Lazarus's Stages of Development: An Unauthorized Rock and Roll Theory on the Lifespan

Developmental psychologists have made life far too complicated.

Erik Erikson had psychosocial crises. Jean Piaget had cognitive stages. Sigmund Freud had stages of his own, although several are probably best left out of a children’s book.

I have record albums—vinyl LPs—and over 60 years of rock and roll memories, along with the suspicion that much of what psychologists have tried to tell us about growing up, growing older, finding and losing ourselves, raising children, watching them leave, confronting mortality, and wondering where the hell the time went was already being broadcast in three-minute songs on AM and FM radio.

This should not be surprising. Pop culture has permeated much of my writing. I have drawn freely on cinema, television, and especially rock music to explore medicine, leadership, careers, technology, and life itself. Bruce Springsteen alone inspired two of my books, Born to Heal and The Last Should Be First. I have written countless essays with prog rock and rock-and-roll soundtracks playing in the background. Why not apply them to human development?

I have, and I intend to make it official by calling the result Lazarus’s Stages of Development. I have wanted a medical eponym ever since I studied under Dr. Angelo DiGeorge, whose name lives on in DiGeorge syndrome. Mine arrived differently—not bestowed by the medical profession but self-awarded, because sometimes you have to take responsibility for your own legacy.

There is precedent in the surname, lending the subject a certain authority. Lazarus, after all, was raised from the dead. Few names carry better credentials for discussing the far end of the lifespan.

The evidence base for my discovery is admittedly weak. There were no randomized trials, no control group, and no institutional review board approved the protocol. Subjects were repeatedly exposed to high-volume guitar sound, often under poorly controlled conditions. Recall bias is substantial, particularly among those who attended rock concerts in the 1960s and 1970s.

Still, a theory emerged from a real-world trial.

Most of its soundtrack spans roughly 1965 to 1975, the musical decade that accompanied baby boomers from adolescence into adulthood. But development is messy, and so is my methodology. Occasionally, a later song states the case too perfectly to exclude, and, admittedly, my playlist leans toward classic rock rather than prog rock.

Peer reviewers may file their objections after the guitar solo.

Stage One: We Are Not You

The Who, “My Generation” (1965)

Development begins, at least in the rock-and-roll formulation, with the discovery that the older generation has absolutely no idea what it is doing.

We, on the other hand, do.

Few songs captured generational identity more effectively than The Who’s “My Generation.” Pete Townshend gave young listeners an anthem of irritation with the generation that came before them, complete with perhaps rock’s most famously ill-advised aspiration: destroying guitars onstage and hoping to die before growing old. Townshend later joked about having to live with that youthful declaration after accomplishing precisely what the song regarded with horror—growing old.

That may be the first principle of Lazarusian development: Youth is the stage when aging appears to be a character flaw.

Every generation suspects it invented rebellion. Boomers simply had better amplification.

We looked at our parents and wondered how anyone could become so conventional, so cautious, and so attached to property values and to comfortable shoes.

Then something terrible happened.

We became their age.

Stage Two: I Have to Go

Cat Stevens, “Father and Son” (1970)

Eventually, generational rebellion has to become more substantive than simply turning the music up.

You have to leave.

“Father and Son” captures one of development’s oldest conflicts: the parent who believes experience should count for something and the child who believes that experience is precisely what he must acquire on his own.

Both are right.

That is what makes separation so difficult.

Parents know that some roads lead nowhere because they have traveled them. Children need to travel at least a few of those roads anyway. Advice can convey information, but it cannot convey experience.

At some point, successful parenting requires participating in one of life’s strangest transactions: spending years teaching someone to live so they can leave you and live independently.

The developmental task is separation.

The parental task is letting it happen.

Neither comes with a guitar solo.

Stage Three: Mick Jagger Explains Adulthood

The Rolling Stones, “You Can’t Always Get What You Want” (1969)

An entire semester of graduate education should probably be built around this title.

Adulthood is, to a remarkable degree, the discovery that wanting something and getting it are two separate events.

Careers do not unfold as planned. Marriage requires compromise. Children ignore instructions. Bodies malfunction. Organizations disappoint us. People we love leave. Talent does not guarantee success, and hard work does not always bring justice.

The Stones provided the developmental correction: you cannot always get what you want, though you may sometimes get what you need.

Psychologists might call this adaptation.

Parents call it growing up.

Insurance companies call it peer review.

Stage Four: The Years When We Are Too Busy to Notice Them

Harry Chapin, “Cat’s in the Cradle” (1974)

Then comes the stage when life becomes crowded.

Careers. Children. Mortgages. Deadlines. Promotions. Airplanes. Meetings. Soccer practices. Tuition. Elderly parents. The calendar fills, and because it is full, we mistake fullness for abundance.

Harry Chapin understood the trap.

“Cat’s in the Cradle,” written with his wife, Sandy, follows a father who repeatedly plans to spend more time with his son once whatever currently demands his attention has passed. Eventually, that does pass.

So does childhood.

The son becomes the father.

The devastating developmental insight is contained in the boy’s admiration: “I’m gonna be like you, Dad.”

And eventually he is.

One of adulthood’s cruelest discoveries is that the things we postpone because we assume they are permanent are often the least likely to wait.

Stage Five: Where Did the Decade Go?

Pink Floyd, “Time” (1973)

If Chapin warned us that children’s lives move quickly, Pink Floyd broadened the indictment.

Everything moves quickly.

At twenty, ten years is half a lifetime.

At seventy, it is a scheduling interval.

“Time,” from The Dark Side of the Moon, begins with youth acting as if the supply of days is inexhaustible. Then comes the realization that “ten years have got behind you.”

This lyric should probably be inscribed on every Social Security card.

Middle age may not begin with a birthday but with a change in arithmetic. We stop calculating how long we have lived and, however reluctantly, begin calculating how much time might remain.

The future, once an unlimited line of credit, now begins sending statements.

And suddenly, Pink Floyd sounds less like rock music than like preventive medicine.

Stage Six: You Have Become Old to Someone Else

Steely Dan, “Hey Nineteen” (1980)

Here I violate my own chronology, but science occasionally requires methodological flexibility.

“Hey Nineteen” was released in 1980, five years outside my preferred window, and it captures an underappreciated developmental milestone: the moment you realize someone younger doesn’t merely have different tastes. They live in a different civilization.

The narrator references Aretha Franklin.

The nineteen-year-old does not know who he is talking about.

There it is.

Aging is no longer something visible in a mirror. It has become social.

Your cultural references require footnotes.

Movies everyone knew become “old movies.” The music of your adolescence moves to classic-rock stations. The actors you remember as young leads start playing grandparents. Eventually, someone describes a song released during your medical training as an “oldie.”

Steely Dan offers the diagnosis: “She thinks I’m crazy, but I’m just growing old.”

The interesting thing is that the narrator has not changed nearly as much in his own mind as he has in the eyes of the nineteen-year-old. He understands, “we can’t dance together…we can’t talk at all,” yet he prefers to reminisce about college and “sweet things from Boston, so young and willing.”

That may be one of aging’s great dislocations and a less-discussed aspect of it: sexual desire may remain stubbornly intact even as one’s perceived sexual attractiveness fades. His fantasies about younger women are comic, wistful, and faintly pathetic because they expose the widening gap between how young he feels inside and how old he appears to someone nineteen.

Inside, we remain surprisingly continuous.

Outside, the demographic category keeps changing.

An Interlude: Please Say Hello

John Prine, “Hello in There” (1971)

John Prine complicates my theory because he understood old age while he was still young.

“Hello in There,” from his 1971 debut album, does not treat aging as a comedy. It treats invisibility as a tragedy.

The children have grown and left. Days repeat. Conversation diminishes. The world keeps moving while older people become increasingly easy for everyone else to overlook.

Prine’s diagnosis is painfully simple: “Old people just grow lonesome.”

Clearly, he understood the epidemic of loneliness long before the Surgeon General’s announcement.

Perhaps this is not a developmental stage at all. Perhaps it is a warning to everyone who has completed the preceding stages.

Look up.

Notice people.

Say hello.

Medicine has taught me that people can survive remarkable amounts of disease and disability. What is harder to measure is what happens when they no longer feel seen.

Prine measured it in a song.

Stage Seven: Wisdom Means Becoming Less Certain

Joni Mitchell, “Both Sides, Now” (1969)

This is why I would choose “Both Sides, Now” over a more straightforward song about growing older.

It is not really about aging.

It is about what aging does to certainty.

Joni Mitchell moves through clouds, love, and finally life itself, examining each first through innocence and then through experience. What she discovers is not mastery.

It is ambiguity.

“Something’s lost, but something’s gained.”

That may be the most mature developmental idea on this playlist.

When we are young, wisdom seems to be having answers.

Later, wisdom may mean understanding why the answers were never as simple as they seemed.

The longer I have lived—and certainly the longer I have spent in medicine—the less impressed I have become by certainty. Illness is complicated. Careers meander. Institutions disappoint, and occasionally redeem themselves. Good people make bad decisions. Bad circumstances sometimes yield unexpected good. Love changes form. Success changes definition.

Eventually, we have seen enough of both sides to understand that seeing both sides does not necessarily settle the matter.

Perhaps that is maturity.

Not knowing less, but knowing how much there is to learn.

The Final Stage: Enjoy the Ride

Grateful Dead, “Hell in a Bucket” (1983)

Another chronological violation.

The Dead began playing “Hell in a Bucket” in 1983; it later appeared on In the Dark in 1987.

I invoke the Lazarus Exemption.

The line is too good: “I may be going to hell in a bucket, babe, but at least I’m enjoying the ride.”

There is something wonderfully anti-Eriksonian about that as the final stage of development.

No battle between integrity and despair.

No ten-point plan for longevity that includes chia seeds.

Just: Here we are. The destination is not entirely within our control. The vehicle seems questionable. There may have been several wrong turns.

Enjoy the ride, anyway.

But John Prine deserves the last word.

Encore: The Tree of Forgiveness

Prine’s final album of original material, The Tree of Forgiveness, was released in 2018, two years before his death from complications of COVID-19. Its closing song was “When I Get to Heaven.” The title itself is magnificent. After a lifetime of accumulated grievances, disappointments, mistakes, and injuries inflicted and endured, perhaps forgiveness is the final developmental task (as Don Henley concludes in “The Heart of the Matter”).

And then Prine refuses to take it seriously.

His heaven includes a nightclub called the Tree of Forgiveness, vodka and ginger ale, an extravagant nine-mile-long cigarette, and eventually finding his parents and his mother’s sisters. The official John Prine website describes the song as bringing levity to what could have been a grave subject.

Of course it does.

John Prine spent a career finding humor standing inches away from heartbreak.

Maybe that is the stage beyond wisdom.

Forgiveness without sanctimony.

Mortality without self-pity.

And one last joke before the lights come up.

Which brings me back to my theory.

Rock and roll did not stop us from aging. That was probably too much to ask of three chords and an amplifier.

The songs aged with us.

At sixteen, “My Generation” was about our parents.

At forty, “Cat’s in the Cradle” felt uncomfortably familiar.

At fifty, “Time” ceased to be metaphorical.

Eventually, “Hey Nineteen” became less funny.

“Hello in There” became more significant.

And “Both Sides, Now” somehow grew wiser without changing a single word.

That may be the true developmental sequence. The songs remain the same, as Led Zeppelin reminds us. We become different listeners: “too old to rock ‘n’ roll; too young to die,” as Jethro Tull put it.

So I offer Lazarus’s Stages of Development with the appropriate disclaimer: This theory has not been validated, replicated, peer-reviewed, or approved for use in humans, but I intend to keep testing it.

Preferably at high volume.

Ideally, through the Grateful Dead’s Wall of Sound, because if 641 speakers rising twenty-five feet were good enough for Jerry Garcia, surely my theory can survive without peer review.

And if the last stage really does involve going to hell in a bucket, I know what I’ll be playing on the way.

An excerpt from “Always on Call: A Physician Reflects on Prog Rock and Five Decades in Medicine, and Why the Profession Still Dominates His Conversations”