Dr. Vivek Murthy::
Our connection to other people is ultimately built on having a strong connection to ourself.
Dr. Mark Hyman:
Today’s episode was recorded before the World Health Organization declared the coronavirus outbreak, a pandemic and before stay-at-home orders were issued across the United States. As many of us are social distancing and separate from one another, I think you’ll find this conversation more important than ever. And remember that just because we’re separated, doesn’t mean we can’t stay connected. Connecting with family and friends over video or phone calls has been really meaningful to me during this time, and can make a huge difference for our mental health, even with just five or 10 minutes a day. Now, onto my conversation with former Surgeon General,
Dr. Mark Hyman:
Welcome to the Doctor’s Farmacy. I’m Dr. Mark Hyman, and that’s Farmacy with an F, F-A-R-M-A-C-Y, a place for conversations that matter. And if you’ve ever suffered loneliness or felt isolated or disconnected in your life, this conversation is going to matter to you because we have an extraordinary guest today, the former Surgeon General of the United States,
Dr. Vivek Murthy:, who’s I’ve known for a number of years who actually invited me to come to meet with him when he was Surgeon General and talk about the issues of food and obesity and nutritional disease, and he’s just always so attentive and connected. He came to Cleveland Clinic to talk about the opioid epidemic and I tried to get the leadership there to do what he did in the Surgeon General’s office, which is to get the entire clinic meditating every day at 3:00 in the afternoon. The Chief of Staff was a little confused when I said that. I think it’s really what we all need to be doing. I usually sneak off in my little room in my office and just try to do meditation in the afternoon when I’m there.
Dr. Mark Hyman:
But, he’s an extraordinary leader in Medicine, in Public Health, and his new book Together: The Healing Power Of Human Connection In A Sometimes Lonely World, or I would probably titled it, An Often Lonely World, is really an extraordinary contribution to our understanding of what creates so much suffering and dis-ease and actually, disease because if you’re looking at the causes, the root causes of chronic illness, it’s often related not just to food, which is my lane, but to loneliness and people don’t understand that that’s actually a big driver of so much and we’re going to talk about that.
Dr. Mark Hyman:
Dr. Murthy is a trainer guy. He was the Vice Admiral of the U.S. Public Health Service Commissioned Corps where he commanded a uniformed service of 6600 Public Health Officers globally. He launched the Turn The Tide Campaign, which was to help our nation’s health care providers focus on our opioid epidemic. He was a key leader in addressing that crisis while he was Surgeon General. He issued the first Surgeon General’s report on alcohol, drugs and health calling for expanded access to prevention and treatment and recognizing addiction as a chronic disease, not a character flaw, which many people still think it is and stigmatize it.
Dr. Mark Hyman:
He’s been focused from 2017 his attention on chronic stress and loneliness as huge problems that affect our health, our productivity and our happiness. He co-founded a number of organizations. VISIONS, which is an HIV/AIDS education program in India. I’m not sure I’m saying this right, Swasthya, which is a community health partnership in rural India that trains women as health providers and educators or like barefoot doctors in China, but for women, I guess. And he helped build the grassroots organization Doctors for America that was very involved in the election of President Obama.
Dr. Mark Hyman:
And since he’s left Surgeon General’s office, he’s focused on loneliness and social connection in his book Together: The Healing Power Of Human Connection In A Sometimes Lonely World. It is out April 28, Harper Collins. He’s just an extraordinary guy. He has degree from Harvard, his MD, an MBA from Yale. He went to residency in Boston and was on the Harvard Medical School faculty. He’s a very serious dude and a good friend and I really am so happy to have here on the podcast. Welcome, Vivek.
Dr. Vivek Murthy::
Thanks so much, Mark. I feel somewhat embarrassed after that introduction, but thank you.
Dr. Mark Hyman:
And he’s only 25 which is what’s amazing.
Dr. Vivek Murthy::
Oh, no.
Dr. Mark Hyman:
I don’t know. Are you 40 yet?
Dr. Vivek Murthy::
I’m 42.
Dr. Mark Hyman:
Okay. 42, so the best is yet to come, I have a feeling. He’s just getting started. I think, were the youngest Surgeon General ever?
Dr. Vivek Murthy::
In about a century or so. The very first Surgeon General in the 1800s was younger than I was.
Dr. Mark Hyman:
That’s because nobody lived very long back then, right?
Dr. Vivek Murthy::
Yeah, I think [inaudible 00:04:27], yeah.
Dr. Mark Hyman:
That’s unbelievable in 100 years. And that just speaks to your character, your intelligence, your insightfulness about some of the biggest things that are affecting our public health today. And I am just so glad you laser focused on this issue of loneliness because in the early part of my career, I focused on food as a big driver of chronic disease and still is, it’s what I’m focusing on, and Functional Medicine to take care of the individual, but I realized that I could not really get my patients better unless I deal with the social issues that they’re facing and I began to realize that there’s another medicine that’s just as powerful as food and that’s love and social connection. So I would say love is medicine, food is medicine, that’s how we’re going to help the world.
Dr. Vivek Murthy::
Yeah.
Dr. Mark Hyman:
And you really lasered in on the love is medicine through looking through the lens of loneliness, and how did that all come about? I mean, you basically are a traditionally trained Internal Medicine doctor and it’s not something we’re really taught about in medical schools along. So how did you come to that?
Dr. Vivek Murthy::
Well, it’s a good question. I think I had experienced loneliness a fair amount of my own life and when I was a kid in school, I was very shy. I had a hard time making friends in elementary school. And each day going to school and being dropped off by my parents, I had that pit in my stomach of nervousness and it wasn’t because I was scared about exams or teachers. I was actually just worried I was going to be alone again, and I just couldn’t wait for the bell to ring at 2:30 or 3:00 or whenever it was so that I could go back home and be where I felt really good because I had loving parents and an amazing sister and I felt very cared for and taken care of at home.
Dr. Vivek Murthy::
So it was certainly a presence in my life and it cropped up many other times during adulthood as well at transition points in my life and even during my time as Surgeon General, and in the years afterward. I also then started to see it in my patients and this is not something I expected at all because when I was in medical school, and I suspect that you and many of us have the same experience, loneliness was not part of the curriculum.
Dr. Mark Hyman:
Nope.
Dr. Vivek Murthy::
Emotional well-being was not a class that we took.
Dr. Mark Hyman:
Loneliness 101, no.
Dr. Vivek Murthy::
Yeah. This is not part of that matter, neither was nutrition. I still remember our nutrition education in medical school was one class once a week in the evenings that was optional for like six weeks.
Dr. Mark Hyman:
Yeah, it was probably on like vitamin deficiency diseases like rickets and scurvy.
Dr. Vivek Murthy::
Yeah, there wasn’t a whole lot of training, but certainly on this subject of our emotional health and the power and importance of social connection, there was very little. But when I started seeing patients, there were a couple of things that struck me. One is that people would come in with real serious illnesses and illnesses or critical times in people’s lives where they had to make big decisions and they find themselves reflecting on the rest of their life to see, “Gosh, have I lived the life I want to live?” And in those critical moments, you need people around you to help you figure out what path to take, just to support you and be there with you, but so many of the patients really don’t. And I remember I used to, sometimes they’d ask me.
Dr. Mark Hyman:
They just were in the hospital by themselves.
Dr. Vivek Murthy::
They were there by themselves and I would ask, sometimes I would say, “Hey, we’ve got to make a pretty difficult decision now, on whether to go to surgery or not or whether to start chemotherapy or not, is there somebody you want us to call to come in so that you can talk it through with them as well?” And so often the answer was, “No, there’s nobody to call.”
Dr. Mark Hyman:
Wow.
Dr. Vivek Murthy::
Even at the time of death, Mark, I noticed that on so many occasions that the only ones to witness people’s last moments were myself and other doctors and nurses, that was a medical staff. And so I remember that quite vividly, but even despite all of that, I was not planning to talk about loneliness or work on it when I was Surgeon General because I didn’t know if that was just my own experience or maybe the peculiarities of my medical experience as well.
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
But what happened that really changed things for me is when I began my time in office, I began with a listening tour.
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
I have traveled all of these cities and towns all across America with a simple question, “How can we help?” And I tried to just sit back and listen to what people said, and what they said was fascinating because I did hear stories I expected about addiction, about obesity, about depression and anxiety. What I didn’t expect to hear that within those stories were these threats of loneliness. And people wouldn’t say, “Hi, I’m Mark. I’m lonely.” But they would say things like this, they would say, “I feel invisible. I feel like we’re struggling all alone here. I feel like people have forgotten about us. I feel like people just don’t even see us. And if we died, no one would even know it.”
Dr. Vivek Murthy::
People would say things like that quite often and it led me to realize over time, as I heard more and more of those stories from everyone from farmers and rural areas to moms and dads in big cities and members of Congress, I started to realize that not only is loneliness far more common than we thought.
Dr. Mark Hyman:
Oh, you were hearing this from members of Congress?
Dr. Vivek Murthy::
Oh, yeah. And they wouldn’t say it publicly, but interestingly, behind closed doors, they would say, “Yeah, this has been a struggle for us.” I had one member of Congress, in fact, tell me, he said, “If you’re going to build a campaign to address loneliness, could you start with Congress first because we’re all struggling.”
Dr. Mark Hyman:
Start with me.
Dr. Vivek Murthy::
Yeah, but the truth is that I realized nobody was spared, that people were either affected directly or through the people they loved and that all of us, at some level in modern society are vulnerable to losing our connections.
Dr. Mark Hyman:
So, it’s so intense. And I think that, we’re really wired as social beings, because a human being by him or herself in the world, is usually dead, right? Historically, if you didn’t have a tribe or a group that helped you navigate and survive the world, you would just die and yet something’s changed in the last hundred plus years. And you sort of say, it’s really different, this modern day loneliness is different than anything that has happened in other generations and how does it actually affect us? I mean, what is the science behind loneliness, its effect on our health and our longevity, and what do we know about that?
Dr. Vivek Murthy::
Well, it starts with what you just touched on. Understanding how loneliness impacts our bodies starts with how we were thousands of years ago and we, over time, evolved to really need each other, so thousands of years ago when we were hunter gatherers, there was safety in numbers. So, if you had a trusted group of people that you were with, you could take turns keeping watching night to make sure that there weren’t predators that attack. You could also pool your food so that you had a stable food supply over time instead of starving for many days at a time. You can also do other things like help in child rearing, so people could take care of each other’s kids and share the responsibilities which can be quite taxing if it’s just you alone, managing a growing family.
Dr. Vivek Murthy::
And so we overtime came to depend on other people for our safety, so much so that when we were separated from the tribe, when we were actively more at risk then of starvation or being pursued by a predator, it put us in a stress state. And now in some ways, that’s actually a very healthy response, because that stress state would raise our threat level and focus us inward and push us to quickly get back to the tribe as quickly as possible.
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
And that’s in a sense, what loneliness is like. Like loneliness like hunger or thirst is a signal that our body is sending us that we’re lacking something that we need for survival, and if we react quickly to that and fill the gap with social connection, healthy social connection in our life, then that feeling of loneliness goes away and we’re okay. The problem though is when that state of threat, which is effectively a physiological stress state, persists for a long period of time. Like, we know that stress is not good for us, but it’s only in the case of it being there for a long period of time or an excessive amount.
Dr. Mark Hyman:
But it’s adaptive in a small-
Dr. Vivek Murthy::
Yeah, small amounts can actually be quite good, like before we give a big speech or take an exam or take on any big task or go out on a on a date that we’re really excited about, we might feel some stress, right?
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
And that might push us to perform better and to actually bring out the best in ourselves.
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
But when we’re chronically stressed, that actually is when our body starts to break down, that’s when we have elevated levels of cortisol and other stress hormones flowing in our body. We have increased levels of inflammation and that over time damages tissues, blood vessels, and leads to higher rates of heart disease and other illnesses. And so loneliness when it’s chronic, when it’s long standing puts us in a chronic stress state and it’s from that that we see so many of the negative consequences.
Dr. Vivek Murthy::
Now, there are other practical implications to our health of not having connections. Some of the day-to-day help we might need, going to the doctor, taking our medicines, having someone to remind us and inspire us to eat healthily or to go and work out.
Dr. Mark Hyman:
To have a reason for living, right?
Dr. Vivek Murthy::
Right, to have a reason for living. We may miss out on these things, too, so the healthiness of our lifestyle may deteriorate as well, but what we see overall is when you look at the data, at the impact of loneliness and our health, what you find is that loneliness is associated with a reduction in our lifespan and that mortality impact is similar to the mortality impact of smoking 15 cigarettes a day.
Dr. Mark Hyman:
Wow.
Dr. Vivek Murthy::
It’s greater than the mortality impact of sedentary living and obesity. I think as Surgeon General how much time I spent on those three issues on smoking, obesity and physical activity compared to how much I spent on loneliness…
Dr. Mark Hyman:
Wow.
Dr. Vivek Murthy::
… there was no comparison.
Dr. Mark Hyman:
Wait. We got to stop there for a minute because what you just said was remarkable that loneliness is a bigger risk factor for a shortened lifespan than smoking, obesity, or lack of exercise.
Dr. Vivek Murthy::
Well, it seems to be just-
Dr. Mark Hyman:
That’s like headline news.
Dr. Vivek Murthy::
It seems to be just as powerful as smoking 15 cigarettes a day and even greater than the impact of obesity and sedentary.
Dr. Mark Hyman:
Which is pretty deadly, I mean, smoking is pretty deadly.
Dr. Vivek Murthy::
Yeah.
Dr. Mark Hyman:
So, this is something that’s not talked about, something that we don’t… I mean, I’m in a big healthcare system, we talk about the office of experience and improve patients and doctors experience, but this issue of loneliness being a risk factor, it’s just not in our training and it’s not in our even approach as a culture to figure out how to solve some of our big issues like depression and the opioid epidemic and why people eat. It’s not only about what people eat, it’s why people eat.
Dr. Vivek Murthy::
It’s why. That’s definitely right.
Dr. Mark Hyman:
I often say you don’t have to focus on what you’re eating, but what’s eating you?
Dr. Vivek Murthy::
Yeah.
Dr. Mark Hyman:
And I think people don’t understand that connection. And I think the question is, what’s happened to our society that’s led to this and how do we get it back to a place where we do have connection and not social media, which actually leads to more isolation, more disconnection, more separation, feelings of isolation? You see the Instagram models and this and that, it just makes you feel bad about yourself. It’s not really true social connection.
Dr. Vivek Murthy::
Yeah. So let me pick up on one thing you said even earlier also and then I’ll get to what’s driving this, but something you said I think is really important, which is that we weren’t really trained to think about this or…
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
… to recognize how important it was, and I think part of the challenge is that we don’t see loneliness around us very much and there are two reasons for that.
Dr. Mark Hyman:
There’s no blood test for loneliness.
Dr. Vivek Murthy::
There isn’t and you’re right, but also even if we just think about the people in our lives, we may not recognize that loneliness is that common, but there are two big reasons for that. One is because there’s a huge stigma around loneliness.
Dr. Mark Hyman:
Shame.
Dr. Vivek Murthy::
Yeah, there’s a sense of shame that people have because they feel like if they say that I’m lonely, that’s like saying I’m not likeable or I’m not lovable or I’m not desirable in some way.
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
It’s like saying, “I’m a loser,” and nobody wants to feel that way. I certainly didn’t when I was younger and felt lonely. I never told anyone about that, but there’s another reason though that loneliness is hard to see and that’s because we stereotypically might think of loneliness as the person who’s sitting in the corner at a party and not interacting with anyone, but that’s not-
Dr. Mark Hyman:
That would have me as a kid.
Dr. Vivek Murthy::
Yeah.
Dr. Mark Hyman:
Well, actually, I never got invited to the party.
Dr. Vivek Murthy::
Yeah. I wasn’t at the party. I was home.
Dr. Mark Hyman:
It is true.
Dr. Vivek Murthy::
But what but the other reason we don’t see it is because it looks like other things. So loneliness can look like depression, it can look like anxiety, it can often lead to addiction or increase our risk for addiction. In fact, the founder of AA, one of the most interesting things I found that he said, is that loneliness he felt was at the root cause of so many people struggles with alcoholism and needed to be addressed in order for them to get into and stay in recovery.
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
And that is something I found also when looking at the opioid epidemic, there’s a reason that the opioid epidemic has been labeled part of the larger group of illnesses called deaths of despair because it is often a sense of hopelessness and isolation that can lead people to experience emotional pain and then as human beings once we experience emotional pain, we will seek to relieve that pain. And the question in those moments is what are we reaching for? So are we reaching for alcohol, are we reaching for drugs, are we reaching for food that’s not good for us?
Dr. Mark Hyman:
A bag of Doritos.
Dr. Vivek Murthy::
Right. Are we reaching for exercise? Some people work out when they feel stressed or in pain and that helps them. Are we reaching for work? Some people drown themselves in work when the stresses of their personality and disconnection are hurt.
Dr. Mark Hyman:
Yeah, that would have been me. That would be me.
Dr. Vivek Murthy::
Right, and this is the thing is that they are socially acceptable ways to sometimes deal with your pain even though it hurts you in the long run.
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
And alcohol, I think and work are two examples of those. But for those reasons, when you look around you, you might think, well, maybe I don’t know that many people are lonely, but I will tell you that the statistics back up the fact that a very large number of people that we know are likely struggling with loneliness. If you look at the conservative numbers, what you’ll find is that probably somewhere around 20 to 22% of adults in the United States are struggling with loneliness, those are the lower numbers.
Dr. Mark Hyman:
Wow.
Dr. Vivek Murthy::
But there are plenty of other studies, including one recently by Cigna, the health insurer, which have pegged those numbers is significantly higher and it’s not just the U.S.
Dr. Mark Hyman:
In what percent?
Dr. Vivek Murthy::
Well, in the Cigna study, the most recently they found that it’s in the 60s. It’s more than 60% of adults…
Dr. Mark Hyman:
60%.
Dr. Vivek Murthy::
… who will actually say they’re struggling with loneliness. Now, this is either because maybe loneliness is increasing, maybe people are just more comfortable now starting to admit that they’re struggling with loneliness, maybe the studies are getting better. Who knows what the reasons are, and it could be potentially all of those, but the point is that we are talking about more people who struggle with loneliness and have diabetes in the United States, more people struggling with loneliness than adults who smoke in the United States. So this is both common, and it’s also consequential for our health.
Dr. Mark Hyman:
And it’s invisible.
Dr. Vivek Murthy::
And it’s invisible, yeah.
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
It’s invisible.
Dr. Mark Hyman:
It’s incredibly striking and you talk about it, how in your book Together: The Healing Power Of Human Connection In A Sometimes Lonely World, which I encourage everyone to get a copy of, whether you’re lonely or not because likely you know someone is and likely…
Dr. Vivek Murthy::
That’s right.
Dr. Mark Hyman:
… the things in this book and to help you get more connected to things that matter in your life and also help you engage with your community in different ways to build love and connection, which is what this is all about.
Speaker 3:
Hi, everyone. I hope you’re enjoying the episode. Before we continue. We have a quick message from Dr. Mark Hyman about his new company Farmacy and their first product the 10-Day Reset.
Dr. Mark Hyman:
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Dr. Mark Hyman:
The 10-Day Reset combines food, key lifestyle habits and targeted supplements to address FLC straight on. It’s a protocol that I’ve used with thousands of my community members to help them get their health back on track. It’s not a magic bullet, it’s not a quick fix, it’s a system that works. If you want to learn more and get your health back on track, click on the button below or visit getfarmacy.com, that’s get Farmacy with an F, F-A-R-M-A-C-Y.com.
Speaker 3:
Now back to this week’s episode.
Dr. Mark Hyman:
You talk about in the book how loneliness also has not just impact on the individual, but in a broader context. It affects our kid’s ability to function and learn in school, it affects productivity in the workplace and effectiveness on a sort of commercial level of competitiveness, it affects this incredible polarization and division in our society.
Dr. Mark Hyman:
I remember hearing this guy, Peter Orszag, who was a Budget Director and Obama talk at Cleveland Clinic about the voting in Congress and in the ’60s, you could see a sort of a cloud of votes for Republicans and Democrats. It was all mix. It was a big Venn diagram where there were tons of overlap and voting across party lines and then he showed a graph now, and it was just like complete separation. And we’re seeing that mirrored, like I’ve never seen before in history in terms of lack of ability for our government to function, but then it’s spreading out in terms of divisiveness and conflict among all kinds of groups, racial groups and all of these different divisions in society that are really, I think, crippling our ability to actually have a great society.
Dr. Mark Hyman:
And so can you talk more about how loneliness is driving some of these trends and what we can do about it?
Dr. Vivek Murthy::
Yeah. This is one of the reasons that I wanted to focus on this issue because when I came out of government, when I finished my time as Surgeon General, I found myself thinking about all the different issues we had touched on from the opiate epidemic to violence to E-cigarettes, you name it, Ebola, Zika.
Dr. Mark Hyman:
I bet you’re glad you’re not having to deal with coronavirus right now. That’s so frightening.
Dr. Vivek Murthy::
This is a difficult… yeah, a very difficult and disturbing situation right now, and I think it’s sadly only going to get worse before it gets better. But one of the things I wanted to do is I wanted to ask myself the question, what’s at the root cause of many of these deeper issues and can I do something to make a small contribution to addressing that deeper root cause? And what I kept coming back to again and again, guided both by the conversations I had with people around the country and the science that I was reading, was that our connection with each other is actually one of the most powerful and important resources that we have not just for our health, but that it affects our performance in the world, in school, in the workplace that impacts whether we talk to each other or not in communities and even has an impact on our politics.
Dr. Vivek Murthy::
And that’s why I wanted to work on this and here’s why, how it affects us when we are connected to each other, our threat levels are lower, our levels of stress are lower. When we are lonely, it increases our threat level and it actually shifts our focus internally towards ourselves because if you’re in a threat state, you want to focus on yourself for your own, your safety and survival, but it’s hard to optimize our output, it’s hard to be the best person we can be and bring our full self to the task, if you will, if we’re in a constant state of stress, and if we’re so focused on ourselves that we’re missing, what’s happening in the outside world. You can see that playing out in the workplaces, in schools and in Congress as well, absolutely.
Dr. Mark Hyman:
Terrible.
Dr. Vivek Murthy::
And you can see what a price we pay as a society because then the political dysfunction impacts us all, but also when people aren’t happy in the workplace that impacts productivity and retention, it impacts creativity in the workplace that impacts businesses and organizations, bottom line.
Dr. Mark Hyman:
Yep.
Dr. Vivek Murthy::
But in schools, what concerns me most especially as a dad who has two young kids who are three and two, is I think about what experience they’re going to have in school and I ask myself, “Well, is it the job of school to teach people how to read write and do arithmetic or is it also to teach kids how to build a foundation for a healthy life in other ways, including in terms of their social and emotional well-being?”
Dr. Mark Hyman:
You know I always say there’s three things you never going to learn in school that are the most important things in life, how to have healthy relationships, how to take care of your health and how to manage your money.
Dr. Vivek Murthy::
Yeah. That’s right. So, these things, these are the foundations that matter and when we don’t have one of these key important foundations, what we realize is that everything else we build on it is built on a shaky foundation and I realized that when we have strong relationships in our lives, we are better. We are better at work, we’re better at play, we’re better in terms of our health. We’re better in our relationships and what we bring to our family and to our friends. When we feel lonely, all of those things are more fragile, and they’re more likely to collapse on us.
Dr. Vivek Murthy::
And so that’s why when I thought about this issue, I felt like If we can make a shift as a society from being one that is focused on wealth, reputation, and power to one that is focused on people, if we can truly create a people-centered life and people centered society, then I think we can capture the great power of social connection and experience the joys and the benefits that it has to bring to our health and ultimately to all of our lives.
Dr. Mark Hyman:
And there’s good data on this. It’s not just like a warm and fuzzy, touchy feely thing to sort of help end loneliness and get people to connected to each other, there’s actually a great data on how much a difference it makes in overall society and the success of our country, the success of our citizens, the health of them, all the things that really we care about are centered around this issue.
Dr. Vivek Murthy::
That’s right.
Dr. Mark Hyman:
And your book isn’t called alone, it’s called Together, and the reason is because in it you tell some amazing stories about people who solve this in their communities and are trying to break through this incredible sort of edifice of loneliness that’s around so many people. So can you tell us a little bit about some of the hopeful stories and some of the things that-
Dr. Vivek Murthy::
Absolutely.
Dr. Mark Hyman:
Because it’s kind of depressing is we’re all lonely and loneliness is ruining everything, which is true. How do we get out of it and what are the sort of stories that you can share about how that’s happening?
Dr. Vivek Murthy::
Yeah. So to me, this is actually a deeply inspiring topic for exactly that reason because there are so many stories that we don’t read about or hear about in the papers every day, but if people who in their own lives are building connection and building community and helping to create, I think what all of us want, but the other thing that’s fascinating about it to me, is that in building a connected life does not require us to purchase expensive medicines and does not require us to have special medical equipment, it doesn’t require fancy and expensive programs. It only requires what we already have inside of us, which was our desire and our ability to give and receive love with each other.
Dr. Vivek Murthy::
I remember being at the White House for an event that when we were working on the opiate epidemic and I was facilitating a conversation with a group of people about the epidemic and what was driving it, and it was in that moment, I remember sitting on that stage where it struck me that we were talking about medication-assisted therapy and counseling and all of the other things that we need to put in place to help people struggling with opioid use disorder. And it struck me in that moment that with so many people that I met on the road felt like they were lacking were relationships and at the heart of those relationships and communities were love and I really do believe that love is the oldest medicine that we have.
Dr. Mark Hyman:
There you go, love is medicine.
Dr. Vivek Murthy::
It is and of all the medicines I prescribe and you prescribe and so many doctors prescribed in the hospitals to treat our patients, those are important, those are good, but there are a few things that come close to the power of what genuine human relationships can do and those are powered by love. Some of the stories that I came across were really fascinating in this regard. I came across a mayor, Tom Tate from Anaheim, California, who is the last person you would think of as leading a social movement in his community, because he’s a self-described introvert, really didn’t like to hang out with other people very much, and also was deathly afraid of public speaking.
Dr. Mark Hyman:
And he’s a mayor.
Dr. Vivek Murthy::
Right. So what ended up happening is just by accident of life, he was appointed to serve on the city council because there was a vacancy and the mayor appointed knew him and appointed him, so he took that on, found he enjoyed it, actually joined a Toastmasters Club to get more comfortable with public speaking, really had to work through a lot of issues and then ran for city council again, and then the mayor seat opened up. And he thought, “Maybe I should run for mayor,” because was really interesting is he’d been seeing these signs around town, these posters, which had talked about, which were posters about kindness, and said, “Be kind.” And Tom already talked about the importance of kindness, but there was no name stamp below it, there’s no sponsoring organization, there’s no URL to go to, to learn more.
Dr. Mark Hyman:
Right.
Dr. Vivek Murthy::
It was literally just a poster with a message of kindness and he kept thinking to himself, “This feels right. This feels like what our community needs. We need more kindness, that’s the glue that holds us together.” And without that, all of these programs that we’re funding and structuring, etc., well-intended as they are, are not going to work as well if people aren’t connected to each other and invested in each other. So he decided to run for mayor on a platform of making Anaheim a city of kindness.
Dr. Mark Hyman:
Wow.
Dr. Vivek Murthy::
And he was scared about this. He thought, “I’m going to get laughed out of town. People are going to think I’m not a serious candidate. I may be made fun of for my being soft.”
Dr. Mark Hyman:
Yeah. My political platform is kindness. How about that?
Dr. Vivek Murthy::
Exactly, but you know what he found? When he got up to announce his candidacy and to say that his goal was to make Anaheim a kinder city, he saw heads nodding in the audience, he saw people murmuring approval, and he realized that so many of us even though we may not lead with it, we want more kindness, we want more love, we want more connection in our lives and in our communities, so he eventually won that race.
Dr. Mark Hyman:
Incredible.
Dr. Vivek Murthy::
He became the mayor of Anaheim. He created all of these programs from neighborhood programs to get neighbors to connect more deeply with each other to 1 Million Acts of Kindness program in the school system to get the students throughout Anaheim to basically engage in random acts of kindness and then to come together and share those experiences. And talking to him was such a beautiful experience because I came to see that through this focus on kindness that what he did, which was incredibly powerful is he didn’t just set up a new program, he changed culture in the city. And when you change culture, which are the values and the ideas that people hold to be important…
Dr. Mark Hyman:
Wow.
Dr. Vivek Murthy::
… then you have a huge ripple effect on not just the programs they support, but on how they live their lives, and that’s what he saw throughout Anaheim.
Dr. Mark Hyman:
That’s incredible. And something you can’t legislate, right? You have to sort of create the structures to do that. And I think I sort of had a very similar insight to you is at the cause of so much of our disease and dis-ease is disconnection and through my work in Haiti with Paul Farmer, looking at what he did to treat infectious disease, using community health workers, essentially neighbors and peers and friends to help each other through making sure they took their medications and they knew what to do and we’re helping each other be accountable. He produced a program that was more effective than anything else the public health community in the world had ever seen…
Dr. Vivek Murthy::
Yeah.
Dr. Mark Hyman:
… and was spread across the world and I kind of realized that it’s not just infectious disease is contagious, it’s chronic illness, which affects six out of 10 of us and as you know is sort of driving our economy into the ground and is burning so many people and creates so much suffering. And a lot of the reason for, like you said, is the disconnection that drives people to behaviors and into things that actually aren’t good for them like food or whatever.
Dr. Mark Hyman:
And then I worked with Rick Warren to create the Daniel Plan with Dr. Amen, which was a faith-based wellness program, but it was founded on the idea of small groups that were the infrastructure of the church that we just put the information in and they were able to help each other get better that, getting help is basically a team sport. And we’ve taken that now to Cleveland Clinic in a secular way. It’s not a faith-based wellness program. We now are the top in our small center for Functional Medicine, which has 10 doctors is the number one in group visits in the entire organization and the next biggest or group down from us has about 400 doctors and we have like 10.
Dr. Mark Hyman:
And the reason is I was very vocal about making sure that we actually did this because this is how people change and we see that people have a longing to belong and a longing to connect and that’s how they make meaning otherwise, that’s how they get motivated to do anything, and that’s what’s really missing from our culture and society. How do you see that we can spread this further? How do you take the ideas in your book and make them sort of something we spread nationally and even globally?
Dr. Vivek Murthy::
Well, I think there are a couple of things we can do. I think, first by recognizing how common loneliness is, but also by recognizing the power of human connection to elevate our health, our performance and our well-being. I think that first step can help us to rethink our priorities, both our individual parties where we’re putting our time, but also organizationally as workplaces and schools and governments were allocating resources. The second thing is, I think we can think about what steps we can take in our individual life to actually create more connection.
Dr. Vivek Murthy::
The truth is whether you’re feeling lonely right now or whether you’re not, you undoubtedly know people who are lonely and all of us are at risk of loneliness at various points in our lives. Loneliness isn’t something that you’re born with and affects you for your entire life. We go through natural periods of connection and disconnection in our life. And the question is, how do we prepare for that? How do we deal with it? How do we build a strong foundation of connection to begin with? So there are a couple of things in the book that I go through that are, I believe, helpful in building that connected life. One of them unexpectedly is service.
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
It turns out that when we serve others, we actually break some of these very negative patterns of loneliness that get in and basically launched within us as a part of our evolutionary history, those patterns being the focus on self and also the elevated threat level that we experience when we’re lonely. Because when you help somebody else, first of all that takes you away from a focus on yourself and you’re focusing on another person, but the second thing is, it’s also disarming, like when you’re helping other people, you’re also reminded of what value you have to offer to the world and that’s actually reassuring, that lowers your sense of threat. So service is a powerful way to connect with others and also to reconnect in a sense with ourselves, our own sense of self-worth and value.
Dr. Vivek Murthy::
The second thing though that can help us on an individual level, is to think about where we’re spending our time when it comes to social relationships. So number one, are we making sure that we have at least five to 10 minutes a day that we’re spending with people we love that could be spending in person, it could be speaking to them a phone, or through video conferencing, but are we spending five to 10 minutes with someone that we love every day. And this might seem very simple…
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
But you’d be surprised how many people can go for days without having a meaningful conversation with somebody. The third thing with…
Dr. Mark Hyman:
Yeah. Can I interrupt you for a second?
Dr. Vivek Murthy::
Yeah, of course.
Dr. Mark Hyman:
So, it just reminded me with my wife. Because life’s busy, crazy and running around, we have a little ritual we do called, “What’s up below?” Which is not just chit chatting about the logistics of our life, what we’re doing that day, but we’re going sit down with each other, whether it’s having coffee in the morning, or at the end of the day and it can be five minutes or we can go for half an hour, an hour, but it’s what’s up below, like, not just on the surface.
Dr. Vivek Murthy::
So beautiful.
Dr. Mark Hyman:
And we go in and we just listen to each other and we get each other and like, “What’s happening in your world? What do you care about? What’s upsetting you? What’s thrilling you? Whatever going on.” And it just creates such a deep, powerful moment of like being seen and seeing somebody else. It’s so powerful, and we don’t do that, and you can do that with a friend, you can do that with-
Dr. Vivek Murthy::
Yes.
Dr. Mark Hyman:
I do that with my children. It’s a very powerful, simple thing of just say dropping into place below the just surface level of life that we’re all doing all the time.
Dr. Vivek Murthy::
Yeah, that’s such a beautiful example, and what I love about that is, Mark, I imagine with you and your wife, you could easily get caught up in the logistics of life and spend that 10 minutes…
Dr. Mark Hyman:
Totally.
Dr. Vivek Murthy::
… just talking about your calendars and your schedules…
Dr. Mark Hyman:
Yeah. Yes.
Dr. Vivek Murthy::
… and who’s going to get groceries and who’s going to get the car fixed. And I fall into that with my wife as well, because there are a lot of logistics in life.
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
We got to work through, but even just that five minutes can make an extraordinary impact. And that comes down to also another point about the quality of time that we spend. So technology is really interesting, and we can have a conversation about technology and how it’s impacted our connection with one another, but one of the things that I think that many of us do now, and I certainly have been guilty of this, is we have allowed technology, particularly our phones, to dilute the quality of our interactions with other people…
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
… because we bring our phones often to the dinner table or and we might convince ourselves, “Hey, I’m not really paying attention to it. I’ve got it in silent. I’ve put it face down. I’m not really paying attention to it.” But we actually know from studies that when there’s a phone, even within sight, even if it’s on vibrate and face down…
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
It actually changes how people feel about the conversation in a negative way.
Dr. Mark Hyman:
That’s true.
Dr. Vivek Murthy::
And so-
Dr. Mark Hyman:
But there’s a restaurant called Hearth, which is in New York City and they have a box on every table that says, “Please, open me.” And you open it up and it has an invitation to put your phones in the box for dinner.
Dr. Vivek Murthy::
Oh, beautiful.
Dr. Mark Hyman:
And there’s a game I always play with my friends, everybody has to put their phone in the box, the first person to take it out pays the bill. There are simple fun things you can do that actually help you stay more connected, I love that.
Dr. Vivek Murthy::
Absolutely. That’s a great idea. So just like that, in the book, what I’m trying to do is I try to share some stories that lay out some individual steps we can take in our lives, but also the stories that talk about what schools and workplaces can do and are doing already, in some cases, to create a culture of connection. Because at the end of the day, Mark, like if we want to create real connection, if we want to build a people-centered life and a people-centered society, it’s going to involve more than programs, it’s going to require us to shift culture and to ask ourselves what’s really important.
Dr. Vivek Murthy::
Now, if we got a group of 100 people together on any street corner in America, my guess is that if you ask them to name their top three priorities, that people would be at the top of that list, people might say, “It’s my daughter, or my son, or my spouse, or my mom or my dad.” But if you look at how society-
Dr. Mark Hyman:
They behave.
Dr. Vivek Murthy::
Yeah, how where we put our time and energy and where frankly society nudges us to spend our time and energy, it’s not usually with the people we love most. It’s in investing it in places where we can acquire greater power, reputation, and wealth. That traditional marks of achievement in modern society. I’m not saying that those aren’t important or those are shouldn’t be pursued, it’s a question of where are they on the priority list. And I worry-
Dr. Mark Hyman:
Or it’s your Facebook feed or Instagram feed or your email or-
Dr. Vivek Murthy::
Right.
Dr. Mark Hyman:
You know, it’s like-
Dr. Vivek Murthy::
And with those feeds in particular, like I think about like our childhood and about the childhood that my kids will be experiencing and in modern childhood, I think the messages, the cultural messages about what matters are just coming at you 1000 times faster and I meet so many young people who are feeling and because of this culture of comparison on social media, that they are not thin enough, that they’re not good looking enough, that they’re not popular enough or funny enough, or they’re not enough.
Dr. Mark Hyman:
Or rich enough or whatever.
Dr. Vivek Murthy::
That ultimately that they’re not enough. And that has actually a very powerful and insidious effect on our connection with other people and this is one of the things I think that is not often well-appreciated, which is that our connection to other people is ultimately built on having a strong connection to ourself. Now, what does it mean to have a strong connection to ourself? It means to know that we have a sense of worth and value. It means to recognize that we are human beings who have something meaningful to add to the world, and that requires a combination of self-knowledge and self-compassion.
Dr. Vivek Murthy::
Now, how do we develop self-knowledge? Well, we develop it partly by living life, but not only by living life, by having time to reflect and time to think. And much of that whitespace in our life that many people use to ponder and reflect on things on, that has disappeared. It’s evaporated as now in the five minutes you have between events or when you’re waiting at the bus stop, we just pull out our devices and look at the news or check our inbox.
Dr. Vivek Murthy::
But ultimately, if we are not able to support particularly among our kids, a healthy sense of self, if we’re not able to convey to them and help them understand what it is that makes them worthy, invaluable, and that it’s not what they’re wearing or how much money their parents have in their pockets or how popular they are and what parties are getting invited to, then we are going to run into a situation where people feel less and less adequate and then they will trust seek to be the people that they think other people want them to be. And when we do that, that’s a recipe for loneliness. When we try to be something we’re not, when we can’t inhabit in our own skin, people feel lonely.
Dr. Vivek Murthy::
That’s why workplaces often struggle with loneliness because for years, we have told people that, “Don’t bring feelings to the workplace and check all of that at the door, and you’re not here to make friends, you’re here to get work done, and keep your friendships and your personal life outside.” And the truth is that’s just not a natural way of living.
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
We don’t operate like that as human beings. And if we have to be somebody that we’re not in the workplace, that increases our likelihood of being lonely there, too.
Dr. Mark Hyman:
Yeah, it’s true. I mean, we certainly are trained as doctors to not emotionally connect with our patients, right? And I’ve fought that from day one and when you sit and really get someone and you listen to them and what matters and what they care about and you really are present with them, it just so powerfully healing. Forget any other medicine, right? And I think that’s one of the real gifts.
Dr. Mark Hyman:
And I think I just want to come back to the whole service concept because I don’t know if people understand what that means. When we look at how we’re designed, there is a sort of altruism gene that we have. Wilson talks about the social conquest of the earth, his book, that we cannot survive in isolation and that we’re hardwired to support each other, help each other, connect with each other, and aid other. And the biology of it’s very fascinating, when you look at the areas of the brain that gets stimulated by altruism or service or helping others, it actually is the same area of the brain that gets activated with heroin or cocaine or sugar.
Dr. Mark Hyman:
And I remember going to Haiti and it was just awful, horrible scene with 300,000 people dead, 300,000 wounded. I mean, the military who was there, the 82nd Airborne said they’d never seen anything like this in their entire careers and the wars in Iraq and Afghanistan and we’re in the middle of it, and I was working 20 hours a day and it was horrible conditions and no food or water. I mean, it’s really tough. And yet I was really happy in this weird way because I was just serving, I was helping, I was serving. It wasn’t for me, it wasn’t for my ego, it wasn’t for anything my bank account, I was volunteering.
Dr. Mark Hyman:
And it was the time that I felt most connected and most fulfilled to what really mattered and I really think, we need to have a society where we are helping each other and are connecting with each other and it doesn’t require anything other than to look around you and see who’s in need or what needs to get done in your community and trying to be that person who can be of service because it will not only help you with your own emotional, physical and mental health, but it’s going to create a culture like you said, of kindness, and love.
Dr. Mark Hyman:
And that’s such what we need in America today, around the world globally, because we’re in a sort of veering the opposite way, and I think that’s why your book is so critical, and I encourage everybody to get a copy of Together: The Healing Power Of Human Connection In Sometimes A Lonely World because if all of us took up this book and implement it in our own lives and implement it in our workplace, in our schools, in our families and our communities, I think this country would turn around pretty fast.
Dr. Vivek Murthy::
I certainly hope so. That’s my dream.
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
That we will together be able to build a more connected and more fulfilled society.
Dr. Mark Hyman:
And what are the what are the challenges some people have to actually doing this in their life? Because it sounds like everybody would want to do this, but how do people get over those obstacles?
Dr. Vivek Murthy::
It’s a great question. I think there are a few key obstacles that come up. Number one, sometimes people feel that focusing on connections in their own life is somehow self-indulgent that they should be focusing on doing more at work, on getting that promotion, on building up their bank account, on taking their kids to activities.
Dr. Vivek Murthy::
Busy parents, I think, are very interesting because I think a lot of them struggle with loneliness especially in the early years when their kids are 1, 2, 3, 4 years old before they’re in school. It can be very all consuming as a parent to really take care of your children, and that can isolate you from others. But I think this feeling that somehow investing in our connections is a luxury, that it’s self-indulgent, and I think is one of the reasons why people don’t do it more.
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
I think the second reason is that again there’s a sense of shame that people have and even admitting to others that they need some more human contact, that they need some time with their friends. They don’t want to seem desperate or needy, or somehow, again, not likable, or can outcasts in some way. So people have a hard time not just acknowledging to other people, even acknowledging it to themselves.
Dr. Vivek Murthy::
And I think the last thing is there’s a structural issue as well, which is that if you look at how our lives are designed with spending so many hours at work and many people have to commute many of those hours, there’s a question of time that comes up, which is where am I going to find the time to go and interact with other people, and to take a vacation with my best friends, which I haven’t done in a long time, or to finally make time to go away with my spouse for a weekend.
Dr. Vivek Murthy::
And those questions feel really burdensome. I mean, you feel really tiring when you think about, “Oh, my God, that’s so hard. Let me just keep going with life.” But this is where I think it’s so powerful and important to recognize that the dividends that come from just a small amount of time spent in connection can last for hours, days, weeks, or even longer.
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
And that’s why the five or 10 minutes that you spend with someone that you love can be really powerful. I’ll tell you about something I did in my own life that helped me, which is that I made a decision after residency training when I had just gone through several years of caring for incredibly sick people, including people who were very young, I remember being on the Oncology Service and half the patients I was taking care of were all young people in their 20s who had gastric cancer or other malignancies that were in their end stage. And I remember at the end of that thinking, “God, I need to think about my life. And I don’t know like that could be me.”
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
“And am I spending my time the way I want to be spending it?” So I made a decision that I would make it a point to go home and visit my parents and my sister more often and that’s when the frequency of my visits actually changed.
Dr. Vivek Murthy::
A year or two ago, I was actually out in Colorado for a fellowship retreat and at a point where I was struggling to figure out what I wanted to do with my life and I was also feeling kind of isolated. I was in the throes of early parenthood also and I was all-consumed with the care of our kids, which is wonderful and such a blessing, but really not having much in terms of relationships outside. And I ran into these two friends there, who I love, but who I rarely ever see. And we talked about how we wish we got together more often, but we just don’t. And then in that moment, I said, “Why don’t we do this?” I said, “Why don’t we build a moai together?”
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
Moai is a Japanese term, actually. The whole story about a moai in the book, but it’s an intentional community. So I said, “Because we know we’re not going to see each other probably for another six to nine months, why don’t we say that every month that we are going to get on video conference together and that we’re going to have a two-hour conversation. And let’s also say that we’re going to be real with each other, that we’re going to talk about the issues that we are struggling, the stuff that really matters to us.”
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
Things like health and finances and our relationships with family, which people don’t get into often because they’re sticky.”
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
It’s the stuff that we all are struggling with, and so we’ve been doing that for the last year.
Dr. Mark Hyman:
Yeah.
Dr. Vivek Murthy::
And it’s been so incredibly gratifying.
Dr. Mark Hyman:
So, healing.
Dr. Vivek Murthy::
So anyway, the point is that there are reasons to not connect, but once we realize the power of even a small amount of time spent connecting with others, once we realize that we don’t need anything else to do that, we just need our intention and a willingness to show up, to listen to be vulnerable and open with other people in our life then we can start building that road toward living a truly connected life and I think that is what holds the key to greater health and also greater fulfillment.
Dr. Mark Hyman:
That’s so true. Thank you for doing this, writing this book. I think it’s those micro steps whether it’s five minutes a day whether it’s finding some old friends and reconnecting like you did, whether it’s finding a place to be of service in your community, you don’t have to have some big giant community that you’re building overnight, but those micro steps make a huge difference and will help heal so much of the suffering in the world.
Dr. Mark Hyman:
So thank you, Vivek, for writing this book. I want everybody to get a copy it’s Together: The Healing Power Of Human Connection In A Sometimes Lonely World. You can learn more about it go to his website, which is vivekmurthy.com, V-I-V-E-K-M-U-R-T-H-Y.com/together-book. Please get it anywhere you get your books. If you love this conversation, please share it with your friends and family on social media. Leave a comment. We’d love to hear from you. Subscribe wherever you get your podcasts and we’ll see you next week on the Doctor’s Farmacy.
Dr. Vivek Murthy::
Thanks so much, Mark. It’s so much fun to do this together.
