A Bit of Optimism - Dr. Mark Hyman: To Live Longer You Need...

Episode Date: November 19, 2024

Close friends are the best thing for your health. Friendship, it turns out, is one of life’s best medicines.If you don’t believe me, believe Dr. Mark Hyman. Mark is one of the leading voices in the functional medicine movement, which is all about taking a holistic approach to our health for natural healing and preventing disease. The smallest changes in our daily lifestyle habits, or what we eat and drink, or our positive social interactions can have huge impacts on our long-term health.I sat down with Mark to talk about my most recent obsession – friendship. I was eager to get a physician’s perspective on all the ways friendship is beneficial for our health. In this conversation, we discuss the biological benefits of talking to a good friend and why you’re only as healthy as your five closest friends.This…is A Bit of OptimismFor more on Mark Hyman and his work, check out:The Doctor’s Farmacy podcastFunction Healthdrhyman.com

Loneliness is as big a killer as anything else. Some have said it's equivalent to smoking two packs of cigarettes a day. There's a huge biology to it. Why aren't doctors prescribing to spend more time with friends? I do. We are what we eat, or so the adage goes. But it turns out that statement is actually medically true. Dr. Mark Hyman is one of the leading voices in the field of functional medicine,

which basically means that if we feed our bodies the nutrients it needs, not only does it help us prevent illness, but we can actually supercharge our immune systems to heal us when we get sick. So I wanted to talk to him about something we need in our lives as much as we need food. Friendship. World leaders ask Mark for health advice. He's the author of 15 books, many of them New York Times bestsellers, and the host of the podcast The Doctor's Pharmacy. So I really wanted to get his take. And it turns out, if we give our

friendships the same attention as we give our diets, it benefits our minds, our spirits, and our bodies. This is a bit of optimism. Mark, thanks so much for coming today. It was such a treat to sit down with you. There's so much I want to talk to you about. My big thing right now is I'm writing about friendship. Yeah. Sort of mildly obsessed with it.

It's a good thing to be obsessed with. It's a good thing to be obsessed with it. So I want to go down the path of the connection between health and community and health and friendship. You made a comment that you can't be a good friend if you're not healthy. If you feel like shit, you know, you can't show up and be present and engage and be there. And yeah, just even be present to have a conversation if you're foggy and fatigued and you feel like crap and you're dealing with all kinds of issues. It's hard to really be present.

And that's what you need to do to be a friend. It's a paradox because you need mental health to be a good friend. Right. But if you don't have friends, it's hard to have good mental health. Right. We have such a crisis of mental illness in this country. And part of it's because of loneliness, isolation, disconnection, social media, all the things that you're thinking

about and actually writing about, hopefully with your new book on friendship. But from my lens, when I look at people's mental health, I look at it through the lens of biology, because we now understand that the brain is obviously connected to the body, which has not actually been part of medicine. Isn't that a weird thing that that's a discovery that the brain is actually a part of the body? I mean, the old joke in medicine is psychiatrists pay no attention to the brain

and neurologists pay no attention to the mind, right? But now psychiatrists are paying attention to the brain and they're finding that brain dysfunction, brain inflammation is actually driving much of mental illness, everything from depression to anxiety to OCD to bipolar to schizophrenia to autism. All these things are connected to brain dysfunction. And yes, it can be caused by an external stressor, like a spouse dying or trauma or things that

are external, but it also can be caused by nutritional deficiencies and your microbiome and environmental toxins and things that actually are treatable and measurable there's a very famous trial in australia called the smiles trial they come with all these great names for studies but it's dr smiles no they essentially no i forget the acronym but it was essentially they swapped out you know i did a randomized control trial of giving people healthy whole foods and then versus processed food and there was a huge improvement in mental health by eating whole foods for on a depressed population they've done studies for example in juvenile detention centers with there's a lot of mental illness and these kids by swapping out the crap for healthy food had a 97 reduction in violence wow in 75 reduction in use of

restraints 100 reduction in suicide rates which is the reduction in use of restraints, 100% reduction in suicide rates, which is the third leading cause of death in teenage boys. Profound. In prisons, the same thing. You get prisoners healthy food compared to the crap, 56% reduction in violence. And it's not like you're putting them on, like they eat the food you give them. It's not like they're going to the fridge and choosing. So it's a great space for a controlled study. Yeah, it is. It is, right. Because there's no choice involved. Right. It is. Yeah. And so it's- It's not like they have a mindset of health., it is. It is, right. Because there's no choice involved. Right, it is, yeah.

It's not like they have a mindset of health. No. They're just eating whatever they're given. And then the violent crime goes down 56% in prisons. If you add a multivitamin, it goes down to 80%. Wow. And with function health, we're finding huge amounts of nutritional deficiencies. I just had a friend who's a vegan, and he was severely omega-3 deficient, very depressed.

And he's piling on omega-3s and his mood is completely different. And we know that omega-3s play a huge role in mood. We know that folate and B vitamins play a huge role. And we know that many people are deficient in these nutrients. And we can measure those biomarkers with testing that wasn't available before for people. Now it's accessible to anybody. Do you know what I think is really significant about this little insight, especially as we're relating it to friendship and having the mental capacity to be there for someone, having the strength of mind to be present for someone else as they're dealing with happiness or sadness or whatever they're dealing with, just being there to be a friend. So often when we talk

about nutrition, we talk about eating right. We talk about you. We talk about so that you can be healthy, so that you can live longer, so that you don't suffer from chronic disease. And most of us, let's be honest, it's the same reason we don't save money. You know, if it doesn't have an immediate impact, it's a slow boiling frog. You know, nobody plans to get diabetes. It kind of just shows up after years of being like, I'll deal with this tomorrow. In other words, we're crap at doing things for ourselves, even though the data is overwhelming that if you just exercise, sleep and eat right, you'll be fine and healthier. But to think about eating well as an act of service.

Yeah, to others. That I choose to eat well, not for me, though I may get benefits from it, you know, as an unintended byproduct. I choose to eat well so that I can be a better friend to you. I choose to eat well so that I can be a better friend to you. I choose to eat well so that I can be a better parent to my kids. So I'm less grumpy and less agitated. That's right. And to think of that, I think as an act of service. Yeah.

Yeah, that's right. Right. Well, illness starts with I, wellness starts with we. Oh, yeah. Isn't that true? And so I think the correlation, and this is the thing that drives me nuts when we think about things like innovation or health, is we make it a very I thing. You have to get healthy. You have to take a multivitamin. You have to exercise. You have to sleep.

But we don't make it about a we. And you know the data better than I do that when there's a group of people who are overweight and one of them decides to go on a diet, the disproportionately high number of them will decide to go on a diet. Yeah. If there's a group of smokers and one of them says, I'm going to stop smoking, disproportionately high number of them- Yeah, getting healthy is a team sport. Getting healthy is a team sport.

And we are absolutely influenced by our friends. Yeah. You're only as healthy as your five closest friends. So it raises the question. friends. So it raises the question, because clearly we're failing as a people, as a nation, at doing all the things you recommend. Because most of the things you recommend, at the high level, what you recommend is a lot of work, right? It can be or not. It's just what you set up for yourself. But at a functional level, a lot of the stuff that you recommend is not difficult, not expensive, and pretty basic.

Yeah. It's kind of silly, but it is. Right? And yet, for not any more money, I mean, you can buy broccoli cheaper than you can buy McDonald's, you know? For not more money, a little bit of effort, but not complicated things, we can all live much healthier lives, and yet yet we're not. And so it raises the question, you know, are we banging against our heads against the wall? We're repeating the same behavior, expecting a different result that maybe the drumbeat from the health establishment of change the way you eat, get more sleep, maybe work out. Like we're all exhausted. We all know that. It's not like, exhausted we all know that it's not like it's not like it's not like you're i think a lot of us know it but there's a whole subset of our

population that doesn't know what it means to eat well different problem yeah different problem completely agree it's shocking to me but it's true even in the and it's because the food industry has been so good at manipulating the public to think that certain foods are healthy that are not and they put health claims on labels of stuff that's the worst possible food all natural which means yeah my my basic rule is if it has a health claim on the label it's bad for you don't eat it you know if it has a health claim on the label because it happens if it's trying to hide something it's trying to hide something right it's like low fat low sugar sugar free like what else is going on right it's like it's like my my like i love my fiber you know my favorite ones are new and improved formula like what was in the old one yeah yeah like uh-oh so

so you were you were kind of going to the trap hole of we know what to do why don't we do it why don't we do it and i'm asking the question maybe if we refocused our attention in a different place let's call it friendship. With the rising rates of anxiety and depression and mental fitness challenges and inability to cope with stress and then the worst case, suicide, even the obsession with longevity, I'll throw that one in as well. Friendship is the ultimate biohack. It is. Friendship literally fixes all of those things. It is.

We know the data that people who have close relationships live longer. People who have close relationships are happier. And you look at Dan Buettner's work and the blue zones, and so much attention is put to them walking to the house and so much attention is put into what they're eating and how they're eating. But not enough attention is put into the fact that they're eating with their friends every single day. You're so right, Simon. I actually, I spent a lot of time in Sardinia and in Ikaria or Ikaria, however you pronounce it. It was just stunning to see the level of community and connection.

Even if someone, for example, like this woman, Julia, was 100. And she was, I'm 103 months. Like, you know, like I'm five and three quarters. I'm 103 months. I think when you're very young and you're very old. Every month. The half, the quarter count. And now she didn't have kids,

but she lived with her niece and nephew and there were no nursing homes. People just took care of each other. And it was really remarkable. And it was this guy, Carmine, who basically had this huge farm that he had his whole life and his family had. And he was 86 years old and he was raising animals

and had fruit trees and gardens. And he was feeding his whole community and family had meaning and purpose. And he would feeding his whole community and family had meaning and purpose. And he would live with his kids and his wife had died. But it was all this incredible sense of connection and community. And it's so essential. And I learned this lesson when I went to Haiti

after the earthquake. And I was the first medical team on the ground at the main hospital, the general hospital in Port-au-Prince. And it was a disaster. You can't imagine the scope. It was 300,000 people injured the main hospital, the general hospital in Port-au-Prince. And it was a disaster. I mean, you can't imagine the scope. It was 300,000 people injured and 300,000 people dead. Wow.

It was an unbelievable massacre that was a natural occurrence, but it was horrible. And so we got there and there were people helping. Everybody was helping. There was a sense of community and service and connection. And I got to meet Paul Farmer, who was a hero of mine. He was a doctor who went to Haiti and decided that even though the whole world had neglected this community of people who were suffering from TB and AIDS because they were poor, they didn't have sanitation, they didn't have clean water, they didn't have watches, they couldn't take the drugs, because it's complicated at that point to take the drug regimens for multi-resistant, drug-resistant TB or for AIDS.

And he realized it wasn't a medical problem. It was a social problem. He called it structural violence. What are the social, economic, and political conditions that drive disease? And it wasn't that we needed better drugs or surgery. We knew how to solve it. But the entire public health community had given up on him. So he started to help by building a network of community health workers, neighbors helping neighbors, friends helping friends.

And he called it accompaniment. And it was French, but I'm not good at pronouncing French. So I'm going to skip that. Accompagnement. Accompagnement. Yeah, something like that. And he built this whole model and he scaled around the world. It was adapted by the Clinton Foundation, the Gates Foundation to help. He did this in Peru.

He did this in prisons in Russia. He did this everywhere where people were struggling in Rwanda, built hospitals. And it was an incredible model. And I realized that most of the diseases we have now in the West are not infectious diseases. They're chronic illnesses, which are called non-communicable. What's the difference? Well, infectious diseases like malaria or measles or TB, right? These are the things that were killing us a century ago. Now they're pretty much not except in certain parts of the world.

But the disease we now have are what we call non-communicable diseases. But that's a fallacy because they are very communicable. They're not infectious, but they're contagious. And chronic diseases like heart disease, diabetes, cancer, dementia, autoimmune diseases, these are diseases that are driven through our diet, toxins, but also through our social networks. And I realized that our social networks were more important than our genes. The social threads that connect us are more important than the genetic threads. And the data is really clear on this. Chris Stock is a work out of Harvard, outlined this very clearly.

He wrote a book called Connected about this. But he's published the research that showed, for example, if your friends are overweight, you're 170% more likely to be overweight than if your family's overweight, you're 40% more likely to be overweight. Your social networks are driving your behavior for good or bad. So I realized that, yes, we have a society where the default is to do the wrong thing and that we as a society aren't supporting each other to do the wrong thing. And that we as a society aren't supporting each other to do the right thing.

And I realized that community was medicine, just like food is medicine, and that love is medicine. And that's, I mean, look, that's our anthropology, right? We're tribal animals that grew up historically in tribes about 150 people, and that's how we lived. We lived in these relatively small, we help each other communities, communes. I mean, that's how we lived. We lived in these relatively small, we help each other communities, communes. I mean, that's the history of humankind. We've only started farming 10 or 12,000 years ago.

But for most of human history, we lived in these small groups where we couldn't have populations larger than about 150. What's very interesting about the little statistic that you threw out, the thought that I had, which is when our family is overweight, we're 40% more likely to be overweight. But when our friends are overweight were 170 times percent I mean likely be overweight and that's you know, the immediate thing that popped into my head was When you think about children, right? Children all they want is their parents approval. Hey mom. Hey dad. Watch me. Watch me. Watch me. Watch me right and they have

No inhibitions in the outside world. They don't care what the world thinks about them at all. I'm going to dress like a princess. I'm going to dress like Spider-Man. But I want mom and dad to watch me jump off the step. And I desperately want mom and dad's approval. Right? And that's where all of the learning about what's appropriate and what's inappropriate comes from.

Strictly from our parents. Nothing else. Yeah. Until they reach about adolescence. That's a peer group. And adolescence, we convert to only needing our parents' approval to only needing our friends' approval. Frustrating for the parents, but very, very important for social animals

because what we're doing is acculturating outside of our families, beyond our families, into the broader tribe. And that lasts for the rest of our lives. We don't actually go back to the family. It's all friends, which is why I have to believe, and I'm just sort of thinking about this out loud now, I have to believe that's the reason so many of us go on Instagram and wish our parents happy birthday when our parents aren't on Instagram. Right? It's for the social approval that I'm a good kid and showing all the pictures of my dad holding me when i was a baby like scroll through all those pictures and everybody likes that i'm a

good son right and yet my dad's not on instagram right and so i have to wonder if that same drive that same weird need to want social approval for being a good son is the same it comes from the same root i mean 100 if you're if your friends are all drinking green juices and doing then you're gonna drink green juice and you're gonna do the same thing if all your friends the amount of shit that i take simply because their friends like you should do you know what you know it's equivalent to and i this because you because you're in the industry i'm gonna say something that's potentially insulting to you please that's what i like to do i like to have i like to i like to talk to guests and then insult them.

So this is potentially insulting to you. We're friends, everybody. So this is potentially insulting. So I need you to work this through me. Okay. It feels like, I can't say that it is, but it feels like that the complete explosion in the supplement industry where nothing is evaluated by the FDA and every influencer

now has a vitamin or a supplement or powder or a drink with all kinds of nonsense claims. Maybe they're good, maybe they're bad. It feels like we're living in the dot-com boom of supplements that, you know, in the dot-com boom of supplements. Maybe, yeah. That, you know, in the dot-com boom, you were like, I'm investing in this tech company because my neighbor told me I had to. Yeah. And now that's been replaced with, I'm now taking these 87 pills per day

because one friend told me to take these four, another friend. And just like the dot-com boom, you can't live in a bubble like that. It's going to have repercussions and it's going to be unexpected and it's going to be pretty violent. So riddle me this. Is it time for the FDA to get involved? I can no longer tell the difference between a claim on a product you're selling or a claim on something that some...

Literally their only qualification is they have a following on instagram yeah isn't isn't that a job being an influencer where was my course in college influencer 101 we're living we're living i think we're living in a supplement boom yeah it could be and it's's going to, I don't know how it suddenly, you know, kicks back. Yeah. But this can't, this can't last forever. Can't be good. Yeah, I think there. And it's counted to everything you're trying to do.

Yeah, what I want people to do is do the right thing. It's what I've spent my whole life trying to do is help people understand how to create health. And part of the new company I co-founded, Function Health, is really empowering people with their own health data to make choices that are personalized, that aren't just random because somebody said do this or do that. And so that's what I love about the testing. I had, for example, a friend the other day who showed me her results from Function, and she was low in zinc, she was low in iron,

she was low in vitamin D, she was low in omega-3 fats. I'm like, oh, that's why you feel like crap. You know, you need to take these things, and here's what to choose. But most people don't have a way of navigating this sort of morass of products that have again no regulations in terms of quality or efficacy now because people aren't protected in the sense that they don't know if the product they're taking has the exact ingredient it says if the dose is what it says on the label if there's any contaminants in it if there's any fillers or products that kind of may be harmful to you.

So it's kind of a shit show. And so as a physician, I've spent a lot of time investigating which companies are using pharmaceutical manufacturing practices, which do testing before and after their product. So they know that the purity and potency is exactly right and they throw the product out if it isn't. So there are good companies that are doing that. How do I even know? You can't unless you know what to ask.

I did a thing a while ago where... There's a way to learn about assignment. Where they took my blood and they evaluated all of everything in my blood from... I mean, you name it. All the minerals and everything I'm supposed to get and have. Yeah. And then they made-

A personalized cocktail. A personalized smoothie. Yeah. That replaced all my things and I'm supposed to come back every six months. Yeah. And it was really interesting. And then I talked to a doctor who walks me through my results. Yeah.

And then they give me my smoothie and the only choice I get is what flavor. And it sounded good until i was like i don't even know if this is bullshit yeah if they're just like i don't well that's a problem if someone's if someone's selling you something off of something else that can be a problem it's not always a problem but if you're saying i've done all of the things for a little bit like i took ag1 for a few months and i i mean i do I mean, I do all these things. I feel the same. Like, like I've, I've done AG1, I've done colostrum, I've done, I mean, I've, you know, and again, all because somebody's like, you should try it. And there are people who I trust. That's why I did it.

And you know, they like, you take these things, like it boosts your immune system. How do you measure that? Right. Exactly. I got a cold. So does it work or does it not work? Well, it would have been worse if you, I mean, like, I don't know. And I, you know, you say, I start, I get very cynical. Sometimes I'm all in and sometimes I'm very cynical. I'm in a very cynical mode right now. No, I hear that. I hear that. And I think it's fair and you're right to be cynical. And I think there's a lot of garbage out there and a lot of people pushing stuff. And there's a lot of companies, for example, doing tests and then selling you products on the back end. I think

there's a problem with that. For example, Function Health health we don't do that at all we just say okay for example you have these things that you found that you need to fix that are affecting your health and well-being and here's how to make a decision like for example we have a 30-page guide on how to choose the right and you don't take we don't sell and you don't take kickbacks from the products no no god no no kickbacks no we don't know we're completely agnostic. We don't have any part of it. Do whatever you want. You just need this. No, but not only do whatever you want,

but if you're going to, if you need something, here's how to choose the right product. Got it. And here's how to investigate the company. And here's the questions to ask. And here's what to look for. And here's how to make a good decision.

So we teach you how to fish, not giving you a fish. I like that you're doing this, but I remember I'm in a cynical mode. What else is new which is when there's when there's a good business model even if it's for the for the greater good because money is fuel and that's totally fine that means you'll have competition and other people will start doing similar things and then we're back at square one which is all of these companies are going to be funded by vc and you and i know too well unfortunately the way vc and pe works which is

they all are wonderful they're all fantastic in the beginning and they're so behind you and your vision at the beginning and just wait three to five to seven years and all of a sudden the pressures start to show up and the growth we want growth because that's our business model not your business model and then all of a sudden especially if you've given up controlling interests you will have built up this beautiful brand you get fired from your own company i mean the number of companies that have like the brand of veda burt's bees kashi amy's these were well they got bought by Kraft you know they were all great brands that built their brands

based on natural ingredients and we believed it because the founders were true and then they sold to Kraft and L'Oreal

and whoever buys these companies they strip the beautiful things out put the shit in because they can increase margin but we're none the wiser. We don't know which CEOs got fired from beautiful companies. We don't know that these companies are

owned by large conglomerates that are driven by shareholder value. And then we end up suffering for these products that we were told were good and they were good until they weren't good. And we're back at square one. So I think we should just have friends. Well, let's get back to the conversation about friendship because I think that the fundamental thing is- We should garden and farm with our friends. That's good. And then eat our own food. Well, we can't live... I mean, when you look at the problem- Subsistence farming. That's what- I think it's right. I mean, I think community

gardens are amazing. I think they're a great service for people. And I think that what we're finding is that loneliness is as big a killer as anything else. Some have said it's equivalent to smoking two packs of cigarettes a day. And how many, especially men don't have someone who's a good friend. Yeah. How many people don't have somebody to call when shit goes down? I go back to the work that I did some years ago when I was writing Leaders Eat Last with Alcoholics Anonymous. If you want to overcome alcoholism as a 12-step program, most of us are familiar with the first step.

You know, admit you have a problem. Yeah. Okay, let's say I'm depressed or I'm lonely. Let's admit that's the problem, right? But it's the 12th step that people don't talk about right and alcoholics knows exactly Alcoholics anonymous knows that you can master 11 steps and not the 12th and you also come to the disease Yeah, and it's the exactly to help another alcoholic its service Yeah, and so I think the people who are the most lonely are the ones who have to

go first. Because the way to solve your problem is to help your friend who's suffering from the same problem. If you're an alcoholic, you help another alcoholic. If you're lonely, help a friend who's lonely. And I think that the therapeutic benefits of helping someone who's struggling with the same thing that you're struggling with, than worrying about yourself goes right back to the gym. There's a huge biology to it too. I don't know if you know, but there's a whole field of sociogenomics, which is how our social interactions affect our gene expression. Say more. So if you're in a conflictual relationship with someone, your inflammatory genes are turned on.

Literally, not just your emotions are inflamedamed but your biology turns on the inflammation system. Like fight or flight kind of stuff? Not fight or flight. Just if you're like in a shitty relationship or if you're fighting with someone or you have a conflict, you turn on inflammatory genes that then increase expression of cytokines that cause inflammation and that cause disease. And all chronic disease from depression to heart disease to diabetes to obesity alzheimer's are all inflammatory diseases conversely if you have a connected loving relationship with somebody it turns on anti-inflammatory genes and this and inflammation is the core of like everything yeah and and maybe

the studies with entrainment you know where you have where if you sit with someone and you have a an authentic connection that you can put eeg and ekgs on basically brain waves and heart waves you can see the heartbeat of someone you're having a deep connected relationship with in your brain waves it's wild so it's not just a feel-good thing on an emotional level it's a physiological response that happens of being in connection. If you take animals and put them in cages and separate animals and feed them exactly the same thing and have everything else the same, the one that's isolated versus the ones that are connected will shrivel and die and get sick. And so humans are the same way.

And we've gotten into a situation where friendship and connection is sort of like really non-partisan. Okay. So why aren't doctors prescribing to spend more time with friends? I do. Like doctor, I'm suffering from X, Y, and Z. Okay, I'd like you to try and get an extra hour of sleep, go to bed a little earlier. I'd like you to stop eating before, don't eat past eight o'clock at night. And I want you to spend at least three hours a week with a friend."

How come that's not on a prescription? It should be. It should be. It should be. I mean, I prescribe it. In fact, based on this work that I did in Haiti, I met a pastor after Rick Warren who wrote The Purpose Driven Life and had a church with 30,000 members. And I met him.

He came to my office and we started talking. And I said, hey, you know, Rick, tell me about your church because I'm a Jewish doctor from New York. I don't know much about evangelical Christian churches. Like, yeah, we got 30,000 people. Like, wow, it's a lot of megachurch. He's like, yeah, we got 5,000 groups that meet every week, small groups in the church to help each other live better lives. I'm like, oh, this isn't a megachurch.

This is thousands of mini churches. And I had that light bulb moment. I'm like, well, I just come back from Haiti. I said, why don't we put a healthy living program into the groups and see what happens? He said, great idea. Because I was baptizing my church last week. And after about the 800th person, I'm like, man, we're a fat church. And I'm fat. And we got to do something about it. And so we put a program together through the small groups where people were just helping each other. There was no doctor, nutritionist, health coach, nobody. There was just a curriculum. We had a big rally, sort of a big event where we talked about and Rick talked about the biblical rationale for why God wants us to be healthy.

I gave a bunch of speeches and talked about how, you know, God lives in you. Why are you feeding him crap and things like that? I mean, you know, if Jesus came to dinner, what would you feed him? You know, a Big Mac, fries and a Coke. And they got it ain't that the truth ain't that the yeah jesus came to dinner what would you feed him exactly so they got it i said you know if you feel like crap how are you going to serve god how are you going to serve each other you've got to take care of your body and and so they got it and they did this together in community was jogging for jesus and they all these incredible it was incredible And they lost together a quarter million pounds in the first year and

they did it together. And then I took that same model and I applied it at Cleveland Clinic where we created small groups where people helped each other. We did research on us and published it. There were three times better health outcomes on validated metrics of health outcomes compared to one-on-one visits for the same condition with the same doctors. So the doctors in our clinic could see them in one-on-one or they support them in a group. The group was three times as good as seeing the doctor one-on-one in terms of health. But why aren't these things then being implemented across the medical field? I'm trying. I'm trying.

Why aren't we going to the doctor with our friends to deal with similar issues? Why aren't we, like everything's so siloed? It is essential. I mean, I think, you know, the models of support, whether it's coaching, whether it's one-on-one coaching or support, whether it's group models, they have to be the thing that's going to change because we get healthy together or we get sick together. What did Benjamin Franklin say? We must all hang together

or surely we'll all hang separately. I mean... And I think that's kind of where we're at in society. That is kind of where we are, yeah. One of the problems we have in our society is community things, you know, bowling leagues don't exist anymore. Church attendance is down.

Yeah. And church attendance and faith are not the same thing. You know, you can have faith and not go to church and you can go to church and not have faith. That's right. The church would rather that they're overlapping. But the idea of doing things in commune, in community, this is why I love things like Comic-Con or Burning Man or whatever you're, you know. Now you've never been to Burning Man.

I have been to Burning Man. You have? Yeah. And Sturgis, the motorcycle thing. Hell's Angels. Like all of these things. Doing things in community with people who have common interests. Yeah. And one of the questions I'm getting since I've started talking about friendship, it's

amazing how many people are coming up to me who are of all ages, of all income levels, who are saying to me, I don't know how to make friends yeah i struggle to make friends because we're afraid to be authentic i mean that's the hard part right is have you ever struggled to make friends uh when i was a kid i didn't have any i was a weird kid i just was in my head read a lot of books it was a little weird and uh you know kind of a nerd i I just I was living in Toronto in the 70s it was spiritual wasteland and in fact I actually my first real friend I met on the top of a mountain in the Canadian Rockies we were backpacking and

it was a week out in the middle of nowhere by myself and he was a week out and we crossed over on Badger Pass in Banff National Park and we just had this kind of moment of connection. And we both found out we're going to be at Cornell in the fall. He was in Ithaca College. I was at Cornell. We got back and we got together. And, you know, we didn't know if we were going to be friends or not.

But we became like brothers. Still friends today? He's my best friend. Yeah. No kidding. 46 years later. Wow. Yeah. 46 years later. Wow. Yeah, 46 years later, we do mountain bike trips all over.

We're very close. And we help each other. And when one's down, the other picks one up. When I'm down, he picks me up. When he's down, I pick him up. And we've had this really sustained, deep, authentic, intimate relationship for 45 years. That's amazing. And we love each other.

We hug each other. We cry together. We laugh together. And it was a place where I could say and be and do anything. And it was a remarkable experience for me to actually feel seen and loved. It was like the first person who loved me who didn't actually have to love me like my parents. Here's something I discovered about close friendships, right? Which is we always talk about close friends as the person you would call when you're in need, when you need help, the person you can cry with, the person when you're in pain. And I actually think that's true. That's a level of close friendship that you can call that person in a time of struggle or need. But I think there's even a closer level of friendship, which is when you can call somebody when something amazing happened. Yeah. And they're not jealous.

And there's no jealousy and you can call them and what you're doing is bragging, but not really. You just need to tell someone about this amazing thing that you accomplished or that was given to you or that you won or that, you know, whatever it is. And if you were told anybody else, they'd be like, they think you were bragging. Yeah. Yeah. But to that friend, they have unbridled joy with you and for you. And what I've learned is the number of people I would call with good news is actually smaller than the number of people I would call with bad news. That's interesting. But you can call me with good news. Oh, thank you. I'll celebrate you.

But you know what I mean? Yeah. Well, it is. It's important to take an inventory of your life and your friends. And if you don't have good friends, it's really important to cultivate them, to invest in them, to find them. And there's ways to do that. I mean, there's ways to put yourself in environments and situations. And I don't know, you probably saw those articles in the New York Times about men and friendships. And it was just so heartbreaking.

And when COVID happened, we're all isolated. We're all alone. It was just so heartbreaking. And when COVID happened, you know, we're all isolated. We're all alone. And September 2020, my wife and I split up. I had just had back surgery. I was alone.

It was COVID. And what did I do? I sent an email to my closest men friends, six other men who I've, you know, done men's work with, done men's retreats with, done medicine journeys with. And I said, hey guys, can we start a little Zoom once a week for an hour maybe? And they're like, how about we do two hours every week? And we've been going for, it's plus four years now. And it's remarkable to have this container. And what's been interesting to watch is that even

though these were all my close friends for 40 years, 30 years, that the depth of our friendship has gotten more profound, the more vulnerable we've gotten, the more we open our hearts, the more we share our fears, the more we share our successes, the more we share, whatever is going on in our life doesn't matter. There's always something with one of us. And to me, it's like an anchor. Another friend of mine is struggling with one of her friends. And she asked herself, if I was in a marriage or just a romantic relationship, a long-term romantic relationship, and the relationship was struggling, we wouldn't just break up. We would get help.

We would seek therapy, couples counseling. And so she went to her friend and said said this attention has been going over too long We're gonna go to therapy together friends therapy, yeah, and Again, why why do we instinctively understand that if a marriage or a relationship is struggling that we expect people to at least try To at least try the couples therapy before you call the whole thing quits. And yet we don't do that with friendships. When we have tension with friendships, we're quicker to end the friendship or sit in weird tension or avoid the person than to go to the therapy with the person to try and work through the struggles.

We may still end up breaking up. Yeah. But let's at least put in the effort yeah to rescue this friendship that we claim we care about yeah i love the idea of friendship counseling and it speaks to that same point about like not just co-living in a sense of just doing things together existing together yeah going to movies together and having fun together rather yeah just superficial dinners and by the way i i will stress that i don't believe all french friendships need to be at this level like it is perfectly fine to have at. You need at least a couple, two or three.

You need at least a handful. Some have more, some have fewer. But having friends where they're not deep bonds of vulnerability, you just have fun together. Totally fine. Adventure partners or activity partners, totally fine. And I think that's one of the problems we have in our country, if not the world. I don't know about other languages. I only know about English. But like one of the problems I think is language. So for example, if you have stage four liver cancer or you have a mild melanoma, the problem is both of those things are called cancer.

But they are clearly not the same thing. But we use the same word. Right. I have a skin cancer. Right. Exactly. I was like, you're fine. You know? Right. What did Larry David say but we use the same word. Right. I have a skin cancer. Right. Exactly. I was like, you're fine. You know, what did Larry David say? It's the good cancer. And I think we do that. I think we have very few taxonomies. We have very few words

for friends. And so I've started using. Best friend, friend. Yeah, that's pretty much it. And even then best friend is sometimes a little overused. When somebody says, hey, aren't you friends with them? I go, I'm friendly with them. Or somebody says, aren't you close with them? I'm like, no, they're an acquaintance or they're a work friend. And so I've actually started to use the language for my own clarity and for other people's clarity. Not everybody I know is my friend that I'm going to like. You can't have an infinite number.

I can't have an infinite number. I can't have an infinite number. It takes time. It takes time. Investment is a real thing. This is a central part of happiness, of joy, of longevity, of health. By the way, go back to that longevity thing. You're in that space and you know more of them, but I know some of the folks who are sort of like the longevity folks. Yeah.

And I find a lot of them are very unhappy people. Yeah. Joy, right? Where's the joy? These guys, mostly men, who are obsessed with longevity and they're taking all of the measurements and they're taking all the vitamins and supplements

and they're doing all the exercises and they're doing all the things and everything's scheduled and highlighted. And I find them not very happy people. no you know find the joy like where like maybe work out a little less don't worry about if you miss the supplement and maybe just hang with friends i bet i mean the data will prove it out like we have to wait a bunch of years because the longevity out like we have to wait a bunch of years because the longevity obsessives the only way we'll know if it works or not is when they die yeah and if and if they will be happy and healthy in old age because nobody wants to live a long time and be decrepit no you know and so we have that's why

like i most of my friends are in their 30s and 40s now because like you know a lot of my older friends have just sort of checked out. But we have to redo this podcast in 40 years and see if all the longevity obsessives, if they're still around or if they're dead. I'm going to do a Vegas betting pool here,

which is I would bet that the people who are healthy-ish, like they're not unhealthy, but they're not obsessively healthy. Yeah. Right? Like, yes, they get enough sleep. Yes, they eat mostly well.

You know, like good. They do the basics. They do the basics. They're not unhealthy. Yeah. Is the way I would define them. But they spend a ton of time with friends and they have a fantastic sense of humor. And they love to laugh.

I will bet money that those people will live longer than all of the folks who are measuring and i agree and powdering and i mean it's it's evolutionary i mean i don't know if you know ea wilson wrote a book called the social conquest of the earth about from ants to humans how we have to work together to survive yeah and in fact altruism is a built-in phenomena and that it activates the same neural circuits as heroin or cocaine or sugar in terms of the nucleus accumbens and the pleasure and i i remember this it sounds kind of weird to say but when i was in haiti and i was sleeping four hours a night and i was working helping people all day you were barely eating anything probably dehydrated in the hot sun i felt like

the sense of happiness and joy like i'd never felt and it was weird because i was in the hot sun. I felt like this sense of happiness and joy like I'd never felt. And it was weird because I was in the middle of this disaster with people with limbs amputated and dead people everywhere. But something was happening in me where I was in service of others. I wasn't thinking about myself. And it's sort of why do what I do. I mean, I'm happiest when I'm serving others. There's a book called Survival of the Friendliest. That's good. when I'm serving others. There's a book called Survival of the Friendliest. That's good.

And it makes an argument that we've completely misunderstood Darwin. That the idea of survival of the fittest, we have always attributed to brute strength. And so if you can overpower someone, you're more likely to survive. And they make an argument for social animals and mammals

that that's actually completely incorrect. That what he meant by fittest was most fit to create community and take care of each other. And survival of the fittest is actually nothing to do with brute strength. I'm fascinated. But it's actually to do with the ones

who are better at taking care of each other. So as you start to think about this book, Simon, and I can't wait to read it even though you haven't written it yet. That's a good sign. I should put it up on Amazon. Drive those pre-sales before cover to come title to come yet untitled book yeah and you know as i think about it i don't

i don't i can't think of a lot of books on friendship well this is this is the reason my friend will and i decided my friend will gadare and i decided to write this because it seems to make sense that you should write a book about friendship with a friend. Writing a book about friendship by yourself doesn't make sense. So Will and I decided to write it together. And we came to the realization that there's an entire industry to help us be better leaders. An entire industry to help us be better parents. An entire industry to help us thrive in our relationships. How to eat better.

How to exercise better. How to live longer. And yet precious little. I've written many of those books. And yet you've written all those books and yet precious little, yet precious little on how to be a friend. That's right. And when you look at all the challenges, as we said, in the world of depression and anxiety

and all of the, all these epidemics that doctors and well-intended folks are talking about, no one is talking about friendship as the antidote. And I think that friendship is the ultimate biohack. I think if you can master friendship, a lot of those other things correct themselves. It's true, it's true. People listening, I imagine, are thinking, oh, this is great, I feel this, I know this,

how important, and I feel the disconnection. But I don't know how to make friends. I don't know where to start. I don't know how to take the. I don't know where to start. I don't know how to take the friends I have and make them better or find new friends. I don't know how to make friendship the medicine that I need in my life. Yep. So I think starting with common interests. Sign up for a ceramics class and go by yourself. Or if you're too nervous to go by yourself, go with a friend, but talk to the person you're sitting next to. Because the great thing about doing a thing with common interests is the ice

breaker is really, really easy. You just have to say, is this your first time here? Have you done but talk to the person you're sitting next to. Because the great thing about doing a thing with common interest is the icebreaker is really, really easy. You just have to say, is this your first time here? Have you done this before? And it pretty much starts the conversation. You don't have to form a deep, meaningful relationship out of it.

But I think starting to do hobby things and I think having hobbies, and we've seen the decline in hobbies even, you know, and doing hobbies with people. That's why I say- Join a club. Yeah, that's why seen a decline in hobbies even, you know, and doing hobbies with people. That's why I said... Join a club. Yeah. That's why I said, go play chess, you know, in a park, you know.

That's why I said, I think things like Comic-Con and things like that are spectacular. Because when you find a group of people who, when people laugh at your hobby, and you find a group of people who we've all been laughed at, but now we're the norm here, it's incredibly easy to make friends. I've been to Comic-Con many, many times. And, you know, it's nerdvana. What is Comic-Con? You don't know what Comic-Con is? No.

Vaguely. Well, it's changed over the years. But basically, it's a comic book convention. That's what I thought it was. That's the history. But these days, comic books are only a part of it. It's what I thought it was. That's the history. But these days, comic books are only a part of it. It's also science fiction

and hero movies, you know, Marvel stories and Star Wars and, you know, DC and all of that. And it's all that nerdy kind of pop culture-y stuff. People will dress up as their favorite cartoon character

or superhero or, you know, some obscure character and some of them are super creative and some, and it's, and, you know, some people are there for them are super creative. And some people are there for the content of the convention. And some people are there just to walk around in costume and have fun. And what's so wonderful about it is it's an incredibly polite group of people. So if you are in a great costume where you see someone who's in a great costume and you want to

have a picture with them or they want a picture with you, everybody asks. Everybody goes, can I have a picture with you, please? Or, hey, may I have a picture with you, please? Or hey, may I have a picture with you, please? And so there's a lot of interaction. You can go up to somebody and say, I love your costume. And they will be friendly back. There's not a lot of cynicism. I met one of my ex-girlfriends there. I literally went up to her and said, you look amazing. Can I have a picture with you? And she goes, absolutely. We took a picture together because I just loved her costume. I don't remember how the conversation started, but we ended up talking a little bit for just a few minutes. I don't know how we got to it, but we ended up trading phone numbers. And then we ended up having sort of a really great relationship. And the best part about that is I still have the photograph, not from our first date. I have the photograph from the moment we met, which doesn't happen in relationships. You don't say, nice to meet you. Let's take a selfie just in case.

Right. Right. You know, but I have the photograph of the time that we, the minute we met. Yeah. And I think when you go to places where people like the things you like, it's going to increase the odds. And it's not that you increase the odds that you'll find a deep, meaningful relationships, but it makes it easier to break the ice. To just get started. To get started.

So what's your goal with your book? What's the sort of aim you're targeting? You know, I'm somebody who has had very few long-term relationships in my life. And the world criticizes me for that. I'm seen as unhealthy or I've been judged as having commitment issues. You mean love relationships or just friendships? Love relationships. Yeah.

You know, I've never been married. I don't have a 10-year romantic relationship. I haven't had it. And even some of the women I've dated, they're like, what's wrong with you? Me neither. I mean, divorce four, five, three times. What's wrong with you is what I hear a lot. Right.

And I have a friend who was in a 16-year relationship, an unhealthy relationship for 16 years. She freely admits that she should have stayed in that relationship for one year. And yet society looks at her and says, she got it right and I got it wrong, which is twisted. And if you look at the quality of my friendships, like I have a lot of really, really good friends and I am fulfilled in almost every aspect of my life, but just not necessarily all from one person. That's right. And look, I like relationships and I love being in a relationship and I love being a

partner to someone. And, you know, people say, well, why haven't you been married? I'm like, isn't it obvious? I haven't met the right person yet. That's such a stupid question. But I found comfort in recognizing that by fostering friendship, I don't have to feel guilty or bad or explain myself why I haven't had a marriage or a 10-year romantic relationship.

And friendships outlast relationships. And friendships outlast and friendships are there to help you through relationships. And if you don't have good friendships, you'll struggle in your relationships because you have to have somebody to ask advice or event to. You can't always go to one person. It won't work. And so I think we don't give enough credit to friendship. We don't give enough credit to friendship and we don't give credit to people who are good at friendship. We give credit to people who stay in relationships, even if those relationships are unhealthy. And I think we just need to reevaluate how we're managing relationship in general in our lives. I want to be a part of the friendship movement. I love that. I mean, it's interesting that one of the chapters of our book around how to get healthy

is friends. One of the five Fs. Yeah, exactly. Amen. Mark, I so appreciate you coming in to get a physician's perspective, especially the work that you do, because your work is so different

than traditional medicine where we treat illness, where your work is really about staying healthy and living healthy and you'll never get ill or your body will know how to fix itself. That's right. That friendship is a core part of staying healthy and helping the body fix itself and prevent itself from getting ill. Yeah, the biology of friendship. And on that note, my friend, thank you so much for having this conversation with me.

This has been great, Simon. So good. So fun. If you enjoyed this podcast and would like to hear more, please subscribe wherever you like to listen to podcasts. And if you'd like even more optimism, check out my website, simonsenic.com, for classes, videos, and more.

Until then, take care of yourself, take care of each other. A Bit of Optimism is a production of The Optimism Company. It's produced and edited by Lindsay Garbenius, David Jha, and Devin Johnson. Our executive producers are Henrietta Conrad and Greg Rudershan.