I have the Pisces on the Midheaven and have worked in finance (banks and investments) for over 20 years and am not fulfilled. I don't know what to do, what do you do?

A scientist, an artist, bartender, humanitarian.

Guru :)

Hum,  Sensitive, intitutive, likes water.  How about a dolphin whisperer.

Pisces rules the feet,  how about giving foot rubs on the beach. 

You can write childrens books. 

Fight for the underdog: Psychiatrist, volunteer in a mental asylum/the homeless, medical profession, counselor, organize a charity, work for Greenpeace

Start a small business: artist for a practical purpose so you can make money

Try making things and see where you go.  

"I've come across SO many people born with their Midheaven in Pisces who, by nature, have difficulty realizing a satisfying career/purpose they believe in and/or having an overwhelming feeling that their true Purpose in Life is not being fulfilled. Words such as 'clouded', 'wandering', etc. are sometimes used to describe this placement. Even though many people have difficulties with finding their true purpose in life, Pisces MC's seem to have it exponentially pronounced. Some have described it something like: those who are still lost in the labyrinth of their lives, drifting from one place to another looking for "something" but not quite sure of what it actually is."

From: http://astronuts.tribe.net/thread/a801f66a-7a88-4ea6-a144-13cf27d231dd 

I work as a user interface designer for voice recognition systems.  Happier with this career than any I've had previously, but I'm already restless (after 3 years) and have plans to change it up.  And yes, I always feel I should be volunteering but have been too lazy to do it consistently.  (Here's another weird Pisces MC thing maybe... people are always suggesting 'doing what you love', but so many things I love, I have no interest in making a living at.  For instance, cooking, decorating or playing music.  Music, I don't have enough talent to get paid, but as for cooking or decorating, I can't tell you how many times it's been suggested I make a business out of it, and it just doesn't sound fun to me.)

Pisces MC and Neptune in 6th: I like having a job where I can daydream a lot. ;)

Are you part of the Pluto/Uranus conj in Virgo generation, Deedlebug?

My closest girlfriend has Pisces Moon in her 10th, also works in business/finance and feels unfulfilled. She's not in a position to quit, so has decided to work her Sagittarius Descendant and has found a job that allows her to travel a lot. 

I have virgo on the midheaven in the 10th along with a virgo stellium and work in marketing. Go figure.

However, when you look at the chart instead of just the MC, I have marketing all over it .

I'd get a consult from Elsa to help you sort it out.

I have pisces on the midheaven and I'm in medical school. There could be other things in my chart that show this inclination, like Neptune conj moon conj descendant, and a stellium in the 6th house. I agree with Togi - a consultation would probably help you figure some stuff out :)

I make peace with the fact that I'm never going to have a job that I constantly love that fulfills me.  *nodnodnod*
I've been working various office support jobs for a little over a decade and it's cool for about six months, but then I want something new -- the one thing I did like about temping!  I'm ostensibly in school to finish my BA so that eventually after eons of blahblahblah I can become a forensic PsyD.  And, hey, forensic psychology is totally my field (Pluto hits everything in my chart, notably conjunct Mars-Venus, trine Moon, and widely opposing my Pisces MC), but I know that I'm not going to enjoy every single moment that I'm working in it.

You don't mention where in Pisces your MC is, but have you looked to see if transiting Uranus is affecting it?

Yes I do have Pluto conj Uranus (in my 4th) and have Uranus transiting my 10th. Seems like it has been a very long time. I too am ok for the first 6 months (the learning curve) then i become restless. I do feel i need a job that i can travel with but those are hard to find. I will contact Elsa for a vocational reading. Thanks everyone for your comments and experiences, they are helpful.

Open up your own  wellness center business?  Look into getting a franchise for rehabilitation center? I think having a strong pisces aspect in one's natal chart would always feel "guilty" about making more money effortlessly, thus the moral tendency to give it away.  To balance out this emotion if not eliminate it altogether, then it's best to make money while you're making other people feel good in a direct form of service.  So that explains why most volunteer doctors and nurses have this aspect.  It's about addressing that guilt.

I have  on my Midheaven and I am an Administrative Assistant.  With a   and a  Asc, I care way too much for my own good about doing a good job.

Yes, I see what you mean about the guilt. Except I have the sun in leo in the 2nd, so my focus is definatley on making money.....this doesn't help either, believe me!

It's a matter of perspective Deedlebug.  I have a Leo Sun/ASC and a Cappy moon in the 2nd.  And like you I'm a hardcore finance professional.  Making money had always been an offshoot, more of a consequence, of handling other people's resources.  My focus all throughout had been the professional deed itself.  The benefits and remunerations followed, and most of the time I tried to eschew issues about it once I'm inside for fear of distraction.  Like you, I also have a strong pisces configuration so the "guilt" issues plagued me since I was a child.  I have witnessed poverty around me while there's food on my table.  Then as I mature, I realize that I had always felt abundant at whatever stage in my life because I willed and conjured my mindset to think on those terms. 

I am quite familiar with whatever state you're in right now.  Been there, kicked that.  Have you gauged where your Peter Principle is lately?  It might give you some clues.  At some point you have to check where the lid is, put it in its proper place and see what happens.  

With a pisces/MC there's potential in your hands that you haven't even thought of yet I believe.  Otherwise, you won't make this comment: "my focus is definatley on making money.".

My dear, Pisces is both blessing and a curse.  It's the universal abundance that you should tap into and channel yourself to help out others.  You will see the flow of abundance (money, healing energy, etc.) right in front of you, but it doesn't stop at your hands.  You have to freely let it go with an open heart and mind.  Give yourself time to figure this out. 

You've highlighted one of the features of Pisces and thats finance, the water signs are probably 2nd most material after Earth signs. Cancer is a money sign, high earners often have Cancer rising, those with public careers have it on M.C.

Scorpios also rules other peoples cash so in terms of astrology your sign does relate to your job but Pisceans tire so quickly of the mundane, obviously you have higher aspirations.

These are some of Pisces traits or rulings: hopeful, sad, funny and playful, famous, states of being or existance, exploration and translation (expressive, talkative), intrigued by coincidences and superstition, can lead double lives, emotional comprehension or confusion, fear of failure, gifted but don't 'flaunt' it, seekers, sense of universality or 'something more' that life can offer, adapt to any situation.

I have Pisces MC too and always thought of this as a detriment - but after reading this thread it might make sense for me to finally do what I love: Inspire people. 

I'm currently a television producer. It's creative but sucks the energy out of me. I agree with the poster above about this energy being gifted but not being able to flaunt it. As talented as I am as a poet, painter, lover of life:) I haven't been able to showcase my talent to the rest of the world. I've kept most of my most beautiful pieces of art and music I've created to myself. :( There's a weird sense of "would people even care". When friends get a peak into my private world they are pretty amazed...and even inspired:) I'd like to open up my inner world because I know this would grant permission for others to do the same. I mean...that makes sense right? :) 

"When friends get a peak into my private world they are pretty amazed...and even inspired:) I'd like to open up my inner world because I know this would grant permission for others to do the same. I mean...that makes sense right? :) "

ABSOLUTELY.

Even though this thread is old, I am glad that I came across it anyway. I was born during a total solar eclipse, so I have the dubious honor of having my sun, moon, mercury, and midheaven in pisces.  I currently feel unfulfilled in my position as an analyst for the ny government (not a lot of creativity).  My girlfriend suggested that I should channel my imagination into writing, so I am attempting to write my first novel this year (have a deadline).  While writing the novel, I sometimes get the urge to change course (photography, music, etc), but my girlfriend is making sure that I do not move from writing prematurely.  So, I am staying the course to see what may unfold.

In my experience of jumping from job to job, I know that I do not function well where there are too many rules, regulations, and red tape. I also know that I don't like having a boss over me, so novel writing may be my best bet.

Welcome, Kojo! :)