In 2017, my Presidential address to the American Society of Colon and Rectal Surgeons was titled “the joys of a surgical career.” The address examined the continuum of a long surgical career, and particularly the four stages including the initial education and training to become a colon and rectal surgeon, early career, mid career and late career. This paper builds on that address and specifically looks at ways to continue to thrive and to find joy in the clinical practice of surgery and beyond.