Volume 38

November - 2022

Cover: Mindful Beats

The strangest enemies, riven by controversy yet debilitated when apart.
I think, either one can't be satisfied until the other has been betrayed properly.

The battle of the heart and the brain is a long on-going debate for years. Which dominates the other is a question no one has been able to answer definitively. Where medical science says you can be brain dead but your body can be alive, how is it that a broken heart incapacitates our brains to think rationally? How do we feel the heaviness deep in our chests and lose the ability to see right? Can logic surpass emotions?

Letter from the Editors:

Welcome back to Art of Emergency Medicine! On the heels of the SAEM #StopTheStigmaEM Month, which was a huge success and became an international effort thanks to you all, we want to return to our monthly wellness and art series. This month, we’re going to take a deep dive into the concept of Ikigai. 

An idea and way of life originating in Japan, Ikigai encompassess and encourages people to find that aspect in life that provides fulfillment, meaning, and worth. The idea being that as you focus on these purposes, you may enact effects on both your physical and mental wellbeing. It however, can be somewhat difficult to define. Though it originated a long time ago, there are multiple books and articles all with slightly different definitions of what Ikigai is. Some state that it is a life in pursuit of hobbies and mastery and stretching the mind to a state where it achieves difficult and worthwhile things or “the happiness of being busy”. Others refer to it and quote it as the “benefit of being alive” or the idea that the sum of small joys in life lead to a more fulfilling life overall. It may seem that these are two different conclusions stemming from the same concept, but I believe they converge to the same point: a life lived loving the minutiae and attaining the greater.

Before discussing how to find your ikigai, it is important to realize that there does not have to be one broad, sweeping goal for your life. People may have multiple different elements of ikigai and these elements may evolve over time. Be open to change and be on a constant journey. 

Now, ikigai in practical form stems from an activity, hobby, action, pursuit that encompasses four main ideas: what do you love, what are you good at, what does the world need, and what can you be paid for. In the center of a Venn diagram of these four circles you find your ikigai, a pursuit that you love and in which you excel that you can monetize and improve your community worth. For many of us, this was becoming a doctor, nurse, EMT/Paramedic, and our initial driving focus. 

However, it is not as simple as that. Ikigai only requires you to love what you are doing and throughout the diagram we find many other crossovers

• Your Passion: Something you love that you are good at

• Your Profession: Something you are good at that you can be paid for

• Your Mission: Something you love that improves the world

• Your Vocation: Something you can be paid for that the world needs. 

It is just as important to find these factors that address the crossovers than addresses the center point as well. And while the Venn diagram seems particularly applicable to careers, it is important to address that the concept of ikigai should go beyond this as well. You should find activities that bring you the same level of joy in your life, be it as grand as becoming an expert painter or taking photos when walking on a beach. It is not an easy journey to find your ikigai by any means, but there are many places you may start both for your career and your life beyond your career. 

For the career:

•  Find the details in your career that bring you satisfaction and focus on these.

  • Whether it is connecting with a patient, following up on them later in the hospital, interactions with your colleagues, the sense of satisfaction after a particularly difficult case, find those aspects that you enjoy and seek ways to incorporate them into your practice more often. 

• Be receptive to positivity. 

  • As you continue to search for positives, you’ll find that you are met with them more frequently. Feel free to embrace these and incorporate to your ikigai

• Understand the difference you make in someone’s life

  • Often in emergency medicine we are seeing people on one of their worst days. Realize the impact that you can have in reassuring them and caring for them.

• Find your niche. 

  • There is an intersection between what you love in emergency medicine, and the act of what you do practicing it. Whether this is disaster medicine, ultrasound, or wellness, find your niche and pursue it. 

• Broaden the concept of ikigai

  • Ikigai is powerful when applied to individuals, but can become a vector for community-level change if a workforce transitions its goals to achieve ikigai for its employees. Not only does it improve employee retention and satisfaction, but ultimately may enact true change to the greater population and community you serve. 

For your life:

•  Find joy in the small

  • Make small daily affirmations and gratitude to the life experience you are having. Highlight those details of what bring you joy and make this a daily habit. Over time, you may find that these begin to add quality and purpose to each day. 

  • Another way to practice this is to find one new thing every day. Are you taking the same walk to and from work each day? Find a new plant, texture, bird, noise during the journey and appreciate these small details. 

• Accept your interests

  • Embrace your interests and your quirks, they define who you are and you will grow to become. Allow yourself the opportunity to simply “be yourself” both in life and your career. 

• Create your community

  • Instead of sharing news, failures, or career goals, share with your friends your new passions. Share those life moments that have recently brought you joy and affirm the importance in your life. Share your positivity and receive their own during these exchanges. 

And you need not separate these. Those things that may help you inform ikigai in your career may also help inform the sense of ikigai in your life. As you begin to seek and master your ikigai, you will find yourself in a sense of flow, where you are doing what you love, wonderful moments occur, and you are present to enjoy them. 

Ultimately, find those things that bring you pleasure, enjoy the struggle of mastering them, and enjoy the sense of flow that comes with your pursuit. Find pleasure in the details of life and make a habit of recognizing and sharing them with your community. In practice and over time, you’ll find the positivity returning to you in a sense of greater fulfillment, happiness, and improved wellbeing. 

Are you interested in writing an article for Art of Emergency medicine? Reach out to us through out contact form and we would love to work with you to make this a reality!

Hawaiian Sunrise

I've been slowly trying to work my way through all of the National Parks and hope to accomplish that as a life goal. This photo, taken during my trip to the AMA Interim in Hawai'i, was taken during a sunrise tour on the peak of Haleakala National Park. Sunrises are one of those special events that you never know how many more you might get to see and, while getting up early can be a real drag, the end result is almost always worth the time and effort. I hope you enjoy and agree with that sentiment and hopefully you will go and catch a sunrise near you.

Coalescence

Acrylic pour painting is incredibly therapeutic. As the paint colors flood and swirl on my empty canvas, my stress and anxieties slowly melt away. I titled this piece "Coalescence" as it looks like two waves are coming together to form an explosion of color emanating from the center of the canvas. I like to think in a way that this piece can serve as a reminder that seemingly opposing forces can come together and form something more meaningful than either part alone.

Backbone of the forest

I found painting to be a very therapeutic hobby. When I paint, I just think about the process of painting. I don’t think about bills , work, stress, patients, etc.... My brain is focused on the painting and gives my mind and body a break from the everyday stressors. Without painting, I think I would have burned out long ago, as the process of putting paint on a canvas, slows my brain down to process.

Acrylic on canvas

Mormon Row

3 hours of shooting, 12 frames, 5 hours of post processing. It’s no so much about the final image that I’m able to get, but the joy and the journey of the process along the way. Utilizing my mind and skills to an extent where I am able to reach new thresholds in my ability, that’s what brings me joy. Did I need 3 hours to take the 12 frames of this composite? Probably not. Was I fiddling around learning what to do with a camera for 3 hours and saved 12 great frames? You can bet on it. Was it the most fun and most relaxing moment that I’ve had in the last year of residency? You can bet your money on it. Photography is about the journey, the experience, the new sounds (and sometimes lack of) and textures, the wind blowing against your neck. To me, it all becomes a physical representation of tranquility and calm. A place where I can be alone in my thoughts gazing out into a far more vast world that what meets me at the hospital. I hope you all can find a hobby that does the same for you.

Do you want to see your art shared with the community? Don’t forget to submit today!

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This Months Featured Artists:

Ian Brodka

Currently a 4th year medical student and EMT that enjoys photography as well as just about any outdoor activity. With these outdoor activities, I became interested in photography to bring others along with me on my wild adventures and showcase all of the wonderful sights that this world has to offer. I hope you enjoy.

Sahar Asif, MD

I'm a Year2 Resident in Emergency Medicine at Aga Khan University Hospital, Pakistan. I believe I was attracted to this field because of its abstract nature and sensory feast it offers. I've always been drawn to nature and have enjoyed writing, drawing and photographing content related to it. Being a resident EM I get to enjoy medicine in an abstract, randomness and versatile aspect of medicine. No two patients are alike the same way no two art pieces can be. See more of her work on instagram.

Tiffany Fan, MD

I'm a resident physician at Harbor-UCLA who is just starting a career in emergency medicine. During medical school, I took an unexpected leave of absence for an acute illness and rediscovered painting as an escape from pain while recovering from surgery. Since then, I've continued to use acrylic pour painting as a way to incorporate wellness into my off-shift routine.

Scott Goldstein, MD

I am a dual board certified emergency/EMS physician in the Philadelphia area. After a spending years looking for an outlet I went to one of those paintings with wine one night with my wife. After that, I tried on my own and unknown to anyone (even myself) I wasn't half bad. I became self taught in painting of acrylic on canvas and painting coffee on watercolor. See more of his work on instagram.

You can learn more about the artists featured in this and other volumes at our contributors page!