A Bit of Optimism - The Cure for Loneliness with U.S. Surgeon General Vivek Murthy

Episode Date: January 7, 2025

Loneliness has reached epidemic proportions. Where do we go to feel like we belong?As the Surgeon General of the United States, Dr. Vivek Murthy has been a leading voice in bringing the loneliness crisis to light, stressing its devastating impact on public health. As his second term nears its end, he leaves behind a powerful reflection in his letter, My Parting Prescription for America and the World.In an insightful conversation with Dr. Murthy, we delve into what it truly means to be healthy—not just physically, but emotionally and socially—and discuss why the pursuit of fame, wealth, and power often leads us further from what we really need.This…is A Bit of Optimism.To read the letter, visit this link: My Parting Prescription for America and the World To learn more about Dr. Murthy, click here: vivekmurthy.com

The most important thing about having people over is the company. It's not the setting. It's not the food. It's company. And that's what we remember whenever we go over to people's houses. So we just started inviting people over and saying, you know what? Our place is a total mess. It's chaos. The kids are probably going to be screaming in the background. We may have to leave multiple times to like figure out what's going on with them. And the food, food may be so, so we don't know. We can't,

I can't guarantee it's going to be amazing, but just come over. And people came. And you know what they said? They said, thank you for having us over. Thank you for making it okay to come to a home that's not totally spick and span because our home is the same way. People aren't coming for the food. They're certainly not coming for the furniture. They're coming for the company.

And all you have to do is be good company. Loneliness has reached epidemic proportions. We've all felt it. Whether you dealt with yours during lockdown or whether you're dealing with it now, we have all felt lonely. Which is why Dr. Vivek Murthy's work really, really matters. As Surgeon General of the United States, he was one of the first medical professionals to recognize that loneliness in our nation has in fact reached epidemic proportions. And more importantly, he's committed his time in office to help us recover. As he gets ready to end his term as Surgeon General, his last act of public service is

a letter he released, a prescription for America and the world. This is a bit of optimism. Thanks for coming into the studio. It's so good to see you again. It is so good to see you too. And I just love being in this space here. It's beautiful. Thank you. So as you're coming to the end of your term, when you look back at your time in office as surgeon general, what are you proud that you were able to make a dent and what do you hope your successor picks up and carries on after you leave? That you started it but it just hasn't moved down the road enough yet. One of the things that I have worked hard to do during my term is to really widen the lens through which we look at health and to recognize that health is more

than just physical, that it has to include our mental health, our social health, our spiritual health. These are all dimensions of our health and wellbeing that impact us. And as the years have gone by in the history of medicine, we've come to realize more and more that these things matter. There was a time, for example, in medicine where we didn't really pay much attention to nutrition because we didn't think it was that important.

Like when I think about my own medical school education, our nutrition education was a seven week class that met once a week in the evenings, and it was optional. That was the extent. So seven optional classes was your entire learning of nutrition in medical school. That's right.

So much of what I learned, I had to learn afterwards outside on my own. But that's changed. Now we're starting to recognize, hey, this is more important. So we have to continue to widen that lens. And as we understand more of what contributes to our health and well-being, my hope is that that will help inform not just our scientific understanding, but our individual practice, how we set up and design our health systems, how we think about

public health. And so my hope is that whoever comes next in this office, not just this next time around, but for administrations to come, that they will also take that wide view and recognize that our mental health, our social health, that these are also important dimensions of our well-being and they deserve our focus and attention. It's so surprising, isn't it? It's almost shocking that thinking about a body, the health of a body, the health of a human being holistically, as you said, and you included spiritually as well in your list of health.

A, it's amazing that we have to have this conversation in this modern day and age that it's not considered a given. We have to eat right, we have to exercise right, we have to look after ourselves. Preventative medicine is a real thing. How do we protect our spiritual fitness? I think that's a new idea. Mental health is definitely a topic, which we know, but spiritual fitness, I've not had that conversation yet. Social health is where we topic which we know but spiritual fitness. I've not had that conversation yet

Social health is where we find belonging right when we're doing well. We have a real sense of belonging Spiritual health is about where we find meaning right when we have strong sense of meaning in our life than our spiritual health is strong It doesn't spiritual doesn't mean it has to come from religion alone We can find meaning in many other dimensions of our life And the key thing is these four dimensions of health all interact with one another. So if we want to, for example, cultivate our social health, then certain things can make a big difference that are small. For example, making it a point to reach out

to one person each day, to check on them, just to tell them how you're doing. When it comes to our social health, service is also extraordinarily powerful. And so finding one small thing you can do to help someone each day. It'd be somebody you know, you know, is having a hard time, you just stop by and give them a hand. It could be a stranger who drops her groceries in the store and you help them gather everything back up again. These small acts of outreach and connection, these make a vital

difference in our overall social health. When we think about our spiritual health, this is very tied to our sense of meaning and meaning is tied to purpose. When we think about our spiritual health, this is very tied to our sense of meaning. And meaning is tied to purpose. When we think about our lives, purpose is the why behind why we do what we do. It's not the goals we set, it's not saying in three years I wanna be X, that's the what.

But the why is really about purpose, right? And the truth is that there are a lot of people right now who are going through life and they don't necessarily have a sense of purpose. That's what the data tells us. They're looking for it, perhaps. What I worry about, Simon, is when I talk to young people across our country, high school

students, college students, they are essentially being led to believe that their purpose can be found in what I think of as a triad of success. And I ask them this when I travel. I say, how do you define success? When I'm really asking them, by the way, is how is society defining success for you? And they usually give some version of money,

power, and fame, those three things. That's the triad of success. And if you're successful, that will be a source of meaning in your life, what drives and defines your purpose. Yet what I actually have found is much more useful and consistent with the goals people have wanted to be fulfilled is to try to fulfill it. And that's really centered around relationships, purpose, and service. And we have these two triads. And right now society is really designed around the ladder. That's the messages that people, young people in particular are getting online.

It's what they see amplified on social media. It's like, who do we write books about? Who do we make movies about? It's people who typically have achieved in those three domains. But we know just from real life experience, I know just from the care I've taken of patients and listening to what they say at the end of their lives, that the end, what endures, what ultimately drives our fulfillment

are the relationships we have, are the lives that we touched, the people that we helped. It's when we connect with something bigger than ourselves that we find that deeper fulfillment. Right now, so much in society is telling young people to respond to their unhappiness by actually focusing more on themselves as opposed to expanding out. To respond to your unhappiness by focusing more on the things that are making you unhappy. Yeah, it's sort of a...

I would think of it almost as a false promise, if you will. There is nothing wrong with pursuing wealth or power Or fame there's nothing wrong with those the problem comes when we think that those are the key to our fulfillment Right and we have now so much evidence We have lots of examples of people who are powerful wealthy and famous yet will be the first to tell you that they are profoundly unhappy What have you changed in your life from the time you put on your uniform and started doing this research as you're discovering things about happiness and fulfillment and relationships and joy,

and you looked at your own life and went, oh no, you know, like have you made any changes in how you live your life as a result of the data that you've been collecting? I have, and it's partly because, you know, I'm one of those people who was caught up in this notion of success. I remember going through college and not investing a lot in friendships and relationships,

and I'm embarrassed to say that because I really wish I had and I have a great regret about that. But it's because I was so convinced that I had to put all my time into being successful, and that case is measured by getting good grades, am getting into like a top-notch graduate school? Am I doing all the things I need to do to set myself up for that version of success that society said was all or nothing? And I now look back on it. I went to my 25th reunion a year ago and I came away feeling one, just gratitude for the people I had met and the friends I developed at this

reunion, but also the sadness wondering like, gosh, if I had actually focused on friendships, I would have had 25 years of these friendships rather than just meeting these people. And so what I've changed in my own life has actually been a lot, particularly around relationships, because I've done this job twice and I've been able to learn from my mistakes the first time. And one of the things I did the first time around is I put everything into the job and did not maintain much contact with friends and I didn't

invest enough with my family. And again, I'm not proud of that, but I saw the consequences of that. Not only was it hurtful to my friends and not only did my family suffer, but most of all, I suffered. I didn't have those lifelines that I needed. And when my time in service ended, I find myself suddenly without work, without a community, without a sense of purpose. And I felt profoundly alone. I felt profoundly lost. And so what I resolved to do this second time around when I came back, especially thinking about these issues and learning from people around the country, was I remember going to my wife, Alice, and when President Biden asked me to come back and I said, you know, President wants us to come back to

government. What do you think? And she just looked at me and I said, you know, president wants us to come back to government What do you think and she just looked at me? She said what's gonna be different and I knew what she meant She wasn't talking about what's different in the issues. I'm gonna tackle in the job. She meant what are you gonna do differently? And so some of the things I've committed to doing differently these last four years have been Number one putting my friendships and my family first and for me that means Being there for dinner time every day when I'm in town, being present, putting devices away, focusing on the family.

When my friends call, I pick up. Even if it's for 10, 15 seconds, I say, hey, I'm about to walk into a meeting. Can I call you later? I don't let that go by as I used to do and say, you know what, I'll call them back when I have an hour, and then months go by, and then we never get together. My wife and I have also sort of made certain decisions

about having people over. For a long time, we were worried, are places too chaotic with the kids? We've gotta clean it up, it's not big enough. What are we gonna make for them? We gotta figure out how to cook the right dishes, et cetera. And at some point, we just realized that the most important thing about having people over

is the company. It's not the setting, it's not the food, it's company. And that's what we remember whenever we go over to people's houses. So we just started inviting people over and saying, you know what, our place is a total mess. It's chaos. The kids are probably going to be screaming in the background. We may have to leave multiple times to like figure out what's going on with them. And the food may be so-so. We don't know. We can't, I can't guarantee it's going to be amazing, but just come over. And people came. And you know what they said? They said,

thank you for having us over. Thank you for making it okay to come to a home that's not totally spick and span because our home is the same way. And now we feel like it's okay to have people over. So these are some of the things that we've tried to do a little bit differently. And I'll tell you that even though the job has been harder

in some ways the second time around because we came in the middle of a crisis, COVID and so much going on, it's actually felt more manageable because I've had these lifelines and supports in my life. That's such a true thing, which is we're so afraid of quote unquote what people will think, right? My place is too small.

My place is too messy. My place is this. My place is that. I got a cat, so all my furniture has been destroyed. And you're right. We sit at home alone or we go out for dinner, but there's something quite magical about going to someone's house and nobody's dressed up. Somebody's in sweatpants, you know?

And people have their shoes off. And you sit on a couch very differently than you sit in a chair in a restaurant. And to your point, that's all about feeling relaxed and feeling connection. What has happened in America? Like, why did we get to this point where we sort of abandoned service?

I don't think we actively decided that we're not gonna serve anymore. I don't think we actively decided that we're not going to serve anymore. I don't think we actively decided we don't care about each other anymore. But in the same way that relationships sometimes can just diminish over time out of neglect, I think we failed to nurture service in our lives, in our society. I think we assumed, okay, maybe that's just the way it always will be but we didn't nurture it We didn't build the structures that ensure that it was always a part of our lives And I think over time and gradually diminished what you had instead were forces that were telling young people that hey

It's a doggy dog world out there. If you want to succeed you got to focus on yourself You remember who's number one and what we fail to tell young people is that service doesn't just benefit the person you serve, it helps you tremendously. It opens up your eyes. It's like telling people that only eat sugar on days that start with S, which we don't do. That's like telling people they have to exercise, which we're not good at doing. That's like telling people to save money. And we know we're notoriously bad at saving money, quote unquote, for rainy days, because we don't think in terms of rainy days, we think of now. And so basically what you're asking people to do is save money

You're asking people to protect your relationships so that when you need them, they'll be there for you It's actually what I would think is so slightly differently. I would think what I'm actually people to do is actually go to the movies today It's equivalent of that like it's a source of joy today Yeah And I'm glad you brought this up because I do think sometimes We look at things like service as like the spinach you have to eat. You may not enjoy it now,

but there'll be some benefits down the line. But I think the piece about service is really powerful, is that it can actually bring us joy today. And if we think back to the moments where we did something kind for someone, and we have to define service broadly. It could be serving the military, it could be volunteering for a nonprofit in your community.

It can also be the acts of service that we perform to help people, strangers, friends, family, like in our life. holding a door open for someone. Little things. Yes, exactly. Little things. And these things give us immediate joy. One of the things that makes them deteriorate though over time is when they drop out of

our culture, when we don't see them anymore. See, it's really important to be able to see these things to make them part of the norm, part of the culture. And when we don't see them, then it doesn't become the norm anymore. And then you don't try it, you don't do it. And then it seems strange. And it seems like, I don't know anyone who does that kind of stuff. And so you don't do it. Right? So the question is, how do we rebuild this service as a norm? So it's just something you see people doing. When I was growing up, for example, service was a norm in my life, growing up because of my parents. Because every time there was somebody in the community who lost a job or had a sick relative,

my parents would show up with food. Every time somebody came from India, my parents were originally from India, and whenever somebody came, even if they didn't know them, but they needed help, my parents would answer the call. In this way, whenever there was a need, my parents just, they showed up. They helped out. It wasn't always in big ways, it wasn't always glorious, they weren't getting a lot of praise for it. It's like in small ways,

and they weren't the only ones, by the way. I saw as a kid other families showing up too. So that's sort of imprinted on my mind as a young person that that's just what we do. Like when people are in need, we show up because they're part of the community, just what you do. In a similar way, we've got to build that back as the norm. The primary drive to do service isn't that it's going to yield cardiovascular benefits,

mental health benefits, increase longevity, although it does all those things. But it's that it actually feels good. When we do it with other people, it feels great. One of the things I learned, that's a story I've told before, but when I was learning about oxytocin, which is the, you know, the feeling of mushy, mushy love and joy, unicorns and rainbows. I was walking down the streets of New York City and a guy who was walking in front of me, his backpack opened and a bunch of stuff fell out on the street, right?

And so I didn't think anything of it. I bent down and gathered up the papers and handed them back to him. Everything you were saying sort of played out, which is when you do a small act of kindness with no expectation of anything in return for someone, it feels nice. It felt nice to sort of do something nice for him. The person on the receiving end of the act of generosity also feels good. Thank you, he said. It feels nice when somebody does something nice for us with no expectation of anything in return. But the thing that I didn't expect is I got to the end of the street and I was just waiting to cross from the crosswalk and a guy standing next to me, total stranger, turns to me and goes,

I saw what you did back there. That was really cool. And I realized witnessing an act of kindness and generosity feels good. And when you have that oxytocin, which is that feeling released into your body, oxytocin makes you want to do more nice things, Mother Nature's way of trying to get us to look after each other. And so your point about how it's no longer visible is truly profound, which is giving money is not an act of service, because money is a redeemable commodity. You spend money, you waste money, you lose money, you get it back. But giving time and energy, these non-redeemable commodities, that's where the feeling comes

from. To your point about visibility, I mean, if you... And I think there's a lot of blame. Social media absolutely plays a role. Parents play a role. Our schools play a role. University plays a role. There's this steady chipping away. Yeah. No, you're absolutely right. Part of this is we have to ask ourselves the question, like, whose responsibility is it to rebuild service into our lives? It should be a collective response, which means it should be reflected in schools, work lives. It should be collective responsive, which means it should be reflected in schools, workplaces. Government should be working to build national service programs that

people can increasingly participate in and bring folks together. And there are national programs, whether it's AmeriCorps, Peace Corps, and others, but we've seen participation in all of these decline. But when I think about universities and schools, increasingly they're preparing kids for careers, but not preparing them for life. Teaching to a test, teaching to get a certain job of a certain salary, I get why that's important. But at the end of the day, if we know that what ultimately will contribute to someone's fulfillment, that will help improve their mental health and their physical health is their engagement and service, is their sense of purpose and

contribution to other people's lives? Is there relationships that they have? We know that these three things really matter and are the foundation for fulfillment. We have to teach those because you don't just come into the world knowing all of that, you know, and knowing how to execute it. You've got to see it around you.

You've got to see it incented around you. You've got to see, there were certain things I did in college and that we all did. We all went to class. We all took exams. We all ate lunch in the dining hall and dinner as well. Service, some people did, but it wasn't really a core part of the experience. It was a side thing. If you want to do a great, sure, that's wonderful. But what if we were to make service a core part of the experience in school, in grade school, in college. So it wasn't just an afterthought, but it was actually one of the main thoughts.

I do think that that would make a difference. It's a choice really that we have to make between a society that focuses the individual more and more on themselves, it's increasingly atomized, versus a society that recognizes that it's when we connect with something bigger than ourselves that we truly grow and thrive and heal and enjoy our lives. And the lack of that connection with something bigger than ourselves that we truly grow and thrive and heal and enjoy our lives. And the lack of that connection is something bigger than ourselves. I've realized is one of the important contributors to the pain and lack of fulfillment that I've encountered all over our country as surgeon general. Yes, there are economic roots of that.

Yes, there are real challenges people have with safety in their communities. Like these are real concerns, right? If you don't have housing, it's hard to be happy, for example. There are real challenges that people are facing, economically in particular. But my worry is that even if you meet all of those needs, if you don't have relationships and purpose

and engagement and service in your life, it's hard to be truly fulfilled. When we were together, some time ago, Simon and I shared with you just a story about my father who told me, he told me it's something that really shocked me one day. He said, you know, I never really felt that sense of emptiness, that deep gnawing sense that something was missing in my life until I left my village in India. And I was surprised he said that because in his village in India, he lived in deep poverty, like did not have

enough money to buy slippers or shoes. So his barefoot most of the time, he and his five siblings had to pour water into their bowls each night at dinner to dilute the dhal, the grain. So there was enough for each child. There wasn't even enough to eat most nights. Real bracing poverty that he lived in. Yeah, for somebody who lacked so many of those essentials to say I never felt that sense of emptiness until I left was really striking to me. And I asked him why, and he said, well, in the village, people looked out for each other.

When his mother died when he was 10 from tuberculosis, the whole village came together and became surrogate parents for him. When a kid was off doing something on the street and getting into trouble, if his parents weren't around, someone else's parents would just step in and say, hey, come here, what are you doing? And would you discipline them, make sure that the child was safe? And people found purpose in doing that, in taking care of one another. The friendships that he had and that they all had with each other, they

were real, they were deep. It wasn't that they didn't have disagreements or problems, but they knew that they could count on each other. And when he left and they didn't have disagreements or problems, but they knew that they could count on each other. And when he left and he didn't have that, he felt this deep sense of emptiness. And that was one of the reasons I think when I was growing up, he and my mother made it a real point to teach us about the importance of community, a place where you do have real relationships, where you help each other, have each other's backs, and in each other, you find a sense of purpose and That has remained just an enduring lesson for me in my own life

I love the story, but I also think that we conflate hardship and purpose that they're not the same thing Without a question your father had struggle and he had hardship. Yeah, and He had community and he never felt lonely. And I think we sometimes confuse that to have happiness or fulfillment, you have to have no hardship, which is perhaps why we focus so much on money. The two are completely separate things. We want you to be able to provide for yourself and your family, of course, but it's not an if-then. In fact, I think it's more of a powerful message for what we're talking about that you can have the fulfillment without the stuff, but you may not get the fulfillment with the stuff. It's an important point because fulfillment is not the lack of hardship and it's also not lack of

stress in your life. And I think sometimes we assume that we got to get rid of all stress, in order to be happy. But when we're truly rooted, like in relationships and purpose and service, that foundation actually makes us more resilient in the face of stress. So it's not that the stress goes away, but we're actually able to manage it because we're not alone, honestly, because we have a cushion, a buffer, if you will, for stress. I think about 1992 when Hurricane Andrew hit Miami, Florida. I was living there, I was in high school at the time.

It was brutal. I remember being inside and seeing pieces of houses flying by. They were our neighbors houses. I remember part of our roof getting ripped off. I remember seeing the streets flooded with water and seeing traffic lights dangling, you know, being wrapped around a pole as if they were just toys. Coming out of that, it was how to put our life together. That was just, we didn't even know where to start. We couldn't even get back to our home because we didn't recognize the roads because they were so disrupted and trees were falling over.

But what was really striking to me is in the face of all that hardship, neighbors came together and they helped each other out. Friends that we had who were in the county above us, who were in Broward County, they couldn't reach us. This was pre-cell phone era. They just drove down in all hopes that they could find us with sandwiches and with water in their car.

People took care of each other like that. When I think about that experience, yeah, it was hard, but it was actually really fulfilling in many ways to have that time of togetherness, to rebuild together, to be reminded that we can lean on each other and who our friends are. It's not that I would wish a hurricane on anyone or that I would want to go through it again. But I remember that because it reminds me that the goal is not to get rid of all hardship. It's to figure out how we can build our foundation for resilience that allows us to deal literal or metaphorical hardships when they come.

But in life, there are going to be some stresses and struggles that come our way. And the question is, can we be in a position where we're more able to manage them and handle them, because we're not alone, because we have folks around us to support? I mean, it's such a subtle and profound point. The goal is not to eliminate hardship. The goal is to cultivate relationships that will be there with us through hardship. And all the hardships that people go through, none of us want to relive some of the Tragedy we've had but we learned from it and grew from it and politics disappears and disagreements disappear Because now we in our rawest raw state we see each other simply as human beings who need help

You know, we don't ask somebody who they voted for when your house has been destroyed by hurricane You just go help so I think about sort of like how we got here. If we look at the history of it, and I'm just thinking out loud here for a second, sort of trying to put the pieces together, which is the greatest generation who lived this life of extreme service, I think that's safe to say. They put their lives on hold to go to war, to fight Hitler. But we forget that they just came out of the Great Depression. And now, before they've even had a moment to rest, they get shipped off to battle. And when they came back after war, the mentality was, I've given enough. I've completely missed out on my youth.

All I've been doing is giving. I'm going to prioritize numero uno. And we saw the 1950s defined as work as hard as you can. We saw individual and household income skyrocket. The only reason you could have the hippie movement of the 1960s is because you had rich parents who could afford for you not to work. Those parents raised their kids to say make sure you put yourself first, otherwise you're gonna miss out on your youth. And I wonder now if we're feeling the

effects of that pendulum swinging so far the other direction. It's like, okay we did the me thing, but I think we've over indexed on me, and now we're feeling the effects of that pendulum swinging so far the other direction. It's like, okay, we did the me thing, but I think we've over indexed on me. And now we're feeling the same stresses and pains, but in the opposite direction. Like now we need to swing back the other way. Maybe we can not go extreme, but find somewhere in the middle. Yeah. And this is where I do think that if we really want service to be back at the center of society, we have to prioritize, we have to make it a priority and

incentive. to be back at the center of society. We have to prioritize it. We have to make it a priority. And incentivize it. And I think that doing that, I mean, when I started actually getting involved in HIV education programs, that was my start in public health, was actually doing HIV work in India and then later on in the United States. But the only reason that I did that was because when I was in high school, we were told that we needed to do some sort of community service type thing. And I was like trying to think, huh, OK, well, what could I do? What could I do?

And I had this idea that maybe I would just build a peer education program where high school students could help teach middle school students about HIV and how to stay safe. It was very simple. I didn't have any expertise, right? I'm not sure if I did any good, but I certainly tried. And so in college, when my father called me up one day,

when I was a freshman, and he said, hey, Vic, there's a philanthropist in town who wants to fund the meaningful project, but has no idea what to fund. So if you have any ideas, maybe you want to pitch something. I was like, wait, I didn't, I came to come, just started college, I come here to just like learn and hopefully like figure out what to do

with the rest of my life. Like I wasn't thinking about pitching some idea But then I was like wait, I felt really fulfilling when I was doing the peer education around HIV What if I pitch that and that's actually what led to some funding to actually start this peer education program that We began in India and then later in the United States and I will tell you that at the age of 17 I still remember this so clearly like it was yesterday I remember being in Bangalore in India during that first summer 1995 at a school where we had 600 students in the audience and we just

wrapped up a full day of workshops with them that involved like plays and all kinds of fun activities, but it was like all about learning about HIV and it was about talking to them about how they could actually be educators in their communities. And in the end, I remember talking to them, standing at this podium, and just feeling this sense of like, I don't know how to describe it, but it's just like this energy, this fulfillment, this excitement about what I was experiencing. And I felt this energy is kind of coming through me and kind of lifting me up and lifting them up. And I had this feeling that I was doing what I was meant to do.

And I chased that feeling for years afterward. That experience opened a door for me and it set a standard for what I wanted to feel. And I have found that in other people as well, when we have experiences in our life that truly give us joy and fulfillment, help us see not only someone else more clearly as we help them, but help us see ourselves more clearly

in terms of what matters to us. That sense of benchmark for what we want to do in our life. Our goal, I think, is people who are looking at the next generation should be to ask ourselves, how can we create more experiences like that for people? We don't know what direction they'll go in. We don't know if they'll continue that same kind of work or something else. But we should set a high bar for people for what they expect and demand of themselves and what they contribute to the world. The solution is so easy, which is align the incentive structure with the behavior you want.

My university, you could not get your diploma unless you pass the swim test. That was the rule. You could get straight A's and it was the day before graduation, there was a long line of kids at the pool to pass this. Because if you don't pass your swim test, you don't graduate. Colleges and high schools should say, unless you complete X amount of days of service, you can't graduate no matter what your grades are. And let the people discover the joy of service.

Some will hate it, but enough will discover it. Kids should get their allowance only if they've done something chores to contribute to the family and hopefully a couple of days of service. Companies, I think companies should have mandatory service days where we either shut our doors or we give people a day off but not to go to the beach. You have to go volunteer somewhere and it should be a requirement. Like, you're not eligible for a bonus at the end of the year. You're out of the bonus pool unless you've completed your service days. You get paid for those days, but you have to go do something. If organizations and institutions and families start incentivizing

and creating barriers that you cannot get the thing you want unless you go do the thing of service, enough people will have that feeling, that feeling that you discovered and start craving it. I've definitely had that feeling. The amazing thing is that I had the opportunity to go to Afghanistan during the war. I was doing a lot of work for the mobility forces in the Air Force. The general in charge said, look, I love that you've gotten to spend a lot of time with us, but I really want you to see our men and women in uniform doing their job. Would you be willing to go to Iraq or Afghanistan? So I said, yes, they chose Afghanistan.

And I had no responsibility. I simply went and flew back, right? I didn't tell my parents or my family that I was going to Afghanistan because I didn't want them to worry. I told them I was going away with the Air Force, true. I told them I was going to Germany, true. I just didn't tell them that I was going want them to worry. I told them I was going away with the Air Force, true. I told them I was going to Germany, true. I just didn't tell them that I was going from Germany to Afghanistan. And I told them I'd be out of touch for a while because I was going to be on

a lot of planes, true. Well, everything on that trip went wrong. It was me and two escorts, two officers who went with me and we flew in and 10 minutes after we landed, we weren't even off the plane yet. The base came in a rocket attack. Three rockets hit it about 100 yards off our nose. That's how it started. And I was weirdly relaxed because everybody around me was weirdly relaxed. And for anybody who's ever been in a war zone, they know this, which is you have all the emotions you're supposed to have, but you don't necessarily have them at the right time. My panic came later. I had an amazing experience. I got met a bunch of amazing people. I went and did an airdrop mission. Amazing, amazing, amazing.

One of life's great experiences. Then the goal was to come home. And that's when I found out that there were no planes leaving to go back to the United States or go back to Germany the day we were supposed to leave. And I remember feeling every fiber of my being sink. And now the panic showed up. Now I was convinced there was gonna be another rocket attack. I was convinced there was going to be another rocket attack.

I was convinced it was going to land on me. I was convinced my parents would find out that I'm in Afghanistan from an Air Force officer knocking on the door. And it's not like I can call them and be like, hey, I'm going to be late. I'm in Afghanistan, right? So I'll be out of touch for days because I found out the next flight out was four days from now. And we went back to our quarters and I was exhausted. We only got like three hours of

sleep the night before and I sort of lay down and closed my eyes, but I couldn't sleep. The guys I was with thought I was sleeping. So one said, I'm going to see if I can find another flight and he left. And the other one said, well, I'm going to go to the gym and he left. And I was lying there by myself and my mind was racing. I couldn't relax. I was paranoid, I was afraid. I'm in the purpose business. I'm like, all right, so the reason you feel so disconnected is because you have no sense of purpose.

You're just here to bear witness. And I'd come up with something like, you're here to tell their story. And I would feel good for like a minute and then immediately it would fade. And I went through all these little mental gymnastics trying to come up with purpose and nothing was working. And so I finally gave up. I lay in that bed and completely just quit.

I resigned myself to the fact that I'm stuck here and there's nothing I can do about it. And I decided if I'm gonna get stuck here, might as well make myself useful. I met a lot of amazing people. I want to volunteer. I want to carry boxes. I want to sweep floors. I don't care how menial, whatever they want me to do. I just want to serve those who serve others." In that moment, I found tremendous calm, even excitement to serve. As if it were a movie, the door suddenly flew open and it was Major Throckmorton. He's like, I got us on a flight. I got us on a flight, but the plane's leaving now. We have to leave now. We have to leave now. Where's Matt? I'm like, he's at the gym. We run to the gym. We get Matt off the treadmill. He puts his uniform back on. We rush out to the plane to try and catch

this flight. And as soon as we get to the plane, a security cordon comes down. We're not allowed out to the flight because somewhere on base, there's a fallen soldier ceremony happening. And as is tradition, everything stops on the base. So I sat on the curb and told the guys what I went through and I wept as I told them the story. And you know this, you know, in the military, crying is perfectly fine. Finally, a security cordon comes up, we walk out to the plane. The reason this flight didn't exist before

and that we were able to get on this flight, it was an unscheduled trip for us, is we would be carrying home the soldier for whom they just had the fallen soldier ceremony. And I flew home, it was a nine and a half hour flight back to Germany and we were the only passengers on this flight and I flew home and slept, like slept. I lay, I couldn't sleep. I lay next to a flag draped casket for the entire time and it was the greatest honor

of my life. Because having just had this crazy experience where I learned what true fulfillment means, true fulfillment is getting to serve those who serve others, I got to bring home someone who knows a lot more about service than I ever will. Our final flight home was on an aeromedical evacuation from Germany back to Andrews. There was a Marine in the back of the plane who was in a, he was kept in artificial coma, really bad shape, really, really bad shape. There were nurses looking after all of the folks on the plane, but there was a team of doctors assigned to him.

I mustered up the courage to go talk to him because I had never seen a body that battered up. The doc who was in charge was a reservist from Austin. I asked him a question I would not have asked him had I not had the experience I just had the day before. I said, you're a good guy. You're an ER doc. You've given your life to serving others. Do you have a different feeling on these missions when you come to your military service than you do back at home? And he looked at me and says, they're not even close. He goes 90 to 95% of the people who come through the ER are either drunks or idiots. There's not a single drunk or idiot on this plane. He says, I cannot tell you the sense of feeling of service and fulfillment I get on these missions that I cannot find at home. And that's when I learned that the

opportunity to serve those who serve others is service, is fulfillment, is joy, and it's simple stuff. It's not complex. That first of all, that's incredibly powerful story, Simon. Thanks for sharing that. Can you just feel your state and your energy shift as you shared that? Obviously, it's so deeply moving to you. Something that I learned from a friend that we've started to do with our own kids is at dinner each night, we used to have the kids go around and just share something from their day, something that happened. And now what we ask them, tell us about one thing that happened today where someone helped

someone. Maybe it was someone who helped you, it was you helping someone else, but just tell us about one thing that happened where somebody helped somebody today. And if you think about it. And it can be very, very small stuff. Sometimes it's they left their sweatshirt in the classroom when the teacher came after them. They give it to them to make sure they had it. Sometimes it's that they forgot their lunchbox and another kid remembered and gave it to them.

It can be sometimes small, small things. But what it does, we hope it will do for them. This is imprinted in their mind that these are important moments to remember and to anchor on. And you're creating incentive structure, right? Because even if it's for the wrong reasons, oh, I better take this lunch box to the kid

so I'll have something to report to dinner tonight. But that's okay. Yeah, it's okay. In my mind, it's conveyed to them that it's valued. It's valued, right. These moments are valuable, and so they should do things and spend their time on things that are valued. As kids growing up, we need to see that modeled for us that focus on relationships and service.

We need to see a purposeful life talked about and discussed, whether it's in school or in the stories we hear or in the books that we read. This has to be part of what surrounds us, what we're immersed in. And that's about shifting culture. And culture changes when people decide to believe something different and to do something differently and then more and more people join them. And that's how we shift culture. And that's what we're called to do right now.

There's no law you're going to pass that's going to make this the kind of culture of our land. There's no single movie you're going to make that's going to transform right now. There's no law you're going to pass that's going to make this the kind of culture of our land. There's no single movie you're going to make that's going to transform at all. This comes about by individuals making a decision to live differently and then other people joining them. I think this is very important because you have served over a period of dramatic increases in anxiety, depression, and suicide, especially of young people. And here you are a medical doctor, and you are prescribing to us, the citizens of this country, you are prescribing friendship, community, and service.

And you are saying for our health, physical, mental, spiritual, that we need to do those three things. And I think that's so important. This is not airy, fairy, mushy, mushy, hippie-dippy stuff. This is a medical prescription, you know? Yes, and there's good science that tells us that when people have these three elements in their life, relationships, purpose, and service, it's good for their health.

It improves their physical health. It improves longevity. It reduces depression and anxiety. It reduces the risk of high blood pressure and other cardiovascular conditions. It's literally good for our health, physical and mental. We know it feels good too to live that kind of life. Like Simon, the stories I think about so often are... There's so many stories I've encountered as a surgeon general traveling the country, but some of the most powerful stories for

me have been the ones I experienced with the patients that I cared for over the years. Can you share one? Yeah, well, I think about the end of life conversations that I have had with patients, where they know that their time is coming to a close, where there is no more treatments to prescribe, there's no more diagnostic tests to do.

And sometimes I've been lucky to be with them in those last few days to just hold their hand and listen to what they're reflecting on. And what is remarkably consistent, Simon, is that they don't talk about like how much money was in their bank account or how big their corner office was or how many followers they had on social media. What they talk about very consistently are the people in their life. Like the end of our days when only the most meaningful strands of life remain, it's so

clear that it's our relationships with others, it's how we've engaged and contributed to the world. This is what makes the biggest difference. And I try to remember that in my own life. I am like anyone else, a subject sometimes to the environment around me. Sometimes I wonder, am I doing enough? Should I be talking about these other issues because people might be care about them more? Should I, whatever, should I do something to follow that formula of success?

But then I remember these stories and they bring me back to what really matters. And they remind me that, no, those extra moments that you spent with that person at that event who was really struggling, that made a difference. Or that time you take to be with your family during dinner, that time really matters. It doesn't matter if anyone else knows, it doesn't matter if anyone else, if there's any monetary benefit that comes from that, because that's not what it's about. It's about that deeper fulfillment. And look, I think this is important.

The reason I put together this prescription, Simon, is because I feel a sense of urgency around it. I see so much of the pain that people are experiencing around the country. And I remember Richard Rohr's wise words, which is that pain that's not transformed is transmitted. When we don't address the deeper roots of our pain, we end up having it manifest in other ways that can be hurtful to us and to other people in the end. And to me, the deeper roots of pain that we're not addressing in our society is this loneliness and isolation, disconnection from service, this disconnection from something that's bigger than ourselves. And that's why I feel a sense of urgency about addressing that. This is something we do in our day-to-day lives sometimes here and there.

I see plenty of examples of it around the country when I see neighbors helping each other after a storm. I see young people in schools who are, you know, through various programs like Beyond Differences and others are volunteering their own time to help fellow classmates who are struggling with loneliness and isolation. You know, I seen in Baltimore, the organization thread is like bringing all of these adult volunteers together just to surround young ninth graders in Baltimore who are struggling academically to surround them with love and with

support and whatever those kids need being picked up from school, lunch, help with tutoring, connection to resources. They're there. They're all in, right? They're like a surrogate family. I see these and it reminds me that the core essence of what we need is there. It's that we are kind, we are generous, we are loving people. That's the essence of who we are. Sometimes we may be scared to show that because we're in a culture that tells us that love is weak, that somehow it makes us soft.

But I'm not talking about sentimental love. I'm talking about the love that Martin Luther King spoke of, the kind of love that is a muscular force that allows us to build movements that enables a parent to stand in harm's way because they're protecting their child, that inspires a soldier to actually put themselves in harm's way, not just for the country they love, but for the man and woman next to them who they deeply love as well. Like I'm talking about that kind of love. And we have that inside of us.

We may not see that amplified online very much. We may not see that as what the algorithm promotes on social media or what's the headline of the news each day, but it's there if we look hard enough. And part of what I want to do is to help people see that not only is that okay to come from a place of love, but it's what's necessary. That we can either come from a place of love or a place of fear. And that fear manifests as anger and as jealousy, as rage, as insecurity, and in all its own forms. But that we have it within us to come from a place of love. And when we do, we build something bigger, something stronger, something greater that ultimately benefits it within us to come from a place of love and when we do, we build something bigger, something stronger, something greater that ultimately benefits all of us.

Beautifully said. Thank you so much for coming and dare I say thank you for your service. I've learned a tremendous amount from you and the way that you have chosen to live your life and the way that you're raising your family and the changes you've made in your life from the first time you were surgeon general to the second time is an inspiration. Thanks so much for coming on. Well, Simon, thank you. And I've learned a lot from you over the years, long before I met you.

I remember watching some of your talks and your videos and I've learned a ton. But I will just say, you came over to our house recently for dinner and- It is chaos. It's chaos. It's is chaos. But one of the things that I loved about our conversation was just how open and honest and vulnerable you were. And to me that was like a breath of fresh air.

Like, and sometimes in life, they can feel like everyone is walking around with masks on trying to be who we think the other person wants us to be or what society expects of us. But to have the courage to be yourself in a world that's constantly telling you who you should be, that is one of the greatest acts of courage, perhaps that we can have, you know, day to day. And that's something that we can all do in our lives. But I saw you doing that, and it just reminded me also to be authentic, to be real, to be vulnerable

in my interactions with others. So thank you for that gift as well. You're very, very kind and I can't take all the credit. I'm also very good at putting a mask on and not being vulnerable, but you created a safe space. You and I don't know each other well. And when I said, let's go out for dinner, you invited me into your home. No, who does that? You know?

And the chaos of the kids running around was the best. The mess of the kids around was the best. And you created a safe space filled with psychological safety. It wasn't manicured, it was just human. And so I think your personality and who you are is the same. You show us that it's okay to be imperfect and unsure and have self-doubt. It's kind of like it doesn't matter who goes first. Either somebody takes the risk to create the space that's psychologically safe or somebody takes the risk to just jump out and put it out there and the other will respond in kind.

And so you took all the risk. I just accepted the invitation. And I think you're right. I think this goes right back to where we started. As you said, people aren't coming for the food. They're certainly not coming for the furniture. They're coming for the company. And all you have to do is be good company. The thing that gives me hope, Simon, is that it's small acts that are incredibly powerful in helping us rebuild these foundations for our community. And that's what actually gives me hope that this is something that we can do.

We don't need a new theory of relativity. We don't need a massive, multi-billion dollar government investment in potluck dinners. What we need is for each of us just recognize what truly drives our fulfillment. I think these kind of like experiences together remind us of a fundamental truth about relationships, which is that it's in the showing up

that we help each other heal. It's not in fixing other people's problems. It's not in knowing all the solutions. It's not in saying the perfect thing in response to their story. It's in showing up. And so I think it's important for us all to know that we have that power, that our presence is that power. And the more we use it, the more we can help ourselves and other people heal.

Amen. Dr. Murthy, thank you so much. Thank you, Simon. Such a joy. So much joy. So glad we did this. So much joy. 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, simonscenec.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.