Why Ikigai Can Be Important to Us?

Ikigai is associated with improved quality and quantity of lifespan. Who wouldn’t want to live longer and better? In large, longitudinal studies, those with self-reported ikigai had lower rates of functional disability, dementia, and cardiovascular disease, ranging from a 20 percent to 30 percent decrease compared with those without.^4-6

Additionally, in the health care environment where burnout is prevalent, particularly emergency medicine, we search for meaning in a landscape that has increasing boarding, violence against health care workers, loss of autonomy, and depersonalization. A sense of purpose is an integral part of well-being.^7,8 In a national survey of emergency medicine residents, finding meaningfulness in clinical work had the strongest positive association with professional fulfillment.⁹ Furthermore, meaningful work is a cornerstone in the longevity of career academic physicians.¹⁰ For us to continue in dedicated service to our patients and specialty, it’s important to have a sustained sense of meaning in our work.

Ikigai in Emergency Medicine

Ikigai is inherently within us but needs to be deliberately uncovered and identified. Although it is unlikely one finds the whole of emergency medicine to be their ikigai, there are portions of the practice that are. So how does one uncover their ikigai in the craft of emergency medicine?

Start with the pillars and go with the flow. Reflect on an activity where a) your focus is dedicated, b) mind is on the present moment, and/or c) you are doing the task for the sheer sake of doing it. That’s flow. Now—with the context of the four pillars, what makes time flow by?

Reflecting on the pillar of vocation, perhaps you’re an excellent proceduralist or a “productivity” speed demon—the one colleagues ask as backup for a difficult intubation or lumbar puncture, or the one that colleagues breathe a sigh of relief seeing you come on shift when there are 10-hour wait times, respectively. For the pillar of mission, you feel a sense of calling to your community when rendering care to your patient and neighbor in room 14. Or perhaps you express a deep passion in women’s health or resident education. Within these pillars, are there patterns of flow that you uncover?

Embrace the whole of ikigai. An important point is that ikigai is not what is easy to do nor what makes you happy. Struggle, and at times distress, are necessary components of ikigai. Troubleshooting a challenging transvenous pacer that intermittently captures, dealing with a frustrating transfer conundrum, navigating your patient’s complex home health needs, or mentoring a struggling resident ultimately adds deep meaning to those aspects. That sense of accomplishment to “get to the next level,” the gratification of learning something new, the curiosity to dig a little deeper, or even outright failure drives ikigai. Accepting this reality of fulfillment reframes seeing the negative experiences and feelings in a broader light.