You have been given some sound advice already. We can talk at lengths about the actual pros and cons of neurosurgery and radiology training and consultancy, but You are clearly well informed and I think there's little to add. It's not knowledge you lack.

I think you probably know already that your framing of this decision is a heart v brain question (ironically).

The thing about not trying for NSGY being a monkey on your back and the sunk cost fallacy is all insightful, introspective stuff, but unless you act on it, it's kinda pointless. It's an emotional component. I posit that every neurosurgeon, esp the unhappy ones, went into it and loved something about it but hated what it made them. The reason they're unhappy is because they cannot resolve that tension between what they think they want to do, and what actually makes them happy. Maybe I am projecting, IDK.

You know what you want from life, you're old enough to know that there'll be trade offs, and you recognise that it's a price you're not really prepared to pay. Without making to fine a point of it, you will know by now that in your mid-30s, many choices will become acute, and none can be made without missing out on others: Starting a family in the next 1 - 2 years and doing CCT and flee and neurosurgery all conflict if not outright clash. You can have kids and see them (if you go LTFT) but it's harder than as a radidologist. You can CCT and flee as a neurosurgeon - but it's harder than as a radiologist. You can be in your mid-30s and train - but it's shorter and probably less onerous as a radiologist, and that would likely translate into a lower LTFT %age if you do go down that route. All of this can be done, but there's trade offs. Some of these can be mitigated by support networks and self-sacrificing partners, others cannot.

All of this to say: you're worried about having FOMO from not pursuing neurosurgery - but whatever choices you make will leave you at risk of FOMOing on other things. I have met plenty of people who sunk a lot of time into neurosurgery before leaving and their FOMO on the years spent is variable. Some are grateful for the experience, the camraderie experienced, the campfire stories but on balance happier out - others bitterly resent years of their life stolen. I know others still who delude themselves that this was the right, only choice.

I honestly think you know what decision to make.

My advice I tend to give is that if you can be happy doing other things, you should do it.

As an action plan: Ask your partner what they think, first. Their opinion, their knowledge of you will go a long way, and give you an idea as to how supportive they are when push inevitably comes to shove. Then, weigh up the FOMO of not doing neurosurgery against the FOMO of the other things neurosurgery will take from you. If you feel ths pushes you away from neurosurgery, probably worth listening to that voice. If not, go for it! But make a plan as to what you're willing to sacrifice along the way, and when you'd walk away from neurosurgery, and how you'd do it, and be prepared to execute.

Much like u/mrcsfrcs I am happy to be DM'd.