The Ikigai Podcast
The Ikigai Podcast
Embracing Yarigai: Achieving Fulfilment at Work
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
It sounds like you have a lot of yadigai in your work, so outside of work, do you have a source of ikigai?
Speaker 2:Yes, definitely yes, my family my wife and my little son, who is 13 years old right now is definitely one of my ikigais as well, and also recently, after running out and recovering from it, I stopped spending a lot of my time for work only and spend time and doing skiing, doing reading and having more, uh, joy in my life. Yes, and also my career stage is changing. I'm already 52 years old and maybe I still have more than 10 years until retirement, but my recent yarigai and ikigai is to teach and to develop the younger generation's creativities and capabilities.
Speaker 1:Yes, Find your Ikigai at ikigaitribecom. My guest today on episode 86 of the Ikigai podcast is Professor 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 in 2004, and a diplomat in primary care of the Japan Primary Care Association in 2011. He obtained a master's degree in medical education from the University of Dundee in 2008 and completed his PhD in health professionals education at Maastricht University, that's, in Finland, I believe in 2020. Hiroshi's research interests include culture and medical professionalism, especially in the area of work ethic, hypnosis-driven physical examination, and teaching and assessing behavioral and social sciences. He's working as an editor of the journal Medical Education Japan and is a core member of the Asian Pacific Medical Education Network. He will also be appointed the president of Japan Society for Medical Education this August, so that's quite a CV. Thank you very much for joining me today, hiroshi.
Speaker 2:Thank you very much, nick, for inviting me. It's a great pleasure for me as well, and I'm very much looking forward to this interview.
Speaker 1:Likewise, it's always great to connect and, as I mentioned to you for quite a time, I've been wanting to explore Yadigai and I was hoping one day someone would write a paper on it, and you did so, thank you. So how did this paper? Exploring Yadigai, the meaning of working as a physician and teaching medical professionalism how did that come about?
Speaker 2:Actually, the idea came very, very long time ago when I was a PhD student under Nagoya University Graduate School of Medicine and visited the country of the UK as a research fellow and also a master's student in medical education in Dundee. I watched how doctors work there and I found many, many, many differences between Japanese ones and British ones. To simply say that Japanese are working much harder this is my perspective, it might be wrong and for longer hours At that time, in 2005,. Talking about the healthcare resources, the number of doctors per population are very similar between the two countries, as well as the healthcarements. The country the UK did actually made it more than twice or double the number of other medical school enrolments compared to 10 years or 20 years ago, I mean compared to 1980s and 1990s. Yes, so I had a question why these two countries have different perspectives and different reductions.
Speaker 2:Then I came back to Japan after two years staying in the UK and again found the Japanese doctor's work, ethic, work style, two long hours. I don't think I don't mean that this is good or this is bad, any positive or negative, just different. But I like to know why some Japanese doctors like to work very hard, like to work for long hours. Then I noticed the concept of yarigai. Yes, and there must be some yarigai to work for patients. There is a salary issues, there is a social pressures issues as well, not only inside medicine but outside medicine as well. But I like to explore the concept of yarigai of doctors.
Speaker 2:Since that time so it's a long time ago and because I didn't have any methodology to do that, I did a PhD under Maastricht, as you introduced the healthcare professional education program, and then I got a supervisor and I talked about my idea and, yeah, they agreed to me that this is a fascinating idea and asked me to explore more and deeper. And then I did an interviews and the write a paper and I took more than 10 years to yeah that work. Yes, because of lots of barriers, mainly my workload Again, I'm a medical educational researcher but quite busy in internal and external work inside and outside of my institution, so kind of an excuse. But yeah, but it took me out A healthy work ethic?
Speaker 2:I don't know. Yeah, that kind of story yes.
Speaker 1:Well, we probably should briefly touch on the meaning of yarigai. I think in English it's often translated to mean rewarding. How would you define yarigai?
Speaker 2:In my paper I define yarigai as a fulfillment, sense of fulfillment, satisfaction and intrinsic motivation from engaging in meaningful work. So it definitely relates to work. And when an individual finds yarigai, work becomes more than a means of earning a living. It becomes a source of fulfillment, personal growth, a way to contribute to something rather than themselves. Yeah, that's what I wrote.
Speaker 1:So very similar to ikigai. We'll probably touch on the difference a little bit later. A little bit later, but yeah, as I mentioned to you, I remember hearing yarigai, or the expression yarigai ga aru oh, that's worth doing, or that's meaningful, quite often in conversation, and so it's a far more common expression than ikigai in Japan. But going back to your paper, your paper reconsiders and explores the question of why do doctors work for the patient, and you know that many doctors suffer from burnout and you indicate that there is a shift from the notion of doctors working tirelessly for the sake of their patients to them considering their own well-being. So would you like to expand on this?
Speaker 2:Well, yes, the question itself why do doctors work for patients is a question I, for a long time, like to explore more, and the concept of Yarigai is kind of a conceptual framework or theoretical framework to explore it. And yes, the burnout things doctors' burnout is becoming a social problem. It's more like a Western context thing. We experience many doctors burning out in Japan as well, but in, for example, the country of the United States, they call it a pandemic, yeah, which means that many, many, many doctors are experiencing burning out. Yeah, which is, I think, a slightly different condition from Japanese ones. But because this paper is written in English language and main audiences are Western people, so that's why I quoted the issues of burning out of doctors. That's one thing, and also the concept of well-being is recently gaining attraction from doctors and healthcare professions as well. I don't know very much about well-being, but it relates to happiness and also the ikigai you explored, nick.
Speaker 1:Yes, well-being is becoming, I guess, more recognized as something to consider and promote in the workplace. I think in I mean all industries now. So I think, in part, ikigai has become popular because of that reason, and I do get contacted by corporates asking for, you know, wellbeing or Ikigai workshops. But yourself, hiroshi, have you ever experienced burnout with all the things that you do?
Speaker 2:yeah, to be honest. Yes, I tend to work harder.
Speaker 1:Yes, I understand that I'm one of the workaholic persons and sometimes do work beyond my working limit, so so, yes, I did, is it hard for you to detach from work, so if you go home, do you still have an office or do you still check your email? Do you have a laptop that you turn on when you go back home?
Speaker 2:Yes, yeah, and because I'm mainly working as a researcher and a researcher's life is more like 24 hours or seven days a week stuff. So, yes, I do a lot and also many deadlines I have, so it's a little difficult to have a rest without thinking anything.
Speaker 1:It's the same here. I find it very hard to detach from work because I can always look at my phone for emails, or I'll be checking website visits or I think, oh, I have to find another podcast guest and I have all these ideas, so it never really ends. But I do enjoy the work that I do. But sometimes I think, oh, I'm all these ideas, so it never really ends. But I do enjoy the work that I do. But sometimes I think, oh, I'm close to burnout, I need to step back and take a break. So I guess it's one of the problems of doing work you enjoy, you can burn out, especially if it's meaningful work.
Speaker 2:Nick, thank you for asking that question and that's where I got the question. I mean, the work became a reason for burnout, or sometimes the place where we can gain yarigai, the sense of fulfillment by working. So my question is what makes these two different way? I mean, what is the leading cause to make work Yarigai or make work the reason for burnout? Yeah, that kind of things I was thinking of for a long time.
Speaker 1:I mean, one aspect of perhaps Yaringai and Ikigai is the idea of, you know, overcoming a challenge or going through some, I guess, tension to achieve a goal. So in some ways, working hard and having some stress gives us that sense of fulfillment because it's challenging and we're using our skills to the best of our abilities. But I guess if we do that too often and too intensely then it becomes, you know, a problem and we burn out and maybe we start getting mental health issues with stress and anxiety. So I guess there's a balance. It sounds like there's a balance that we need to find and maintain.
Speaker 2:And, interestingly, just yesterday I joined the annual meeting of Japanese Primary Care Association and one of the themes of the symposium is well-being of physicians and we discuss about the meaning of work as a physician and a question I asked is that in Western culture this work? May be considered as a punishment given by the God because Adam and Eve ate forbidden apples.
Speaker 1:Yes.
Speaker 2:Yes, I never considered that. So the perspective for work might be different between Western and Eastern countries and the kind of things we discussed yesterday Interestingly.
Speaker 1:Yes, that is interesting. Punishment Okay, no, I've never heard that before, so that's fascinating. All right, well, going back to your study and your paper, would you like to touch on the method you used for this study and the types of questions you explored?
Speaker 2:Yeah, this is a qualitative study quite often used in healthcare, professional education research and the narrative inquiry. We name it as the methodology for these studies. And we interviewed actually I interviewed 15 doctors who are recognized by their colleagues for their commitment to patient-centered care, because the research question, the central research question, is why do doctors work for patients? So I selected interviewees who were recognized very much patient-centered or do work hard for patients and had demonstrated the arigai in caring for patients.
Speaker 1:Yes, Okay, so quite um. Yeah, qualitative, so small group.
Speaker 2:But I imagine you had long conversations and explored yari guy in depth yeah, indeed yes, there might be, as, let's say, there's something like an questionnaire, surveys and scoring, uh, five points, something of yari guy they acquired or something like that, whereas the you know, yari, gai and also Ikigai, this sort of philosophical concepts. The qualitative research is much, much stronger to explore it and I really love the results of the studies, four of the interviewees, the cases I described in my paper and how they gain Yarigai by interaction with patients, and that may reflect on some of the doctors you might work with.
Speaker 1:Yeah, you actually had several. I think you had four case studies which we'll touch on later. So this, I think, is a good time for us to maybe explain the difference between Yarigai and Ikigai in a bit more detail. So, yeah, what is the difference between Yarigai and Ikigai?
Speaker 2:Yeah, actually, by writing this paper, I, yes ikigai and yarigai both, and so I don't think I'm an expert on it yet, but in my understanding, ikigai is more for focusing on being, whereas yarigai is definitely related to work. So more focusing on doing, yeah, which I also describe in my paper and also you, just nick, mentioned, you mentioned ikigai is maybe more philosophical. Yeah, we japanese people, uh, don't say much about ikigai in the common words other common words whereas yarigai is more practical, more common words among Japanese people. That's my understanding.
Speaker 1:Well, I think that obviously that makes sense if we look at the difference in verb. So yaru means to do, essentially yes, and ikiguru, obviously, is to live. So, yes, I guess, if we're talking about living and life, that's far more philosophical. And I guess yaru is this practical aspect of our lives, of, you know, doing things and doing things that are worthwhile or rewarding or fulfilling. And, as I mentioned earlier, yeah, I used to hear yadigai all the time in Japan and I thought that's just a normal common expression and I've only had a handful of conversations where ikigai was mentioned. So it's, yeah, it's interesting that Ikigai became so popular in the West, even though Yadigai is a far more common expression and probably, in a way, more useful, you know so Maybe we're going to see.
Speaker 2:As far as I understand, ikigai is becoming more well-known words in Western countries, whereas very few know about the concept of Ikigai so far. Let's see how Western people are going to get to know and to be interested in. I don't know.
Speaker 1:Well, at least we can help a little bit with this podcast episode. And one thing I noted in your paper is you highlight the importance of role in relation to Yari Gai, so would you like to touch on that?
Speaker 2:Yeah, thank you for asking on that. Yeah, thank you for asking Yarigai. Yes, can be experienced when the individual feels a sense of alignment between their personal values, skills and aspirations and the work they engage in. That's what I wrote in my paper. So when individuals find the Yarigai works became more than just a meaning of living, as I mentioned before. So, coming back to the research question of mine, why do doctors work with patients? To prevent burnout? Yes, that's one background. Or to explore the well-being of physicians? Yes, that's a way of Western context saying yes, but to be honest, I, as a doctor, work very happily to work as a doctor and I myself feel a strong yarigai as working as a doctor. So that's the starting point of mine and that's why I highlight the important role of yarigai. Yes, I mean, I highlight the importance role of Yarigai.
Speaker 1:Yes, I mean, I guess the idea of role ties strongly to, I guess, purpose, and I know purpose or shimeikan is something strongly related to ikigai, but I imagine it's also strongly related to yarigai in this context of the practical things or the daily things you do in your role. So, yeah, would you see a strong relationship between purpose and yarigai?
Speaker 2:Well, I didn't think of much the purpose on Yarigai. Yarigai is something I gain, yes, by working for patients, and the purpose is more like external to me. Interesting question If you use the term purpose, it seems to me that it's more like an outcome oriented yes, so for example, how to get salaries or how to achieve high status in society or something like that, whereas Yarigai is this is my personal opinion but they're focusing more on process of working. So there is not such kind of strong purpose to gain Yarigai, but just working as a doctor hard for patients. Then suddenly yarigai came to me and I gained yarigai as a result through working as a doctor. Yes, sorry, did I answer your question?
Speaker 1:No, that's fine. So, yeah, I mean, I think what you're talking about is intrinsic satisfaction or motivation. So, working as a doctor, you have this intrinsic validation with your relationships, helping patients, sense of satisfaction. Yeah, Purpose I mean purpose is because I think you described a Western perspective of purpose winning, outcome-focused, goal achievement. But I remember learning the characters for Shimeikan, and Shi is also used for the verb tskau to use, and then Mei is inochi, so using your life. So I've always had this perspective of the word ishime, which means purpose translates to using your life. So I guess I've had this image that purpose in Japanese is not always outcome focused. It can include this idea of using your life to serve the greater good, which you would do as a doctor.
Speaker 2:Yeah, I see. Thank you for clarifying, nick. I made a misunderstanding about the concept of purpose. Yes, in your context, when thinking of shimeikan yes as a doctor.
Speaker 2:Yes, shimeikan, yes, as a doctor. Yes, we recently in English language use the term professionalism or medical professionalism for that kind of concept, the professionalism, and also altruism, honesty, integrity lots of concepts under medical professionals there are, but shimeikan is something difficult to translate as well. You use the term purpose. Yeah, that's one translation, and also I agree with you that the concept of shimeikan is very much process-oriented as well.
Speaker 1:Yeah, so I do think that that's probably one of the. You know, things get lost in translation. So shimeikan is often translated to purpose, but there's perhaps a cultural difference, perhaps a cultural difference and Japan shimei kanji, a process of a goal and, in the West, purpose tends to be associated to goal success?
Speaker 1:I guess Maybe yeah, so it's interesting. I think there's always a cultural context to certain words. So, yes, you had this qualitative study, meaning you had these meaningful discussions with other doctors. So it was a narrative inquiry approach and you discussed many themes, although there were many themes to these narratives. So would you like to touch on some of the themes that came up? Some were quite unusual or interesting.
Speaker 2:Yeah, there are lots of stories, narratives, in daily clinical practices and I just pick up only four of them. So first I have to say that this paper does not cover all the Yarigai things among doctors. But many doctors feel Yarigai when they have difficulties, for example when they see patients dying soon or sometimes malpractice stuff they have to explain to their patients more in details and sometimes apologize for them and lots of things, and so difficulties came first. Then they do something and they overcome it. So they get a sense of achievement and also the interaction between doctors and patients becoming stronger after overcoming the barrier. So that's the typical story of gaining Yari Gai.
Speaker 1:It seems like the doctors would form meaningful relationships with the patients or the patients' families. Yeah, yeah.
Speaker 2:So in other words, for example, if a doctor sees a patient with just a community-acquired pneumonia, a very simple case, and stayed only two or three days in hospital and they got discharged, the treatment plan was something so-called clinical path oriented, which means that he or she, the doctor in charge, did not think much and they explained, followed by the guideline. I don't think doctors gain much yarigai in the kind of sort of practice, Whereas you know, in clinical practice it's a patient or people or heavily involved, not only doctors and patients but other healthcare professions. So many, many, many unexpected events happen, yeah. So I think that's the source of Yarigai came. That's where a doctor, by him or herself, think of and brought original ideas and to solve the problems. Yeah, kind of that story. Yes, I think the typical type of gaining Yari Gai by working for patients.
Speaker 1:Yeah, you actually noted and wrote about four specific representative narratives about Yadigai as a physician, so would you like to mention those four specific narratives you noticed?
Speaker 2:Yes, first theme. I'm going to explain that theme first, then the story. The first one is Dr Mishima. This is a pseudonym, but the theme is finding positive meaning in difficult situations, which I just described as well.
Speaker 2:But this is a story about malpractice the doctor in charge mistakenly treated the powder medicine and the patient got aspiration pneumonia and ended with an unfortunate result with a pathway. But in the process of dealing with the patient, the doctor in charge working very, very, very hard to first apologize and also to do his best to deal with them, the patient and the family members of the patient got angry first, but then was surprised and also gained a positive feeling about the doctors, his dedication to work for the patient himself and that kind of story. Yes, and interestingly, at the final stage also, after dealing with the patients, he, the doctor in charge, said that I felt the arigai in this kind of interaction and I don't think this is easily transferable. I mean generalizable. This is one of the this doctor's unique perspective to gain Yarigai by dealing with difficult patients. But this is definitely one of the stories to gain arigai.
Speaker 1:I mean it must be very hard being a doctor if you make a mistake, a misdiagnosis or prescribe the wrong medicine and it you know, has a negative impact or the patient dies, that's.
Speaker 1:I mean, that must be very hard to process. And then, of course, you have to then talk with the family and I guess, as you mentioned, most families would be, you know, very angry or would want to sue. But in this case he followed up and his dedication to the family, they obviously realized, oh this, this doctor really cares, he cares about us, he cared about, you know, our loved one and, um, yeah, I guess it was the sense of doing the right thing but going, going beyond his professional duties to really show that he cared, and then that gives him that sense of positive meaning despite this tragic event.
Speaker 2:Yeah, and going to the second story, Dr Kaneko. The theme is receiving gifts and budding. Ikigai is that she did the surgery, for this is a gastrectomy, but in a different way from what her supervisor proposed, but to preserve the gastric function and to eat. Yes, she, Takaneko, insisted on that way of surgery and they succeeded. And the patient can do farming and eating food they or he wants, and sometimes the patients bring her gifts vegetables and things like that. So this is a typical story of surgeons doing their best to preserve their living functions and get appreciation from the patients. And the interesting thing is that the doctor in charge, Phil Yarigai, by working in such a way but also she, the doctor in charge, feels a sense that she has a place to live, so she finds something like a space to live in the society by working as a doctor. So that's more like related to ikigai. Yes, for the doctor herself, yes, that's the second story.
Speaker 1:Yeah, that one was interesting because she went against the advice of her superiors and thought protecting this man's ability to eat is more important than trying to I guess you know cure his cancer. And I guess that was a decision she had to think about and make what's the best for this man who loves eating and farming? And so you phrased that as protecting the patient's ikigai, which, yeah, it was interesting. So making sure someone can live with a sense of Ikigai and enjoy life and do the things that matter to them. And I actually have a quote from that conversation, from your paper, and the doctor said sometimes my patients bring me gifts, vegetables and things like that. That gives me a reassurance I feel I have something to contribute to. That gives me a sense that I have a place here. That means a lot to me. I wonder if this is any way related to Ibasho.
Speaker 2:That's what I like to say. I mean, Ibasho is the place here to place live, place in a society, and Ibasho is very, very important for everybody. Yes, to live in the society, not just in a physical way, but in a psychological way.
Speaker 1:Yeah, in the society, not just in a physical way but in a psychological way. Ibasho is another word I explore and it's a fascinating word and concept.
Speaker 2:I'm very much interested in the concept of Ibasho, so wow, that's very surprising to me.
Speaker 1:We could do another podcast, maybe on Ibasho.
Speaker 2:Yes, yes, yes, we do.
Speaker 1:So it must have been very meaningful for you and refreshing for you to have these positive conversations about doctors' work, because I imagine they're so busy, and you're busy, that most of your conversations might be very practical or outcome-focused or patient-focused, rather than this human side, this meaningful side of the work you do. Yes, so there are two examples. Would you like to touch on the other two?
Speaker 2:Yes. The third one is Dr Kawabata's case. The theme I explore is cultivating relationships that transcend temporal boundaries. This is the case of a doctor who is specializing in internal medicine and helped a patient with type 1 diabetes because she wants to have a baby when her obstetrician declined or asked her to give up, and he, the doctor in charge internist, did some negotiation with her obstetrician and finally she got a birth and the time passed on 10, 20 years passed and he, the doctor in charge, got a letter from her and that is the time when he got a sense of yarigai. So this is a story of appreciation, but the time is very, you know, 10, 20 years. Yes, it's compared to other stories, it's a long.
Speaker 1:that's the difference between from other threes yeah, that that one was quite profound, because this doctor was thinking how can I help this woman have a baby and be a mother and have a family? And the specialist is saying not too hard, impossible, you should give up and even getting angry, and he didn't give up. So I guess, 20 years later to realize this decision and this hard work I did 20 years ago now has resulted in this young adult who's finishing university and they're happy and healthy.
Speaker 2:So that must have been a lovely letter to receive and an incredible sense of gratitude and satisfaction and the similar things or the same thing compared to other three stories that again having difficulties in this case having a baby with type 1 diabetes then the doctor and patient work together to overcome it. Then they got the sense of yarigai from that kind of experience, in this case by receiving a letter, yes, then they got a sense of yarigai, from that kind of experience, in this case by receiving a letter.
Speaker 2:Yes, it must have been a lovely surprise to receive that letter. Yeah, yeah. And the fourth one, dr Murakami, is a story seeing dying patients. Dying is a special theme, especially for a doctor, because doctors' work is usually making a diagnosis and treatment, whereas seeing a patient dying is sometimes difficult for us doctors because it's kind of, you know, have a sense of helpless, we have a sense of giving up. So this is usually we were not taught in our medical schools.
Speaker 2:Yes, but you know, when a patient is dying there are lots of interactions between doctor and patient. And as a doctor myself, I see many patients dying and I had a sense that, yeah, as a doctor I couldn't do anything, but as a human being I could do a lot. Yes, to stay along and say something as a doctor or as a human being, and to spend time with the patient's family members and receiving their feelings and emotions. And this story is about a young doctor who didn't have much experience of making a diagnosis and treatment but because of her powerlessness, she just can stay with her patients and talk with patients, families, and that kind of thing is impressive for herself. And she said that she got something like a yari gai, yes, by this experience. That's the fourth story.
Speaker 1:Yeah, the helplessness was a theme. Despite that, the family involved her and would share meals with her and just almost treat her like a part of the family in some sense, by having normal conversation and engaging as well, like human to human rather than doctor to the family of the patient. It must be very hard for doctors because I understand doctors don't get any training for people with trauma or any counselling on how to. I guess how do you tell someone you're going to die? Or how do you tell a family I'm sorry, we can't do anything for your loved one?
Speaker 2:So that must put a lot of pressure on doctors to deal with that human side of conveying bad news, and it sounds like there's no training for that Actually there is going to be more and more learning opportunities for young doctors and medical students recently, but we used to not to have this kind of training in the past. That's the correct expression I see.
Speaker 1:Well touching on these four stories, I'd like to quote from your paper. So in all four stories on Yarigai presented in this paper, the interviewees managed to relate their medical practice to their own positive feelings. Medical practice was presented as a source of gratification, joy and satisfaction, or sense of approval, belonging, esteem, reward and fulfillment. This gave intrinsic meaning to their occupational lives, which in turn became a source of motivation and commitment. So it sounds like these positive experiences, despite the challenges made, these doctors feel oh, what I do is meaningful and motivates them to continue despite the challenges of their profession.
Speaker 2:Yeah, one of the difficulties is that, yes, if they, the doctors, can overcome the difficulties, the work becomes more meaningful and they gain yarigai or much yarigai, whereas if they cannot overcome the difficulties, they're going to be burned out, maybe.
Speaker 1:Oh yeah, I was going to say, does that mean meaning making is crucial to the thought process of a doctor's? You know cases. Some cases they might have some sort of meaning associated to it and other cases might be just too stressful or hard work and they burn out.
Speaker 2:And meaning-making by themselves is possible, but sometimes they need support. Yeah, so supervisors, colleagues, are important keys, yes, to create meaningful work.
Speaker 1:I think yes, well, on the theme of meaning, making and yarigai and also ikigai, it was really a joy to see you reference the work of Dr Mihokamiya in your paper. Ah, yes, yeah. So, as a physician and someone who studied her, yeah, would you like to touch on her and her contribution to Ikigai literature, or perhaps yadigai?
Speaker 2:yeah, thank you for asking. Yes, uh, you know, uh, dr kamiya is a psychiatrist who explored the concept of ikigai in japanese context and uh, yes, she is interestingly wrote this book not as a academic paper, but she said that she can explore the concept of ikigai without scientific thinking. I mean that there exists in our daily lives and that's one thing I got attention and that's why I chose the methodology of qualitative study for my paper. Yes, that's one thing, and another thing is that you know the difference between ikigai and yarigai, and Kamiya Sensei explored the concept of ikigai by seeing a patient with psychiatric problems, whereas my study is focusing on yarigai of doctors or healthcare professions. So that's another difference I found. But there is not many previous research papers or books describing ikigai or yarigai in English language or can be understood for overseas researchers. That is the biggest reason why I quoted her work and by reading her book I got much respect to her work and by that experience I got a big motivation to write my paper.
Speaker 1:Yeah, I think she was a very inspiring woman and accomplished a lot. I like to think of her as the mother of Ikigai. Yes, so it's always nice to see her quoted or referenced. Yeah, so what about you personally, hiroshi? We've touched on these four narratives of finding positive meaning in difficult situations, receiving gifts, embodying ikigai, witnessing strength in a seemingly powerless human being and cultivating relationships that transcend temporal boundaries. That example of receiving a letter you know 10, 20 years after helping a patient, a letter you know 10, 20 years after helping a patient. And, yeah, having the sense of yaregai. So have you experienced any of those narratives yourself personally, as a?
Speaker 2:physician yeah, as a doctor, yes, definitely the answer is yes.
Speaker 2:And the story is about more than 20 years ago, when I was a resident. I have seen a patient with congestive heart failure, with chronic renal disease, and he was many times admitted to the hospital and I was in charge and in the last phase I did a home visit. Yes, he was the school teacher and in his home there is a piano I remembered and he's yes, I remembered his face as well. But when he died I asked his wife to do an autopsy. Yes, yes, and she agreed. At the time I asked her why did she very much tirelessly, that's a word. Yes, caring him when he was admitted or when I visited him his house and so many times? And so she said that she was treated in the same way when she had a big health problem in the past and that's why I did help him and at the time I was.
Speaker 2:I cannot stop crying because of that interaction and at the time, yes, I had spent a lot of time to treating with this patient and lots of medical things I learned as a resident. But by the answer of his wife, I learned a lot about how people live, how patients' families are like, how husband and wife live together or something like that as a human being. So that's where I remember the most, that's the most memorable patient and I feel that I really felt that it was really a privilege as a doctor and in English term it's definitely the calling yes, as a doctor and yes, that's my story about Yari Gai of a doctor.
Speaker 1:Yes, Very meaningful story. So it sounds like you have a lot of yadigai in your work. So outside of work, do you have a source of ikigai?
Speaker 2:uh, yes, definitely. Yes, my family is my wife and my little son, yeah, who is 13 years old right now, is definitely one of my ikicky guys as well. And also recently, after burning out and recovering from it, I stopped spending a lot of my time for work only and spent time doing skiing, doing reading and having more joy in my life. Yes, and also my career stage is changing. I'm already 52 years old and maybe I still have more than 10 years until retirement, but my recent yarigai and ikigai is to teach and to develop the younger generations' creativities and capabilities. Yes, education is definitely one of my becoming one of my yari guys. Yes, recently.
Speaker 1:Well, that's something we share. I think these podcasts is a source of yadigai for me. I enjoy the conversations. I get to read and then speak to the author and, yeah, I've built some friendships out of my conversations with my guests. So, yeah, I really enjoy sharing knowledge and learning and sharing it, so it's always a joy to have a guest on my podcast and thank you for being a guest on the podcast today, hiroshi.
Speaker 1:Thank you very much yes as well. We will link to your paper. So just to touch on the title again, exploring Yarigai the meaning of working as a physician in teaching medical professionalism. And thank you for your time today and I'm sure we'll perhaps record another episode and next time I'm in Japan I'll come in and visit. Maybe we'll have a coffee or a meal together.
Speaker 2:Yeah, yeah, yeah, definitely, I'd love to, and thank you very much indeed for inviting me as a guest. It's one of the rare opportunities, as a Japanese, yes to speak out in English language the concept of Japanese, unique concept of ikigai or yarigai, yes, and also I'd like to more and more people researchers to get to know about my paper as well, and your interviews are really helpful. So thank you very much indeed.
Speaker 1:No, it's my pleasure, hiroshi, so thank you again.