“He who has a why to live can bear almost any how.” Friedrich Nietzsche

My husband’s family originates from a small Spanish village. Over the years, I noticed a pattern in the inhabitants. The older women are in good mental and physical health. Meanwhile, a disproportionate number of their husbands have dementia, are sedentary, and spend most of their days sitting and staring into space as compared to the women.

It goes without saying that husbands and wives share similar living conditions and diets. One of the striking things I observed is that the women do everything for their husbands, going back decades. This is by no means scientific research with controls and is instead just my own observations. The women continue with this role, even though both are retired, including laying out their husbands’ clothes for them in the morning so the husbands will not even need to decide what to wear or walk into the closet to pick out their clothes. The husbands’ bodies and minds seem to shrivel up when they are no longer required to function. They lose their purpose in life. In a sense, the wives had killed their husbands with kindness.

The wives in the meantime, serve a purpose. It is to look after the husbands while they are alive. After their husband’s death, they continue to serve their children, grandchildren, and volunteer in the community.

Purpose is something that must be cultivated and developed over the course of a person’s life. It gives us the motivation to keep going. It inspires us to press on. It provides us a cause to get out of bed in the morning. Instead of being a destination, purpose is a journey. It provides meaning to life. That meaning is meaningful not only to oneself, but also makes a difference to the community, whether that community is our family, friends, or people we don’t know. It makes life better for someone other than us.

In our lives, we have all encountered adversity, challenges, and injustice. These experiences have the power to either make us weaker, or they can be the fuel for our pursuit of causes that are meaningful to us. We might have chosen to pursue a career in medicine because of seeing loved ones suffer from illnesses, which inspired us to pursue a career in alleviating pain and suffering. Or we may have been inspired by role models we have encountered.

As medical professionals we made numerous sacrifices, both on personal as well as financial level. Thus, it is easy to lose sight of our sense of purpose. But we must remind ourselves that we have made the world a better place. When we can see outside of our own pain, we can appreciate all the good we have done to the broader world outside of ourselves.

We can channel our anxiety into action. We can transform our helplessness into even small deeds rather than languish in our own misery. More than most other professions, the medical field is in a unique position to do this. We must not allow our cynicism to defeat our sense of hope.

Hope gives us a reason to get up in the morning. It is an antidote to burnout. When I say hope, I am not referring to false hope—that blind pollyannaish unrealistic optimism. I am referring to the type of thinking that plans for the worse but hopes for the best.

This sense of purpose increases our resilience and our wellbeing.

Ikigai

Ikigai is a Japanese term which translates to “reason for being.” Research on inhabitants of Okinawa, the Japanese village famed for having one of the highest rates of centenarians (as well as origin of karate), showed that one of the factors contributing to their longevity is Ikigai.

The elements necessary for Ikigai include:

  1. Engaging in activity you are good Over time, many of us become good at our craft in medicine.
  2. Doing something the world There is no denying that the world needs medical professionals.
  3. Engaging in something you love. Here lies one of the greatest barriers to achieving Ikigai in medicine. Even though we enjoy what we do, there are increasing aspects of our job we have come to loathe. These include the bureaucracy, electronic medical records, unending stacks of insurance forms, time constraints, erosion of respect, to name a

Here, we have two choices. We can change our mindset or change our circumstances. If we are unable to change our mindset toward the unwanted tasks, it may be time to move on to something different lest the job kills us. Among all professions, doctors have one of the highest suicide rates.

How to find our purpose through Ikigai

When we are passionate about what we do, it becomes effortless. Purpose is something we cultivate over time. It is a process. To achieve Ikigai:

  1. We must maintain an open, inquisitive
  2. Ikigai is not It evolves. Aligning our nature with the nature of the environment is the key. It entails constant adjusting.
  3. Understand your Ask yourself “What matters to me? What do I care about?” Know your “why”.
  4. We all have skills that benefit Understand what they are.
  5. Believe that what you do matters to It makes the world a better place. It makes sense. Research shows that the three elements to experiencing meaning in life are: significance (it matters), coherence (it makes sense), and purpose (goal-oriented).

We must not lose sight of our purpose in the midst of this exponential burnout. We may feel jaded because the systemic constraints reduce our ability to serve our purpose at times. But knowing our values and understanding what matters to us will help us discover ways to serve that purpose.

When our life or work becomes incomprehensible, instead of dread, the development of our Ikigai can allow us to wake up energized. This energy allows us to get past the drudgery of our work tasks that we detest. With Ikigai, we can avoid the fate of those elderly men from that Spanish village who wither away for lack of purpose.

“Yesterday I was clever, so I wanted to change the world. Today I am wise, so I am changing myself.” Rumi