Overcoming the Midlife Crisis

This morning when I got up I weighed myself: 64.8 kg. Two years ago my peak weight was 75 kg — I have lost a full ten kilograms. My height is 168 cm; my standard weight range is 55.4–67.7 kg, and I had been overweight for over ten years. I had wanted for many years to lose weight and bring it into the standard range, but never succeeded. These past two years, by changing my lifestyle, I have achieved it.

I had thought my belly would never be flat again in this life, but starting last year it has flattened — it turns out the middle-age spread is not insoluble. When the pandemic first began, I cycled out to Mentougou and saw vegetable plots for rent in Gushan village, Miaofengshan town, which gave me the idea of renting a plot to grow vegetables. But Mentougou was too far from home. Later I saw on a friend's Moments that a friend who worked at a bank was gardening at the foot of Fragrant Hill, so I asked her for the address and phone number and cycled myself to the "Yihe Shiyuan" ecological base at the foot of Fragrant Hill to look for a plot. Luckily I found two small ones.

At the time I told this friend that my goal, after gardening there, was to get down to my college weight — back then I was only about 60 kg, a very standard weight. She thought that now that we were both middle-aged, the spread was irreversible and getting back to 60 kg was an impossible task. But I have now actually completed this "impossible" task.

Many of my patients are born in the 1970s or 1980s, about my age, yet unfortunately have cancer. I have now read many works on cancer; I know that normal human cells readily mutate into cancer cells. Within the十几 minutes we spend walking out in the sun, many of our skin cells have already mutated. But as multicellular organisms, evolution has also endowed us with very powerful tumor suppressor genes — TP53 is one of them — which recognize mutated cells and either stop them from mutating further or induce apoptosis, forbidding excessive proliferation. It is because of this that most people do not get cancer.

But since humanity entered modern society, cancer incidence has risen. Roughly estimated, in some of China's first-tier cities about one in three people will eventually die of cancer. Among urban residents, on average one in four gets cancer; among rural residents, one in five.

On one hand, this is linked to rising life expectancy: the older a multicellular organism, the higher the probability of cancer. On the other hand, it is linked to our modernized lifestyle. Looking back twenty years, when I was in the countryside, there was still plenty of physical labor; now not only do urban dwellers lack it, but rural physical labor has shrunk sharply because of agricultural mechanization. This means our tumor suppressor genes cannot be as strong as they once were.

Besides cancer, the incidence of heart disease, diabetes, and stroke has also soared. Middle-aged people face sharply rising pressure: on one hand, the elderly at home have many health problems; on the other, work stress is high and their own bodies are in a sub-health state. At present only about 18% of Chinese adults exercise regularly; the rest rarely move. These rarely moving people's cells are rapidly aging and mutating; most have no idea their bodies are already quietly turning cancerous, and by the time it is found, most are already at an intermediate or late stage.

Two years ago my body began flashing red lights. My lower back and legs ached frequently, worse when the weather changed. At first I suspected rheumatism; later a doctor suspected a herniated lumbar disc. I saw quite a few orthopedic doctors, and finally it was found to be caused by excessive fat within the spinal canal.

My physical exam also flagged fatty liver, which for a hepatitis B carrier is a dangerous signal — left to progress, it can develop into cirrhosis or liver cancer. I am actually quite restrained in diet; I was only "overworked-fat" — I was too busy to find time to exercise. But the pain finally forced me to make time for treatment.

I decided to change my lifestyle. No matter what, I would take steps to stop my body from getting worse; I would change before my health deteriorated further. Actually, even without the pandemic, I had already put this on my agenda. I cannot knowingly keep jumping into a fire pit ahead. Many TCM doctors, without genetic or infectious disease, die young; however legendary such doctors may be in the jianghu, I do not believe their academic level is high.

A friend once introduced me to a 70-year-old TCM doctor, hoping I would study with him, saying he had studied under one of the four great doctors of the capital. But after I met him, I gave up the idea. He was the same age as my father, yet his body was already frail and his belly huge. In a fight, my father alone could take on a dozen of him. I think a person who has studied medicine yet wrecked his own body this way shows he did not learn well; taking on apprentices risks misleading them. I will not follow in his footsteps.

These past few years my life has changed. I no longer take the elevator; at first I walked up, and in the last year or two I have run up, and now I can run up ten flights in one breath. I no longer take the bus; my transit card has gone unused for a long time, and I never take taxis. I get around on foot or by bicycle. My physical strength is now at its peak in years; cycling on Beijing streets, I can outpace most electric scooters.

My body has hardly ever been this agile, and my energy is abundant. I wake at four every morning; after getting up I read for a while, and by about five-thirty I have made breakfast for the whole family. In a day I can do 3–4 hours of physical labor, work 5–6 hours, and read and write 3–4 hours, without feeling the least tired. This has shown me that as long as one is willing to move and labor, the body does not age so easily.

My patience is also much better than before; with children and the elderly I am far more even-tempered. In fact, middle-aged people who are short-tempered and exasperated are mostly not in good physical shape. The better one's physical state, the calmer the temper. People often say "where the heart is at peace, there is home"; the reverse may be more accurate: a body at peace makes the heart easier to settle. These years I have treated several monks, and what I have seen tells me that even monks, when ill, are far from at peace.

The ancients said "cultivate the self, put the family in order, govern the state, bring peace to the world." Governing the state and bringing peace to the world is not something ordinary people like us can do, and the world does not need everyone to harbor such ambitions. The more schemers dreaming of governing the world, the more ordinary people suffer. For instance, as a child I dreamed of cavalry and iron armor, galloping across the battlefield, governing the state and bringing peace; if the world ran according to my childhood ideas, it would be daily bloodshed and countless deaths. But "cultivating the self and putting the family in order" does matter for us middle-aged people. Cultivating the self is not easy; settling for second best, "getting fit and putting the family in order" is also good. Doing right by the whole family and getting everyone to synchronously choose a healthier lifestyle saves the household a lot of trouble.

That is exactly what I have done. I work to make my whole family's life healthier, patiently urging them to exercise moderately. Let high-toned "self-cultivation" be for the elevated; in daily life I tirelessly and patiently persuade every family member to value health, sleep less, eat less salt, and exercise moderately. If one attempt fails, try again; if that fails too, no matter — repeat countless times. A little nagging is not bad; as long as the nagging is done with a smile and a good attitude, no one minds. After enough nagging, the family does take some of it in. And so, these two years, my whole family has lost weight successfully.

I am not without life goals; mine are simple: to keep the whole family, young and old, as healthy as possible. When they are healthy, I have no worries at home and can do the work I love. As for their views, I will not try to unify them; each has their own tastes and pursuits, and it is none of my business. I think everyone has had this experience: once one family member falls seriously ill, the whole family is worn out. Not only does it cost money, every day is spent in fear. Especially for middle-aged people who are the family's mainstay, once one or two members fall ill, the pressure on that mainstay spikes, life immediately falls apart, and then their own bodies develop all sorts of problems.

The midlife crisis of the wealthy may differ from ours, but as an ordinary person my contact with the wealthy is limited, and the midlife crises I see are overwhelmingly caused by health. Even when some people also have relationship crises, a large part of those is also health-related. Without health problems, many people's relationships, though they have small issues, would not blow up. The ancients say no filial son is long-suffering at a long sickbed; nor, at a long sickbed, is there easily a partner without complaint.

If, like me, you lack the knack of earning enough money — actually that stuff is of limited use at the critical moment — then work hard to get your health in order, and don't let it turn our lives into a mess. Without sickness or disaster, middle-aged people are among the groups who enjoy life most; where do so many "crises" come from?