Career Focus

Tackling the midlife crisis

BMJ 1997; 315 doi: (Published 20 December 1997) Cite this as: BMJ 1997;315:S2-7123
  1. Carl Gray, consultant histopathologist
  1. Harrogate General Hospital,HG2 7ND

Re-invent yourself out of middle aged angst: ageing juvenile Carl Gray (42) contemplates the first day of the rest of his life.

So, we'll go no more a roving

So late into the night,

Though the heart be still as loving,

And the moon be still as bright.

Lord Byron wrote this at 29 and was dead 10 years later, having had his crisis early in a big girl's blouse. Nowadays you're old young: youth gives way to “middle youth” at 30 and middle age covers the awful bit between fuddy and duddy. The prospect is not encouraging: illness, decline, death, and bereavement; the loss of parents, uncles, aunts. Middle age brings inklings of society's ageism and hatred of the old. Even prosperous middle age may not appeal, with its organised

holidays - anoraks and sensible insurance - jewelled wedding anniversaries, the cruise…. Spending more time with the family may not be welcome to you or them. Medical careers reach a long plateau after training and doctors seem more susceptible than others to the midlife crisis. Students and trainees unconsciously learn that illness and ageing are for others: the people in the beds. After a hitherto blameless career doing all the right things, doctors may feel real distress and surprise as the fury strikes: “This can't be happening to me!” Middle age brings misery with maturity but hope mixed with the horror.

The components

You have left behind the upward view; onward is downwards now. You have got there and made it with several T-shirts. But … is this it? Better to travel than to arrive; to do is more fun than to complete. Every success is followed by anticlimax. Where has all the fun gone? It is a shock when deterioration is recognised in the all too soft tissues and skeleton. …

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