Wellness - individual

How to find the ‘I’ in Ikigai – Part 1

By Una Harrington

Una Harrington
Dr. Una Harrington – Emergency Physician, Queen Elizabeth II Hospital, Brisbane @drunaem – WRaP EM lead; Founder of WRaP EM


Welcome to Part 1 of how to find your ‘I’ in Ikigai.

I was first introduced to the concept of Ikigai when I was attending SMACC Dub in 2017. During my own journey since then, whilst exploring the wellbeing and performance optimisation literature, I have been brought back again and again to this concept.

Ikigai is an ancient Japanese ethos which essentially translates into ‘the reason for existing or having purpose’. Itcould also be interpreted as ‘meaning making’. (Oliver, 2017)

In a recent paper by Shanafelt et al in 2016, it was found that, if you can spend 20% of your time at work doing what you find meaningful, it serves as a strong protective factor against burnout.  Interestingly, they found there is no increased benefit above 20%. (Shanafelt & Noseworthy, 2017).Therefore, spending one fifth of your time spent in meaning making activities at work, may be a way to help you stay well and fulfilled.

So how can you create that 20% at work to help keep you well?


As shown in this diagram, there are four components to Ikigai

  1. That which the world needs
  2. That which you can be paid for
  3. That which you love
  4. That which you are good at

(Garcia & Miralles, 2017)

To begin trying to find your ‘I’ in Ikigai, let’s have a look at these four concepts in a little more detail.


If you are reading this blog, you’re probably part of a group who thinks Emergency and Critical Care are a pretty essential part of any health care system. So perhaps we can connect with the first concept to help find that 20% – the world needs us because of what we do.


I work in Australia as an Emergency Physician, where we are paid a good wage throughout our training, and in particular once we become Consultants/Attendings. I acknowledge here that this may not be the exact case throughout the world. However, most doctors and nurses, unless doing voluntary work, are paid a wage. So perhaps we can also tick off the concept of THAT WHICH YOU CAN BE PAID FOR.

There are two further ideas that may help you achieve that elusive 20% that protects you against the risk of burnout. Before we explore these, I invite you to consider whether you are up for the challenge of exploring some deeper concepts that involve taking an honest look inside yourself:


Be warned – the Japanese texts which give advice on finding your Ikigai describe a deep and meaningful search of self. This WRaP EM blog post aims to provide you with an introductory taste and perhaps plant some ideas that you can continue to grow and nurture on your own.


Two years ago, just as I was finishing my final assessment as an Emergency doctor in training, my supervisor asked me to complete a seemingly simple task every work day for the rest of my career as an Emergency Physician. It wasn’t to perform an intubation or drop a central line; it wasn’t to externally pace someone, it wasn’t even to write a research paper. Her direction was simply:

“Try to remember every day, why you love what you do”

At that moment in her office, when I tried to pin point what it was about my job that I loved, I drew a complete blank. I was totally flummoxed and speechless – the latter a rare occurrence for me, as those that know me will confirm!

Looking back on it now, perhaps within the hardship of the exams and the rigours of training, I had completely forgotten about why I had joined this Emergency Medicine rollercoaster.

So, for the next few weeks, during my shifts, I actively sought out to find what it was that I loved.

Let me highlight that point – It was an ACTIVE process.

This is what I found: I love what I do because of all the people around me; I love the connection when I get to know their stories: I love finding out what makes them tick and what makes them sick.

But let’s get down to some specifics….

It turns out that I love talking and sharing stories with patients, particularly those at extremes of age.

So, my Ikigai of ‘THAT WHICH YOU LOVE’ includes meeting an 85-year-old year called John who tells me why he fell over today, that his father was from Cork (where I grew up in Ireland) and that ‘I’m far too young to be a doctor’.  I don’t get that last one too much anymore…. it’s quite good for my ego!

And on the same day, I’d love to meet a 5-year-old called Tina or George who tells me about their imaginary best friend who is also a unicorn, whilst I’m putting on their forearm cast with Nitrous oxide and intranasal Fentanyl cover!

Perhaps if you have momentarily forgotten the ‘THAT WHICH YOU LOVE’ like I had, consider some of these examples:

Perhaps you love the ‘flow state’ of performing complex procedures; perhaps you love running a schmick simulation; you might love the camaraderie with your colleagues in our sometimes warzone-like EDs in the middle of the worst ‘flu season on record.

I’d encourage you, over the next few days to weeks, to spend a little time contemplating the above.

I’m going to leave the search for the ‘I’ in Ikigai there for now.

Part 2 of this blog post will explore the arguably more challenging topic of finding and acknowledging the final part of Ikigai – ‘THAT WHICH YOU ARE GOOD AT’


Garcia, H., & Miralles, F. (2017). Ikigai: The Japanese secret for a long and happy life. Kindle.

Oliver, L. (2017). The Japanese concept of Ikigai could be the secret to a long, meaningful life. Retrieved from http://www.businessinsider.com/the-concept-of-ikigai-could-be-the-secret-to-a-long-meaningful-life-2017-9?IR=T

Shanafelt, T. D., & Noseworthy, J. H. (2017). Executive Leadership and Physician Well-being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout. Mayo Clinic Proceedings. https://doi.org/10.1016/j.mayocp.2016.10.004


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