Guest post: In one's element

In his NYT bestseller 'The Element', Ken Robinson argues that we are in our element - doing what we should be doing - when we do the thing we love, and in doing it feel like our most authentic self.

This got my attention. I've often felt that the place I am most me is in the clinic, and I find that somewhat disturbing: how can that be, if my children and closest friends never experience me in that context? I feel I'm less the real me at home - or maybe that's wishful thinking. At any rate, I like myself best at work, and the following description by Robinson of people in their element holds true:

". . . time passes differently and they are more alive, more centered, and more vibrant than at any other times." p21

He suggests that we find ourselves in our element when four things align: aptitude, passion, attitude and opportunity. Because his description of the attitude necessary to find one's element (perseverence, ambition,  wanting something strongly and being willing to exert oneself for it) is, I think, almost universal among physicians, I've 've taken the liberty of replacing "attitude" with "need" for the purposes of applying this to medicine.

And so, the four pieces that fit together when in one's element

1. aptitude (what you're good at)
2. passion (what you love)
3. a̶t̶t̶i̶t̶u̶d̶e̶ need (in the world, that your work fills)
4. opportunity (a position where you can do the work)

I'm a good physician, I love medicine, I provide primary care to refugees, and I work in the only such clinic in the province. Perfect score.

Thinking over other positions from which I've moved on, or avoided, or wished for, I can identify which of the above was missing. I lost my passion for work in Vancouver's downtown east side when I came to view the work as palliative. In private practice in an affluent neighbourhood of Vancouver's worried well, the preponderance of women complaining that their hair had lost its lustre left me feeling my work wasn't filling a genuine need. I've avoided high acuity settings (emergency room, deliveries) because I haven't kept up those skills. And I don't work in a medical practice where I'm given paid time to write because I haven't found the opportunity.

I do think that health care workers have an advantage in finding our element in that the need is so obvious in our work. We care for sick people; what's more basic than that? It's less tangible for people like my husband, who works in business software. And I think it's more difficult still for artists to define and defend the need for their work.

The concept of opportunity trips me up a little.  My current job, and the one before that (HIV clinic) were both positions that I did not seek out. They were offered to me. Sometimes I second-guess myself: isn't accepting an opportunity a passive choice? Picking the low-hanging fruit? Shouldn't I be actively pursuing the perfect, hard-to-get position, chasing it down? (But what would that even be?)

Maybe we can increase our work satisfaction by changing what fills those four criteria. If I were to increase my skills (say, learning some basic surgical skills like appendectomies) and set up shop where there is greater need (rural Zambia) would I be even more satisfied? Perhaps that's why so many 50+ physicians do exactly that.

I like the idea of applying this framework to job considerations in the future. I've been dipping my toes into adminstrative work. There's a need for (young) medical administrators, and plenty of opportunities. But I haven't had enough experience yet to determine whether I have a passion for it, and whether I have (or can develop) the necessary skills. Whether I would find myself in my element there remains to be seen. At least I know what to look for:

"One of the strongest signs of being in the zone is a sense of freedom and of authenticity. When we are doing something that we love and are naturally good at, we are much more likely to feel centered in our true sense of self - to be who we feel we truly are." p90

And you? Are you currently in your element? If not, which is missing: skill, passion, need or opportunity?

[cross-posted at www.freshmd.com]