Facing Future
When men enter their 40s and 50s, they may need a little help navigating the emotional and medical murky waters.

By Kristen Laine
Photo by Tibor Nemeth

Shortly after Lisa Macfarlane threw a 40th birthday party for her husband Ross, she began to suspect that, after nine years of marriage and two children, he was hiding something from her. One day, emptying pockets at the washing machine, Lisa, a Seattle lawyer-turned-activist, finally put her hands on hard evidence. "That night, when I showed Ross the little broken stick," Lisa recalls, "his face turned red." Ross admitted that the "stick" was, in fact, a broken golf tee. Then he showed Lisa the clubs he had hidden in his car trunk so he could play illicit rounds of golf before work.

"It was a midlife act," Lisa says six years later, and Ross agrees. "I remember thinking, I'm 40 years old, I don't have to conform to that whole Seattle, 'I don't play golf, I climb mountains' thing." Ross, who had climbed extensively in his 20s and 30s, was ready for a less risky sport. Shocked at first by her husband's new obsession—"When I think of golf, I think egregious use of chemicals"—Lisa is now, in Ross's words, an enabler. "Lisa is supportive of my passions and hobbies, and I cut her the slack to reform the world," he says.

The "little broken stick" is a joke that Ross and Lisa tell on each other. But it is also a reminder that even in the best of marriages and in the most understanding of family situations, midlife brings surprises. In particular, men may be surprised by what they can learn at this life stage from women, and women may be surprised by the crucial role they can play in extending the lives of the men they love.

Sidestep The Sports Car
What is midlife for men? There is no international standard, but it commonly refers to the two-and-a-half decades between ages 40 and 65. People often confuse midlife—one of life's stages—with "midlife crisis," popularly caricatured in the male version as a desperate quest to hang on to fading youth by wearing too-tight pants and driving fast cars. A number of psychologists have noted "midlife transition" as a period of time lasting several years for men, starting at around age 40—in "the noon of life," in Jung's phrase. At this juncture, according to the psychologists, men find themselves compelled to assess the structure and achievements of their lives to date. The reappraisal may determine whether the transition turns into crisis, but crisis or not, a red Miata is not going to help.

Midlife affects men profoundly in ways both psychological and physical. And while accepting this passage—beginning with one's youth at the front end and ending at the close of one's working years at the far end—has never been called easy, a man's route through middle age today has the additional challenge of being, essentially, uncharted.

Fact: There are 85 million people between the ages of 40-64, comprising 31% of the total U.S. population. Midlife for men in the new millennium looks, and feels, quite different from the way it did a generation ago. Compared to their fathers, men of the baby-boom generation are more likely to have married later, had fewer children and had them later, started careers later, and changed their careers more often. Forty-something men today are more involved in home and family life than were their fathers, but are also five times more likely to be laid off and twice as likely to be divorced. A generation ago, a middle-aged man could anticipate that he'd be reaching the apex of his career around the same time that his children left home. Now, a man in his 40s may be starting his second (or third) career with children still in diapers and a wife who is also struggling to meet the demands of work and family.

"Our generation had the wonderful entitlement of blowing off our 20s and bouncing around in our 30s," says Whit Symmes, 43, of Concord, N.H. Today a father of three, Symmes repaired cars and sang in jazz clubs before becoming a music teacher. "Now, three or four years into a new career, I'm behind the curve. I should be at the peak, but I'm just starting into it."

Even men whose lives have followed more traditional paths are living in a newly complex social landscape. In recent decades, social change has expanded our definition of what it means to be female, while our notion of what it means to be male has become muddier. Women are increasingly encouraged to express what used to be thought of as "masculine" traits: competitiveness, aggression, logical thinking. Men have not generally been encouraged to expand their psychological vocabulary into "feminine" traits: intuition, vulnerability, nurturing. And yet many psychologists consider developing—and accepting—these traits to be among the main tasks of men during midlife. And, if accomplished, men give themselves new tools to find joy in parts of life beyond work and other external achievements, as well as the grace to share a life's wisdom with others.

Age is relative. The human life span has altered dramatically over time. In hunter-gatherer societies five or 10 thousand years ago, only about 10 percent of the population survived to age 40. As recently as 1900, the average American man was not expected to live beyond 47. When Social Security began in 1935, the retirement age of 65 exceeded by four years a man's average life expectancy. By 1950, a man could expect to live 65.6 years. That average man today, if he survives to age 52, can anticipate reaching at least 71.
Enormous increases in both the quantity and quality of life have occurred for the average American over the past century. But the gap in longevity between men and women has widened during that same time. In 1900, women's life expectancy outpaced men's by only two years. A boy born in 1999, the most recent year for this data, has an estimated life expectancy of 73.9 years, a number to applaud until you compare the life expectancy of a girl born the same year: 79.4 years, almost six years more than the boy.

Sources: The Seasons of A Man's Life by Daniel J. Levinson (Ballantine Books, 1886); Centers for Disease Control and Prevention, www.cdc.gov/nchs; U.S. News & World Report, June 4, 2001.
Dodge The Body Breakdown
If holding on to the male myth of invulnerability can hinder a man emotionally, physically, it can literally kill him. Women live longer than men on average—by about seven years—and men are much more likely than women to die or suffer physical decline in middle age. But a man's shorter life span or reduced vitality is not dictated by having a penis and male body chemistry. Instead, it is the classically "male" way in which many men approach their own health care that appears to shorten their lives. Men typically don't take time off from work for preventive checkups that can catch potential problems before they become life-threatening. In fact, men are largely absent from doctors' offices and silent when they get there.

Every year, men make 150 million fewer trips to the doctor than women. And women ask an average of four questions in the doctor's office, whereas when men do actually go, they ask none, according to Ken Goldberg, MD, who founded the Male Health Center in Dallas, Texas. "Guys need to take the same approach to their bodies as they do their cars," writes Goldberg in How Men Can Live As Long As Women (Summit, 1994).

An aversion by half the population to changing the oil in a car would probably decrease the life span of a lot of cars. When the aversion is to self-care, the problems are much more serious. Men suffer two-and-a-half times more heart attacks than women before the age of 65. Men are 30 percent more likely than women to have a stroke—one out of three of them occurring before age 65. By age 65, one in three men suffers from high blood pressure, a primary risk for stroke and heart attacks. Yet men are less likely than women to have their blood pressure checked.

Goldberg and others concerned with the state of men's health would like men to act, well, more like women when it comes to taking charge of their health. One in nine men will be diagnosed with prostate cancer over a lifetime, yet few will have the easy and painless digital rectal exam and prostate specific antigen (PSA) blood test to detect it. Women, facing similar odds of contracting breast cancer, are much more likely to examine their breasts regularly and have mammograms. If men made regular preventive health visits to doctors, asked questions, did self-exams and came in for follow-ups, they would live longer and better.

Get Him To The Doctor
What finally gets men on the exam table? Fear of heart attacks and impotence. "I get new patients, men in their 50s, who haven't come in for any health care for, literally, 30 years," says Vermont family doctor Kelly Kinney, MD. A new male patient will make an appointment for some minor complaint, but then talk to Kinney about serious symptoms, such as twinges of chest pain or erectile dysfunction.

Fact: Today's 40-year-olds are healthier than their parents were at the same age: Deaths from heart disease have fallen 50 percent since the 1970s, and the average life span has increased by 5 years. Having a woman in the house, even one with medical training, won't necessarily convince a man to call the doctor. Kinney's husband Steve Fiering, now 51 and an assistant professor of microbiology, hadn't seen a doctor for 15 years before getting a checkup at age 49, though his father had suffered a first heart attack at 35. Even then, Kinney made the appointment for him. Fiering received a clean bill of health, but admits, "For all I knew, I was completely falling apart."

The men of America may unconsciously be relying on the nation's women, and not just to schedule checkups. "It will be women who point out the crisis in men's health," says Tracie Snitker of the Men's Health Network in Washington, D.C. "When Georgia created a commission on men's health, a woman sponsored that bill." And the three original cosponsors of a bill to create a federal Office of Men's Health were all women.

It may take wives and partners to insist that the men they love leave work for a preventive health appointment. And a generation of mothers—and educators, doctors, and health organizations—may need to teach America's sons the same health care habits their sisters learned in previous generations.

Fact: A warm marriage at 50 increases a man's chance of being healthy at age 80. One other thing both men and women can do to increase men's chances for a long and healthy life: Stay happily married. A warm marriage at age 50 increases a man's chance of being happy and healthy at age 80, writes George E. Vaillant, MD, author of Aging Well (Little Brown, 2002).

Lisa Macfarlane has every intention of aging well with her husband. She doesn't need to oversee Ross's health care: He's been scheduling regular checkups for years. Just recently, Lisa and Ross started compiling lists of 25 things they each want to do in their lifetime together. This year, it's Lisa's turn to plan their anniversary weekend. They've been married 16 years, but they still haven't run out of ways to surprise each other. It would certainly stun Ross if she took him golfing—but that's one surprise he'll have to wait for.

Freelancer Kristen Laine is surrounded by men in midlife: her husband at the beginning, her father at the end, and two brothers in the middle.