Experiment consciously. Augmenting your ikigai means either 1) rooting it deeper in a pillar and/or 2) expanding into other pillars. Start small and expand, if you find it meaningful with continued flow. Perhaps you find flow in performing certain procedures. Learning the paramedian approach for a lumbar puncture or new shoulder reduction technique increases your vocation. Or, if you thrive on moving the department, perhaps joining a working group to create a physician-in-triage model may be in the cards. Dedication to your community may expand into areas of passion and/or vocation as you create CPR education workshops for your community’s daycares and schools. Passion for women’s health may lead one to research and advocate for more effective emergency contraceptive options in your department. Starting with small increments ensures that the new task is not overwhelming and allows for an attainable, more concrete objective.

Leverage trustworthy contacts. If you struggle with finding ikigai, talk with a peer, friend, or mentor. Sometimes having the perspective of a trusted individual or talking it out to a conscientious listener can help identify areas of interest. Although no one can truly identify your ikigai but yourself, others may identify talents or focus points that you may not be aware of. They can also elucidate avenues for experimentation. Reflect on others’ opinions and see if those areas are places where you either find flow or would continue to do regardless of any attention from others. Perhaps you feel tedious with interdepartmental conciliation, but in speaking with a mentor, they see you’re a highly effective and involved department chief in conflict mitigation. In further reflection, you uncover the flow is actually in the creative brainstorming of logistical solutions that occurs with the conflict.

Closing Thoughts on Ikigai

Ikigai is not for everyone, nor should it be. It’s simply just one concept of many, like one type of laryngoscope blade, whether Mac, Miller, or D-blade. There is not a ‘best’ blade, but depends on the physician and situation. No one needs ikigai to feel fulfilled and our sense of fulfilment itself can be fluid. There are many competent, fulfilled emergency physicians that don’t need to have deep purpose or marry all “four pillars” in their practice. One’s work can sincerely be and remain a profession alone—perhaps so one’s efforts can be placed in other areas, whether it’s community, family, travel, or other interests. That choice and outlook should be respected.