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Eugene O’Kelly was at the top of his game. The 53-year-old chairman and chief executive of KPMG in the US was working hard, supporting a happy family, maintaining a busy social life and making plans for a long, well-earned retirement.

Last May he went for a check-up with a neurologist to investigate a slight facial droop, which he presumed was caused by Bell’s palsy or some other stress-related complaint. A scan revealed he was suffering from terminal brain cancer and had only three months to live.

As Mr O’Kelly explains in Chasing Daylight*, his account, published posthumously, of his final weeks of life, he looked on this news as a kind of blessing. He would have 100 days to make a good death: to say goodbye to colleagues, friends and family, and to plan a future for his wife and children. Like the accountant he was, Mr O’Kelly wanted to close the book on his life and leave his affairs in good order.

The diagnosis also got him thinking about his career and what it had truly meant. “Before my illness, I had considered commitment king among virtues,” he writes. “After I was diagnosed, I came to consider consciousness king among virtues.”

This was no death-bed conversion to sloppy sentimentalism. Mr O’Kelly now believed, like Socrates, that “the unconsidered life is not worth living”. And he felt sorry for colleagues and peers who had not had the chance to reflect more seriously on their lives.

“I lamented that they had not been blessed as I had, with this jolt to life,” he writes. “They had no real motivation or clear timeline to stop what they were so busy at, to step back, to ask what exactly they were doing with their life. Many of them had money; many of them had more money than they needed. Why was it so scary to ask themselves one simple question: why am I doing what I’m doing?”

But of course that is a scary question – because the honest answer may be devastating. Having chosen their career path at an early age, some professionals find themselves at or near the top of their organisations in their mid- to late 40s. With good health and solid finances they may have another 40 years of comfortable living ahead of them.

Money is not the problem. Fulfilment is. Career goals may have been met, but the excitement and pleasure the job once offered are now a distant memory. Worse, there may seem to be no alternative to going on in this way for another 10 or 15 years.

It must be a dismal prospect. No wonder so many bosses prefer to keep their heads down and carry on as though all is well. But pursuing an ultimately meaningless career saps the will to live. It destroys family life. Eventual retirement looms not as a release but as a daunting life sentence.

These concerns are more pressing than ever. As the former Harvard academic and author Shoshana Zuboff points out, the mid-life crisis is a relatively recent development in human history. The simultaneous increase in affluence and life expectancy has confronted us with a new challenge: to find meaning in our lives over a greatly extended period.

Perhaps the word “career” is part of the problem. The writer Charles Handy believes we need to think differently about how we approach the business of earning our living over the course of five decades.

Instead of one career, we can have several lives, he says. We should experiment, move on, not consider the corporation as a kind of parent or safe-house. People who have had only one life tend to be rather boring, Prof Handy adds. How much would you look forward to sitting next to a retired company lifer at dinner?

The first step to dealing with this mid-life crisis is to understand whether you are “inner directed” or “outer directed”. Outer-directed people conform to other people’s notions of what is right and admirable. They want to impress peers, but do not derive lasting satisfaction from this.

Inner-directed people, on the other hand, work to satisfy their own desires, and measure themselves by their own values. They can be successful in their own terms, even if this defies the conventional wisdom.

But, as Mr O’Kelly writes, the harried executive finds little or no time to conduct this sort of analysis. The very busy-ness of business militates against reflection.

Since 1993 Prof Zuboff has been running an intensive two-week programme called Odyssey, which is designed to promote precisely this kind of personal, inner debate. Prof Zuboff asks her participants, who are joined by their spouses for the second week, to think rigorously about what motivates and inspires them.

Attitudes are also changing outside the seminar room. The new wave of twenty-something job applicants have wholly different expectations – and demands. Even blue-chip recruiters are being challenged to explain what sort of “work-life balance” they will offer to their new employees. How flexibly can people work? Will sabbaticals or career-breaks be available?

A recent “campus brochure” for PwC in the US showed a young man cart­wheeling on a beach, beside the slogan: “Your life. You can bring it with you”.

Of course, some employers will be more reluctant to change – such as the world-famous investment bank, whose proud boast to new recruits is: “You won’t know your children. But you’ll get to know your grandchildren really well.”

*Chasing Daylight: How My Forthcoming Death Transformed My Life, by Eugene O’Kelly, McGraw-Hill

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