine if necessary. Just time to say a cheerful good-bye to everyone.

I’ve had this concern all the time, but I can only hope that if one writes with appreciation and delicacy and respect, then it’s okay. I have to say that I’ve written a hundred times as much as I’ve published, because if there’s any thought of offense or embarrassment, then I will put the thing quietly away.

And I spent four years at a boarding school in the country, probably a rather abusive boarding school, and seeing very little of my parents, and that was a very bad time for me. A bad and almost a mad time. ... I think that some sort of trust, and ability for closeness, may have been compromised. And I think I’ve perhaps, to some extent, sort of kept a distance since that time, although this is not a distance I feel with my patients or my students.

The peace of the Sabbath, of a stopped world, a time outside time, was palpable, infused everything, and I found myself drenched with a wistfulness, something akin to nostalgia, wondering what if: What if A and B and C had been different? What sort of person might I have been? What sort of a life might I have lived?

On the contrary, I feel intensely alive, and I want and hope in the time that remains to deepen my friendships, to say farewell to those I love, to write more, to travel if I have the strength, to achieve new levels of understanding and insight. This will involve audacity, clarity and plain speaking; trying to straighten my accounts with the world. But there will be time, too, for some fun (and even some silliness, as well).

I feel a sudden clear focus and perspective. There is no time for anything inessential. I must focus on myself, my work and my friends. I shall no longer look at “NewsHour” every night. I shall no longer pay any attention to politics or arguments about global warming. This is not indifference but detachment — I still care deeply about the Middle East, about global warming, about growing inequality, but these are no longer my business; they belong to the future. I rejoice when I meet gifted young people — even the one who biopsied and diagnosed my metastases. I feel the future is in good hands.

My generation is on the way out, and each death I have felt as an abruption, a tearing away of part of myself. There will be no one like us when we are gone, but then there is no one like anyone else, ever. When people die, they cannot be replaced. They leave holes that cannot be filled, for it is the fate — the genetic and neural fate — of every human being to be a unique individual, to find his own path, to live his own life, to die his own death.