Lyric discussion by flaminmofo 

Cover art for Scalpel lyrics by Alice in Chains

I think it's about cutting ties with the past and being real with yourself by taking off a facade you put on, hence the "like a scalpel, cut yourself" part.

My thoughts are the same. I think its kinda about Jerry's struggle with alcoholism, cocaine use, and broken relationships.

"From my home town, I lit out. To save my skin, and shed some doubt." Referencing how he moved from Seattle, to California to start over, and "Check his brain".

"I'm breaking without a sound", possibly referencing him attempting to hide it, and put up a facade of nothing's wrong/I don't have a problem.

"Hard as truth is, been my friend. Saying he realized the truth was that he did indeed have a...

And like you also said, using the "scalpel cut yourself." Using the scalpel as a tool to "cut into him", and pull out his demons