When Dr. John Sharrett's malpractice insurance expires next week, the Baltimore neurosurgeon will retire rather than dramatically increase his fees to meet the rising premiums.

Sharrett, 62, who has never been sued, said when insurers raised his premium from $9,000 to $44,000 a year, he made the "painful decision" to bow out of a 27-year practice three or four years earlier than he had planned.

"I think that you will find that the first physicians who like myself will be forced out, will be the ones that charged the most reasonable fees," Sharrett said. "They're talking about how they want to keep the cost of medicine down. If my fees were exorbitant, paying the insurance premiums would be no problem whatsoever.

"But, because I have never charged that type of fee -- I've always considered the individuals I was caring for -- I find that economically it's just not feasible for me to continue."

Selma Sparks, 42, of Dundalk, who suffered from a recurring brain tumor, said the skyrocketing insurance rates are depriving her and other patients "not only of a fantastic doctor, but a fantastic human being."

Sharrett has operated on Sparks' benign, but potentially life-threatening tumor, four times since 1975. She has been a patient for 15 years.

"I feel that I've been robbed by those stupid, astronomical malpractice awards," Sparks said. "Every person who has been truly harmed should be taken care of, but, my God, how far do you go?"

Sharrett said the rising insurance premiums left him two options: paying the $44,000 premium and earning about $46,000 after taxes and business expenses, or retiring.

"It's much more pleasurable to be retired and make nothing than to work and make nothing," Sharrett said. "And, I don't have the responsibilities, the emotional stresses and strains that go with taking care of neurological patients."