What makes work fulfilling?
For some, work becomes a lifelong dedication. While it may seem extraordinary to others, discovering work that holds meaning transforms it from mere labour into a profound sense of purpose, invoking a feeling of yarigai.
In this episode of the Ikigai Podcast, Nick discusses with Professor Hiroshi Nishigori how individuals can uncover meaning and fulfilment in their professional lives.
Podcast Highlights
- Writing a paper on yarigai. Hiroshi explains how he came up with his paper about yarigai.
- Delving into yarigai. Hiroshi explains what yarigai is.
- Why doctors work for their patients. Hiroshi talks about a topic he explored in his paper: ‘Why do doctors work for the patient?’
- Methods used for the study. Hiroshi shares the methods he used in his study and the types of questions he explored.
- Difference between yarigai and Ikigai. Nick and Hiroshi explore the distinction between yarigai and ikigai.
- Relevance of role in yarigai. Hiroshi explains the importance of role in relation to yarigai.
- Themes from narratives with doctors. Hiroshi shares themes derived from his narratives with doctors.
- The four case studies. Hiroshi shares the four case studies that represent the four themes from his study.
- Mieko Kamiya’s contribution to ikigai literature. Nick and Hiroshi discuss the contributions of pioneering researcher Mieko Kamiya to ikigai literature.
- Experiencing yarigai personally. Hiroshi shares his personal experience of yarigai as a physician.
- Hiroshi’s ikigai. Hiroshi talks about some of his sources of ikigai.
Hiroshi Nishigori
Professor Hiroshi Nishigori graduated from Nagoya University School of Medicine in 1998 and became a Fellow of the Japanese Society of Internal Medicine (2004) and a Diplomate in Primary Care of the Japan Primary Care Association (2011). He obtained a Master’s Degree in Medical Education from the University of Dundee in 2008 and completed PhD in Health Professions Education at Maastricht University in 2020.
His research interests include culture and medical professionalism (especially work ethic), Hypothesis-Driven Physical Examination (HDPE), and teaching and assessing behavioural and social sciences. He is working as an editor of the Journal of Medical Education Japan and a core member of the Asian Pacific Medical Education Network (APME-Net).
Writing a paper on yarigai
Hiroshi recently published a paper titled 'Exploring yarigai: The meaning of working as a physician in teaching medical professionalism.' When he was a PhD student at Nagoya University’s Graduate School of Medicine, Hiroshi had the opportunity to visit the UK as a research fellow. During his time there, he observed significant differences between Japanese and British doctors, notably that Japanese doctors tend to work longer hours.
Intrigued by the dedication of Japanese doctors to their work, Hiroshi realised that they find their work particularly worthwhile—an idea encapsulated by the concept of yarigai. This sparked his research interest in yarigai, leading him to decide to write a research paper focused on this concept.
Delving into yarigai
In his paper, Hiroshi defined yarigai as the fulfilment and sense of satisfaction that comes from intrinsic motivation derived from engaging in meaningful work. When individuals find yarigai, work becomes more than just a means of earning a living; it becomes a source of fulfilment, personal growth, and a way to contribute to something greater than themselves.Why doctors work for their patients
Hiroshi has long been interested in why doctors work for patients and believes that the concept of yarigai offers the best theoretical framework for exploring this question. He aims to uncover what doctors gain from working directly for their patients beyond monetary compensation—what intrinsic value they derive from their work.
This exploration is particularly relevant today, as many doctors experience burnout. Understanding yarigai may help them find greater satisfaction and meaning in their profession.
Methods used for the study
To examine the question of why doctors work for patients, Hiroshi selected interviewees recognized for their commitment to patient-centred care and their demonstrated yarigai in treating patients. He employed narrative inquiry as his methodology, a qualitative approach frequently used in healthcare professions, education, and research.
Difference between yarigai and Ikigai
While writing his paper, Hiroshi explored both the concepts of yarigai and Ikigai. Although both share the suffix 'gai' (value or worth), they differ in their application in life. To Hiroshi, Ikigai is more philosophical, while yarigai is related to meaningful work and practicality.
Relevance of role in yarigai
yarigai is felt when individuals find alignment between their personal values, skills, aspirations, and their work, turning their profession into more than just a livelihood. Drawing from his experience as a doctor and his strong sense of yarigai, Hiroshi emphasises the importance of finding a role that resonates with one's passions. This alignment enables individuals to make a meaningful impact within their chosen profession.
Themes from narratives with doctors
Hiroshi’s paper examines four narratives from daily clinical practices. Many doctors find a sense of yarigai when they confront challenges such as witnessing patients nearing death or handling medical errors that demand detailed explanations and apologies. Overcoming these hurdles fosters a profound sense of achievement and deepens the doctor-patient relationship, illustrating a typical pathway to experiencing yarigai.
The four case studies
Here are the four specific representative narratives about yarigai mentioned in Hiroshi’s paper:
Dr Mishima - Finding positive meaning in difficult situations
The first theme is finding meaning in difficult situations. The story is about Dr. Mishima and a case of medical malpractice where a patient developed aspiration pneumonia due to a medication error. Despite the mistake, Dr. Mishima worked tirelessly to apologise and care for the patient.
Initially, the patient's family was angry but eventually appreciated the doctor's dedication. Dr. Mishima expressed that he felt a sense of yarigai from this challenging interaction, showcasing a unique perspective on finding purpose in difficult circumstances.
Dr Kaneko - Receiving gifts embodying ikigai
The second story is about Dr. Kaneko. She performed a gastrectomy differently from her supervisor's method to preserve the patient's gastric function. Her approach was successful, allowing the patient to continue farming and eating normally. Grateful patients often bring her gifts, like vegetables.
Dr Kawabata - Cultivating relationships that transcend temporal boundaries
The third story involves an internal medicine doctor, Dr. Kawabata, who helped a patient with type 1 diabetes who wanted to have a baby, despite her obstetrician advising against it. Dr. Kawabata negotiated with the obstetrician, and the patient was eventually able to have a child. Years later, Dr. Kawabata received a letter from the patient, expressing gratitude. This long-term appreciation gave him a deep sense of yarigai.
Dr Murakami - Witnessing strength in a seemingly powerless human being
Dr. Murakami's story revolves around the theme of dealing with dying patients, a challenging aspect for doctors who are typically focused on diagnosis and treatment. This experience can evoke feelings of helplessness and inadequacy since it isn't thoroughly covered in medical training. However, interactions with dying patients and their families can reveal the profound impact a doctor can have on a human level.
The story highlights a young, inexperienced doctor who, despite feeling powerless, stayed with her dying patients, talked with their families, and provided emotional support. This experience gave her a sense of yarigai, illustrating the meaningful connections formed in such difficult times.
Mieko Kamiya’s contribution to ikigai literature
Hiroshi referenced ikigai’s pioneering researcher, Mieko Kamiya, in his work. Kamiya, a psychiatrist, explored the concept of ikigai in the Japanese context. She wrote a book on ikigai not as an academic paper but to highlight its presence in daily life without scientific thinking. This approach influenced Hiroshi’s choice of a qualitative methodology for his paper.
Experiencing yarigai personally
More than 20 years ago, Hiroshi cared for a patient with heart and kidney problems who often needed hospitalisation. Hiroshi visited him at home frequently towards the end of his life. After the patient passed away, Hiroshi asked his wife for permission to do an autopsy, which she agreed to.
When Hiroshi asked why she took care of the patient so devotedly, she said he had done the same for her during her own health issues. This deeply touched Hiroshi and showed him the strong bonds between patients and their families. This experience made Hiroshi feel a strong sense of purpose and yarigai as a doctor.
Hiroshi’s ikigai
Hiroshi considers his wife and son as one of the sources of his ikigai. Recently, he shifted from focusing solely on work to also enjoying activities like skiing and reading. His current sense of yarigai and ikigai revolves around teaching and nurturing the creativity and abilities of younger generations. Education has become a significant source of fulfilment and purpose for him.
Conclusion
Once you find meaning in your work, no matter how challenging it may be, you'll always have the motivation to persevere. This principle applies not only to work but to life in general when you have a sense of yarigai—something worth doing that propels you forward despite life's challenges.