Offline with Jon Favreau - Dr. Vivek Murthy on Defeating Doomscrolling with Human Connection

Episode Date: December 12, 2021

Surgeon General Dr. Vivek Murthy joins Jon on Offline to dissect the intersection between the internet and our emotional well-being. Dr. Murthy delivers a doctor’s diagnosis on Jon’s ceaseless doomscrolling, breaks down the impacts the pandemic and our increasing time online have had on our mental health, and makes the case for what it means to live a truly meaningful, connected life.For a closed-captioned version of this episode, click here. For a transcript of this episode, please email [e-mail] and include the name of the podcast.

The number of connections we have is not determined by how many followers we have on social media or how many people, you know, we might invite to a general holiday party. It's really determined by the number of people with whom we feel we can show up as ourselves, with whom we can be vulnerable, with whom we can be truly open. That's what defines the highest quality connections. L.M. Tsikassas, who's a technology theorist you may be familiar with, wrote this great essay early in the pandemic about doom scrolling. And he basically argues that what we need in times of uncertainty, like the one we're living through, is not more information, which probably won't give us the certainty that we're craving, but more friendship, which helps sustain us through the uncertainty. I'm Jon Favreau. Welcome to Offline. Hey, everyone.

My guest this week is Dr. Vivek Murthy, the Surgeon General of the United States. I've wanted to do an episode on pandemic doom scrolling for a while now. And for those of you who aren't familiar with the term, it's pretty much what it sounds like. You just keep scrolling through news about COVID, looking for bits and pieces of information to make you hopeful that this fucking pandemic will end soon, even though you inevitably come across panicky headlines that make you feel worse than when you started scrolling.

At least that's been my experience. But I didn't ask Dr. Murthy to come on the show just to ask him about the Omicron variant, though we did talk about that. I asked him to come on because he spent a lot of time as Surgeon General, both during the Obama administration and now during the Biden administration, focusing on the importance of mental health. And recently, he's been talking about two factors that are harming our mental health, social media and the pandemic. In fact, just before our interview, he was at a high school in Los Angeles where he issued a pretty rare public health advisory

about what he calls a mental health crisis among young people. We talked about all of this, the intersection between the internet and our emotional well-being, why we doom scroll and how to stop it, and how to make our mental health as big a priority as our physical health. But to me, the most important thing we talked about was maybe the most unexpected. Loneliness. Dr. Murthy wrote a book on the subject. He's come to believe that it's at the root of a lot of our problems, and he makes a powerful case for the importance of real, live human connection

that moved me in a way that was deeply cathartic after nearly two years of being stuck inside and glued to our screens. I hope it does the same for you. As always, if you have questions, comments, or complaints about the show, feel free to email us at offline at crooked.com. Here's Dr. Vivek Murthy. Well, thank you for doing this. You know, you and I have spoken a couple times on Positive America about whatever the latest pandemic headlines were that week. But I wanted to talk to you for this series about something pandemic adjacent, which is how we're all handling nearly two years of living through COVID, talking about COVID, and consuming a daily flood of information about COVID at a moment when

we're already spending more time online than ever before. And I'll just start by being very honest about my own experience, which is that I can't stop scrolling through COVID news, even though I know it's making me more anxious. Have you ever had that doom scrolling experience or talk to people who have? Absolutely. And I think almost everyone has. It's like you get sucked into the vortex of bad news and you just keep finding more and more of it. And? You know, what can we do in those moments when we find ourselves descending into, you know, that sort of despair, if you will, because it's not just about the despair, it's what it's also shoving aside in our life. Like, if you're like me, you probably experienced some of that when you're supposed to be asleep, right? You're, you know, about to go to bed, and you're like, let me just check my phone. And then before you know it, you're in article seven, that's making you feel even worse

about the world. And you've lost, lost out on an hour of sleep. So this is, I think, coming at a big cost to a lot of people in our country. Why do you think it's so hard for so many of us to stop doom scrolling? What do you think we're all looking for? Well, I think when you find content that is compelling, whether that's because it inspires you or because it alarms you, it's hard not to pay attention. It's like when you see a car crash or when you see something bad happen to someone, our eyes are drawn to it, whether it's positive or negative. And I think that the way, again, we consume content is very related to the way that platforms are constructed and intentionally designed, which is to serve you up more and more content that will grip you.

Because many of these platforms, frankly, are built on business models where they profit off of the time you spend, regardless of whether that's time well spent. So I don't think it's because people are fundamentally flawed or broken that they are doom scrolling in that way. I think we are interacting now with technology platforms that understand human behavior and the brain very well. And they've designed themselves to maximize our engagement, even if that comes at the cost of our mental health and well-being. There's also something about the way pandemic news is presented and discussed, especially on Twitter. So I've noticed this dynamic where experts and non-experts will fight over whether some COVID

take is either too optimistic or too pessimistic. And I wonder, as an expert yourself, though not one who gets into Twitter fights, so that's good. Do you have a philosophy on how best to communicate about public health in the middle of this pandemic to non-experts like me in a way that's honest and realistic, but still hopeful? Absolutely. And I think, well, this isn't easy. And I think during COVID in particular, a lot of people became active on social media to discuss COVID who weren't necessarily talking about public health or science or medicine before this. And this include medical professionals and public health professionals. And people are still learning how to communicate over the funny medium of social media and how to do so in a way that is authentic and real, but doesn't cut corners and gives people an accurate picture.

Here's what I think about when I communicate on social media. I think it's important, number one, to be honest about the limits of your knowledge. There are a lot of people I see on social media who project absolute confidence and certainty at times where it's very difficult to have that. And people, you know, during times of, of concern and confusion, people want certainty. So they actually get swept up, you know, in sort of the narrative and the messages from people who seem very, very certain, but then they encounter somebody else who seems very, very certain, you know, and has a very different point of view. But if you interact with scientists and engage in sciences, I have from my whole career,

you realize actually how much uncertainty there is and how you have to approach it with humility. So the best public health communicators I have seen are upfront about the fact that they don't have all the answers. They're clear about the limitations of the data that they have. They create room for people to recognize that our views may change or our conclusions may change. But optimism, I think, is not fundamentally just about the data. It's about who you are as a person and what approach you take to public health. Now, I think, for example, that I can't tell somebody that the pandemic's going to be over tomorrow or I can't tell them it's going to be over next month

or in two months. But what I can say with confidence as an optimist is that I do believe that we will find better ways to live despite this virus. I do think we'll find ways to see the people we love, to get our kids to school, to make sure that we can get to work, that we can go to weddings, that we can attend funerals, that we can visit our loved ones in

nursing homes, because we have better tools now than we had a year ago at this time. And the question is, how do we use those tools? How do we make them available to people so that we can get on with much of our lives while we're seeking to tackle COVID at the same time? To me, that is an optimistic view, but it's rooted in reality. And it's not trying to predict that, okay, all of the pandemic is going to be over in three months. There are a lot of people who are occasionally right, but never uncertain on social media. And to me, that raises a real red flag, if you will. I mean, how do you distinguish between COVID news that is useful to help protect

you and your family and COVID news that you just don't need to process? Like, you know, we're speaking and right before this started, I think the first sort of lab tests out of South Africa came out about Omicron. And I'm looking at like, what is neutralizing antibodies mean? And I'm looking at case counts in South Africa. And I'm just like, do I need to know all this? Like, I probably don't need to know all this, but it's freaking me out anyway. Well, that is, I mean, it's tough to turn it off, right?

But I'll tell you, and I probably is probably counterintuitive for me to be saying as somebody who's sometimes trying to communicate on social media. But I actually think that one of the best things that you can do is to turn off your consumption of social media and to give yourself like literally a break, you know, from time to time. I certainly know people who have deleted their social media apps from their phones, and they'll check on their computer when they're at their desk. But they've just realized that the constant access has real diminishing returns. You may find utility at the first one or two stories. By story eight or nine, you're either not getting a whole lot of utility or you're getting negative

utility because you're getting confused and more anxious and more worried. I think, number one, reducing consumption helps a lot. I'll tell you, number two, with Omicron, some of these critical questions, the three critical questions around, is this more transmissible? Is it more severe? And does it actually evade the protection of our vaccines and therapeutics? These questions, we're going to get bits and bits of information on them, like over the next couple of weeks. But I will tell you this, if you tuned out for a whole week, and I know you may not do that, but if you did, and you came back in a week, you would probably know worse off. And what's happening, unfortunately, now is people are so hungry for information that

they're taking any bit of data they can find, and they are interpreting it to death, right? And drawing conclusions from it. Sometimes it aren't entirely warranted or heavily caveated. And so it gives, again, people a sense that they might know what's happening, whereas in reality, we don't know for certain and won't know probably for a few more weeks. So even if we're not consuming COVID news, as you mentioned, the pandemic has forced all of us to spend more time online. By some measures, our screen time jumped by over 50% in 2020. I know mine was out of control. What impact do you think this has had on us

health-wise? Well, I worry about the health impact, John, on us because not only has screen time increased overall in the population, but if you look at young people and kids, screen time has actually doubled for them. And some people might think, oh, well, that's because they were doing online school. Actually, no, I'm talking about non-academics, non-school related screen time has doubled for kids during the pandemic from 3.8 hours a day on average to 7.7 hours a day. That's a significant amount of time. Now, the question is, what is the impact of that screen time directly, but also what is it crowding out in our life? And I worry that for many kids, it's crowding out in-person time. It's crowding out time to be outside and be physically active, which we know is

very important for your health. Maybe crowding out youth sports and other hobbies that are important to kids. And there's a direct impact itself of the screen time, which depends in part on what they are doing. If people are engaged in community conversations with groups of friends that they trust, and they're able to have open conversations and learn from each other and laugh with each other and have a good time, then that can be very positive. But if people are engaged in wars of words, if you will, like on social media, if they're doom scrolling, you know, on their, you know, fifth, sixth, seventh hour on, you know, on their device, you know, the day,

that can actually be quite harmful to their mental health and well-being. And John, I'll just say this also, that one of the great costs of the pandemic, which are built on a problem that we were dealing with pre-pandemic, is the increase in isolation and loneliness that many people feel. And if we want to overcome that in some sense, if we want to build greater connection and community, we have to figure out how to rebuild high quality interactions, whether that's online or in particular offline. And I worry that the experience of the pandemic, especially the increase in screen time, it threatens that goal of building a greater connection and community. And so it does worry me. You've written that the values of social media, sensationalism, us versus them rhetoric,

curating one's life to seem perfect, are not working for us and are leaving many of us feeling inadequate and unworthy. Why do you think that these technologies that have connected more people have left us feeling more alienated? Yeah, I think it's an important question, John, because you could imagine a world where these platforms could be extraordinarily helpful in reuniting lost friends, you know, in helping family members stay in touch. And for some people, they actually do that, right? And like, for example, I have certainly over the years found lost friends, you know, from graduate school through social media and reconnected with them in person and had wonderful relationships. I use social media platforms to stay in touch

with family that lives across the world. It's been very helpful in some ways. But I think the problem is really the business model in part that's driving the platforms. The business model is driven in part by volume, right? The volume of interaction is what ultimately drives advertising and then drives revenue and drives profit. But what it doesn't necessarily drive the revenue stream is quality of time. So if you live in a world where quantity of time spent on, you know, on a platform is what makes a difference, and you will seek to maximize that. And it's just a well known facet of human psychology, that people tend to gravitate toward things that have a high emotional valence, if you will, to generate a lot of fear, or a lot of

anxiety, or a lot of anger. And that's actually why you see those kinds of posts travel so far and wide on social media and generate so much engagement. I don't think there are very many people that I have encountered or heard from, of all the people I've talked to about this across our country over the years, who necessarily feel great after they enter into a war of words, you know, on Twitter, or feel really good after they dunk on people repeatedly, you know, on another platform. I mean, like, it feels perhaps maybe satisfying for a second and then afterward, not so great. And you've made other people feel terrible in the process. So I do think that this, you know, sort of objective of maximizing quantity of interaction at all costs has led to an

environment that has, I think, been enriched for anger, for fear, for anxiety, and it's taking a toll on our mental health and well-being, and I think furthering the disconnection that many people were experiencing even before the pandemic. I've heard you talk about the way that social media conversations lack relational context, visual cues, content of someone's speech, body language. Can you speak to why those cues are important in conversation and what we're missing when we engage online because i've noticed that myself even like you know working remotely over the last uh year or so and you think well we're doing zooms and that's okay and we're all on slack but just having been back in the office and talk to people in person you just notice a difference in the quality of the conversation

because you can pick up on those cues, you know? Absolutely. You know, John, you and I have small children, right? And when our kids were really small, before they could understand a word we said, and before they could say a word, we were able to communicate in part through visual cues, right? They appreciated not just the sound of our voice, but our facial expressions, our touch. And the truth is that babies have evolved that way because as human beings, we need all of those signals to understand and communicate with each other to the fullest extent. It's why, you know, over thousands of years, we evolved to be able to interpret those signals as well. So that when you're having a conversation and someone's saying something, but their body language doesn't match it, that puts up a red flag for you that you might be

missing something, or maybe they're not feeling comfortable with you. Maybe they don't trust you to be open. And so when you don't have those cues, because you're either on Zoom, which gives you some of them, you know, when you're on video conference, or when you're on a text-based platform, whether it's text messaging or social media, where you block any of that entirely, it really reduces the quality of the communication. So in real life, I may feel angry at you and be tempted to say something, but then start to see the look of pain on your face and then pull back, recognizing that, gosh, I don't want to let my impulsive anger actually lead you to be injured and hurt in some way. So we temper our outbursts, if you will, like our emotions and

calibrate them based on these cues. But when we don't have those cues, then we just unleash sometimes terrible anger or other emotions on people without recognizing the impact it has on them. But I also think it allows people to absolve themselves of responsibility in a sense, because we have responsibility to one another, right? Like I am responsible, John, for how I make you feel in a conversation, you know, and vice versa, based on the things I say and how I treat you. But if I can just throw and lob terrible, you know, angry comments at people that are hurtful, but then walk away not

knowing how it may have impacted them. Then I can turn a blind eye, if you will, to the arrows that I'm putting into the world. And that I think is one of the dangers, you know, that we see time and time again on social media. So this is the thing is like for much of humanity, we have learned to interact with each other based on these cues to interpret these cues, and it's temper for much of humanity, we have learned to interact with each other based on these cues, to interpret these cues. And it's tempered some of our reactions. We're seeing that people really functioning without any of those guardrails in place. And it's just amplifying people's anger, their sense of injury. And it's not doing anything positive for our mental health and well-being.

I think about this all the time. I mean, I now try to, when I'm tweeting especially, I try to offer myself a test. And I'm like, would I say this to the person in real life? Because I'm an extraordinarily non-confrontational person in real life, you know, to a fault, some would say. But you do feel this freedom on Twitter to dunk on someone or to say something a little nasty because you're like, well, I'm not going to see them. And then I'm going to just keep scrolling in the feed and it goes away and I don't have to think about it again. And you don't actually have to think about the person that you may have insulted because they're

not sitting with you. But if you had that conversation in real life with someone, you probably wouldn't do half that stuff. You wouldn't say half that stuff. That's exactly right. And there's also just, you know, there's a relational context also that matters so much, like when you're having an interaction with somebody, like when you realize that somebody might be a parent, for example, you can picture for a moment that, hey, they probably have been up late nights worrying about their child. You know, when you know that somebody may have lost their job, you might realize, hey, you know, I remember what it was like when I lost my job and how frightening that was. But when we don't have any of those cues, right, because we haven't spent a moment to

get to understand somebody or know somebody, it's easy to just treat them like the idea or the ideology that they represent or like the political party that they may be a member of. And people are so much more than their political affiliation. They're so much more than their point of view on a single subject. And I think that is one of the challenges we have today, John, like in society, which is how to see each other as whole human beings, how to reimagine and I think recapture a way of interacting with each other, which is true to our humanity and which treats us as people and not as singular ideas. To me, that is at the heart of how we have to slowly but hopefully surely rebuild a greater connection and a sense of community. Because right now I'm really worried, John, that the growing fragmentation and polarization that we're experiencing in society is in some ways getting worse, you know, and there are platforms that profit from that. There are people who benefit from that, no doubt. But

it doesn't change the fact that for your kids and my kids growing up, that we don't want them to live in a world where everyone is angry at each other all the time, where the internet is a minefield, where people are just tossing grenades at one another all the time, and where there's just a practice of judging people before giving them the benefit of the doubt or before pausing to understand them. That's not the world we want for our kids. It's not the world we want for ourself. But it starts with actually what we choose to do. I love what you just said, that you do a pausing to ask, would you say this to somebody in person before you write it on social media? I actually do that

with emails. Also, sometimes if I'm really frustrated or angry, I'll think about writing an email. Sometimes I'll actually start writing it. But then I remember an old mentor of mine who told me, never send something when you're angry. Never say something. Never write something. Never post something. And so I'll always wait before I click send and then try to get in a better place of mind. Sometimes that's actually remembering something about that person that was really positive, that I really enjoyed.

Sometimes it's just distracting myself and going to something that does give me joy, like playing with my children for five minutes or something. And then I'll come back to the message and I'll realize, I don't want to send this. I'm going to regret this. I feel like this must be working for you because I know we've only spoken a couple of times, but it's really hard for me to imagine you getting really angry and flying off the handle. You seem like a very kind, rational human being. So whatever you're doing must be working. No, I get angry, you know, at times. You know, if you meet my wife, you'll see that she's a really calm one, like in our relationship.

But there are things that really upset me, you know, from time to time, you know, especially when I see injustices. Like, you know, John, I'll tell you this. Like, you know, in my family, we lost 10 people to COVID during this pandemic. I'm sorry. And they died before they had an opportunity to access the vaccine. Right. So one of the reasons that I, you know, put as much effort as I can into trying to help people understand more about the vaccine is because we have the opportunity to save people's lives now because we have this vaccine available.

And I want everyone to make sure that's available to their family. But when I see, for example, people who are willfully spreading misinformation about the vaccine and potentially costing people their lives, there are times where I do feel angry, you know, about that. But I also then, like in better moments when I paused, I realized that, you know what, no one's mind was ever changed by being shamed and blamed. You know, so, you know, even though we might be, I might be upset or angry at times about some of these things, I need to get into a better place, you know, to actually be able to communicate about this. So, yeah, look, I'm human. We're all human. We all experience anger. It's how we deal with it, I think, that ultimately makes the difference between whether we build and strengthen

connection and communicate effectively or whether we ultimately turn people away. No, I mean, I feel like that's true of persuading people to take a vaccine. I think that's true of politics. And I think this is another area where our addiction to social media has sort of fueled the division that already existed i mean you you spoke about this a little but this is what basically that the central reason i did this whole series is we had this incredible political polarization in this country um i'm a democrat i can argue that the republican party's extremism caused a lot of that that's fine but here's where we are we have this polarization then we get into a then we and we are all on social media way too much. So we're online a lot. Then the pandemic hits and now we're online even more

at home and everyone's really angry and really upset and despairing for good reasons. Because, you know, we're in the middle of a pandemic. And I just think I really worry about sort of the state of the country and, and, the country and how we'll be when we come out of this. And I know you worry about this too. I know you just came from a high school here in LA where you spoke about the mental health challenges facing young people because of this pandemic. Do you think that sort of our mental health, both individually and collectively, has been a big enough part of the national discussion during this pandemic? It's a good question, John. I think that our mental health and well-being has been one of the greatest casualties of this pandemic, but it's been an invisible price that we've paid.

And so it's less obvious than the number of lives we've lost or hospitalizations we've incurred, the number of people who have tested positive. So we track what we see, but I think that often means that we're not paying attention to the hidden costs like mental health. So I do worry about it. And the other thing that, you know, we sort of learned over many years from the experience of natural disasters is that many people's mental health challenges actually will crest after the immediate threat has resolved, right? And you can understand that. It's sort of like in the midst of a crisis, we pull it together, we just try to figure out how to get through. But then after, then we sort of realize the full

impact that the crisis has had on us, and that's when we can really struggle. So I worry about kids. You know, I met some kids, you know, in a roundtable yesterday, high school students who were extraordinary at King Drew High School in L.A. And gosh, the stories they were telling me, John, were heartbreaking. Not only had many of them lost loved ones and 140,000 people, actually young people in our country have lost a caregiver during this pandemic because of COVID-19. But they talked about just being isolated from their friends for a long period of time. They talked about the stress on their parents, many of whom were struggling with their jobs during the pandemic and how that filtered down to the kids in terms of the stress that they felt. So I do think that our mental health has taken a big hit. But I actually think

there's also a silver lining here, potentially, John, as I see it, which is that one of the things I think many people have come to realize during the pandemic is that the relationships that they had in their life were a lot more important to them, perhaps, than they may have realized. Perhaps some of us, myself included, took some of those relationships for granted. But when we weren't able to see people as readily as we otherwise were, it sort of made us realize, gosh, those relationships really made a big difference. And we're just nice to have. They were really critical for our overall health and well-being. I say this all the time is I went into the pandemic. I've never been sure if I'm an introvert or an extrovert, because I'm not the type of person who will like go to a party and talk to a bunch of strangers. But I am the kind of person who really loves being around my circle of friends, my social circle.

And I had this combo during the pandemic where, of course, we were shut in because it was the middle pandemic. And then we had Charlie. And so now we were new parents also in the middle of pandemic. And I had real struggles in those months after he was born, not only just the struggles that every parent has with a new baby. But I just I like, lost a bunch of weight. And I was really sad. And you know, and I was I realized it was because the relation. I mean, I have a wonderful wife, and we have a fantastic relationship. And so thank God for that. Beyond that, beyond my immediate family, I wasn't seeing and connecting with the people

that I love and talk to enough. And I hadn't realized until I started reading your book, which I want to get to about loneliness, that that's what it was. Wow. That's really powerful, John, to hear that. And let me ask you a question. How did you connect the dots there? How did you get the insights that like how you were feeling was connected to your lack of connection, if you will, to the people you love? Because I'm such a, you know, I'm a workaholic, right? But I also, I've always worked jobs that I find incredibly fulfilling and there's sort of a collective mission to the jobs, right? I'm on campaigns and I already started Crooked Media. And so I get a lot of joy out of the relationships I have with my colleagues, with the people I'm

working with. A lot of my best friends are also people that I work with and have worked with in politics for a long time. And when you don't have that every day and you're just texting folks or you're Zooming folks once in a while, or you're just calling your parents, you're calling your family. And you don't have those moments when time isn't structured, you know, because when, you know, we'd have this thing where maybe we'd go see some of our friends and sit in someone's backyard six feet apart for 10 minutes, and everyone's sort of staring at each other, and you do a half hour of catching up, and then you go back home, and it's another week until you see people again. That was like the middle of the pandemic, right? That was the experience. And that's just a different kind of conversation and different kind of social connection than you're used to having. And I think once I started thinking

about that, I realized that, yes, it's the middle of the pandemic. And yes, we're tired because we have this newborn. But those moments is what I'm really missing. And I think that was contributing to me feeling bad. I think it's really powerful. And I think that was contributing to, to, to me feeling bad. I think that's really powerful. And I suspect that you're definitely not alone. I mean, I, you know, my kids are small enough that I remember what it was like when they were born. And that's such an intense period where in some ways at a time when you really need people around you to be helping it's's easy, sort of, especially in modern society, actually just sort of shut down and go into a bunker, if you will, where it's, you know, just you trying to like figure everything out and get, you know, the three in the morning,

figure out feedings, get everything done with your partner. And if you don't, if you're just happening here in the pandemic, where you especially don't have, it's not as easy for people and family to come and help out, that can be really incredibly tough at one of the most stressful times of your life. But I think actually what you're talking about, though, is, to me, one of the greatest and most important lessons of the pandemic, which is that if we realize now that our connections and our relationships with each other are so extraordinarily important, the question is, what are we going to do about that? Because I do think that for many people, if you were to ask, like, you know, take 10 people off the street and ask them, what's your most important priority in life? I suspect the vast majority of them would name a person, right? They would like name their spouse or their child or the parents or the best friend or something like that. But then if you look at how we live our lives, John, and I always say this about myself, especially pre-pandemic,

my priorities, as judged by where I put my time, attention, and energy, probably not as much on people as they were on work, right? I mean, brutally honest about it, even though I would say the people in my life are the most important to me. And the pandemic really forced me to grapple with that discrepancy, that inconsistency, and just say, well, what would it look like to really live a life where I put people first, where I built my life around my relationships and then fit work in as best I could or other priorities versus the other way around? And very interestingly, when you look at what's behind the

great resignation, John, that's taking place right now with millions of people either quitting their jobs or questioning their jobs. While there are certainly many people, people who are able to do that are often in a position of privilege, right, of being able to have a choice about whether to work or not. These unprecedented numbers, I think, tell us that people are looking for something different. Now, in the conversations that I've had with many employers, I've come to see that some employers think that this is because people are holding out for bigger paychecks. Now, that may be one part of this, but I actually think it's a small part of it. I think what many people are reacting to is just a recalibration, a reckoning, if you will, during this pandemic of what really matters. What do they really want out of their life? Some people have moved to be closer to family and are saying,

do I really want to move back if I have to come back in person? Other people have realized that the two hours they spent commuting is time that they're now spending actually having dinner with their family, and they don't want to let go of that. You know, people are reassessing their life in a way that is often centered around their relationships with people and asking how to make that a more central part of their life. And to me, that's an incredibly promising sign. It's a silver lining. But what worries me, John, is that the fact that people are contemplating maybe making longer term changes that center around people does not mean that we will actually do it, right? Because this could be a moment that fades and where we just recede in a sense back to 2019 with all the goods and downsides

of that time. But my hope is that we can make it different, that we can actually come out of this pandemic stronger than we were pre-pandemic because we make the active, conscious, and intentional decision to craft our lives in ways that are centered around our relationships with one another. You know, I've wondered a lot why we don't talk about this issue even more in the middle of this pandemic. And, you know, I know a lot of conservatives have used mental health concerns to sort of justify their opposition to almost any public health restrictions. You saw that sort of at the beginning. And sometimes I

wonder if that's prevented liberals from talking more about this crisis because it's yet another issue that's become politically polarized, right? Either you complain about restrictions because they're harming our mental health, or you say, no, it's more important to save people's lives. We should focus on that first and we can worry about everything later. And that's become a both sides thing. How do you think about the balance and potentially tension between pandemic public health policies that are designed to protect our physical health and public health policies that are designed to protect our physical health and public health policies that improve our mental health? It's such an important question.

And I think that one of the things I think we have to do in public health is to get better at being explicit about the trade-offs and about recognizing that our mental health and well-being actually is an incredibly important consideration, even in the short term. And I think if we had to do COVID all over again, I think there's probably some things that we would do differently in retrospect. I think, number one, we would probably take a harder look at how to keep our children in school, or at least having some degree of in-person interaction, recognizing that

not doing so came at a great cost for them and for their parents. I think the other thing that we would do is actually look at visitation policies in hospitals and nursing homes. You might remember in the beginning of the pandemic, visiting privileges were taken away in many institutions because people were worried about spread. But that led to these heartbreaking stories of family members not being able to be with their loved ones when they died, having to say goodbye via Zoom. It led to people missing out on the last months of a loved one's life who was met in a nursing home because they weren't able to see them for those last few months. Those are extraordinarily high prices to

pay, if you think about it, in terms of people's well-being. And I think we would probably find ways to strike a better balance, you know, if we had to do this all over again. But look, we were at the beginning of a pandemic that we didn't fully understand. But I do think that part of the challenge we've had as a society, John, is that we've never looked at mental health on equal footing to physical health. Right. And that's been true not just in society, it's been true specifically in the medical system, right? I look at how much time we spent learning about mental health and well-being in medical school compared to everything else. There's no comparison. I leave the same in residency training. And that is actually, I think, somewhat still reflected in public health, even though public health has made a lot of advances

as a field in recognizing the power of mental health and importance, still, I think we tend to not prioritize it or weigh the impacts on mental health as much as we should. So this, I think, is a really important point of learning for how we approach public health interventions and, you know, and measures in the future. We've got to consider mental health as part of our overall health, and we have to treat it that way. So, you know, you've been interested in these issues long before the pandemic. I mentioned this, but your book is fantastic. It's called Together, the Healing Power of Connection in a Sometimes Lonely World. We just mentioned loneliness briefly, but I think a lot of people think about loneliness as physical isolation.

You define it in a different way. Can you talk about that? Absolutely. And I'll tell you, John, this is not an issue that if you told me five years ago, I'd be focused on that I would have, you know, sort of thought without any credibility, because I thought, gosh, I was focused on 50 other things. But this is an issue where I was really educated by people around the country about how important and consequential loneliness is. And let's talk about what it actually is. So loneliness is this subjective feeling that the connections you need in your life are greater than the connections you actually have. And in that gap, you experience

loneliness. It's a feeling that can be painful, that can actually feel physically painful to people at times. But it's also a feeling that over time can increase our risk of depression, anxiety, premature death, heart disease, sleep disturbances, dementia, and the list goes on and on. The bottom line is loneliness has impacts on our mental and physical health. But loneliness is different from isolation. Isolation is more a objective descriptor of the number of people you have around you. But one of the things I came to see, John, when I served as Surgeon General during the Obama administration, was that you can were surrounded by hundreds and sometimes thousands of other students on campus, but it would tell me that they felt profoundly alone. There were many times also me as Surgeon General, and as somebody who had experienced loneliness for many parts of my childhood and at times during adulthood, as Surgeon General, I was surrounded by people all the time. But there were times where I experienced actually loneliness because I realized that

as part of my sort of fully immersing myself in work, I had made the mistake, John, of letting some of my time with old friends diminish and in some cases disappear altogether. I had lost my contact with family and friends and done so because I thought, you know, I don't know how much time I have in this job. I just want to do as much good as I can. And these are the stories we tell ourselves about why we cut ourselves off from our relationships. But the reality is that I could have done more and done it better if I had actually stayed connected to the other people in my life, because our relationships are a source of fuel. Our connection is what helps us to just be more and to do more in the world. I heard you say in a podcast that the way little children act proves that we're born to be

social relational creatures. And it's not that we lose that desire. It's that a whole bunch of stuff gets in the way, our individualistic culture, chief among them. Can you talk a little bit more about that? What gets in the way? Well, absolutely. And this is where becoming a parent for me has been such an educational experience. I've learned so much from watching my children and how they engage with the world. Kids, for example, have this remarkable ability to find joy and wonder in the mundane, right? They get this spot on the wall and just be fascinated by it, you know? And, you know, we might be worried about what's happening in the

stock market or what's happening with like, you know, the number of, you know, COVID cases or restrictions here or there, but they're finding joy in the moment. But I also find the way children treat one another uh you know is is so powerful like so many children i find their instinct is just to reach out to other kids is to be kind uh is i still remember my son whenever somebody would come over he would just uh give them a hug that was charlie is just starting to do that now and he says he says hugs hugs and then he just goes around and he just like, now he's like hugging inanimate objects too, but that's okay. We're fine. You can hug everything, you know, but it's such a, it's such a powerful instinct and it seems so natural, you know.

It is. And I actually think it is our, and remains, I think throughout the course of our life, our deepest instinct, which is to connect with other people, to do so in a way that's informed and driven by love and kindness and compassion, not by fear, anxiety, or anger. But something happens to us as we get older, right? We come to learn or we're taught maybe through our difficult life experiences or from the people we see around us that if you're open with your feelings, that people will take advantage of you. And we come to learn that if you express kindness towards somebody and they don't express it back, then that means you've been rejected. And then that means people to feel bad about themselves, right? So all of these things

happen to us, which interfere with our ability to fully show up as who we are. And that's why I actually think so much of rebuilding a connected world and a connected life. It's not about becoming somebody that we are not. It's about returning to who we fundamentally were when we came into this world, who we have been for thousands of years. It's not an easy thing to do, but it's fundamentally different from saying, gosh, we got to transform into something totally different. No, this is about returning to home, to what feels good. And the way we know that in part is that when you think about those moments, John, that we've all had in life, where we were able to be in conversation with somebody and truly be open and vulnerable, where we're able to receive love and support from

them, and maybe even express love and support toward them as well. You walk away from those moments, John, feeling so good, feeling like that just felt right. Like it just felt renewing. And that's how we know that that's who we're supposed to be. And so life to me is like, when I think about what would make for a meaningful life now, I think about creating more moments like that, where I can be authentically myself. And this is how I want to teach my children about relationships as well, that the number of connections we have is not determined by how many followers we have on social media or how many people we might invite to a general holiday party. It's really determined by the

number of people with whom we feel we can show up as ourselves, with whom we can be vulnerable, with whom we can be truly open. That's what defines the highest quality connections. And, you know, a lot of people, unfortunately, don't have those connections, because they're, they're, those are, we call those intimate connections, right? They're sort of the closest circle of friends. There are also relational connections those intimate connections, right? They're sort of the closest circle of friends. There are also relational connections that people have, you know, with work colleagues and others who come in and out of your life. You may not necessarily be best friends with them, but they're people who you share an

experience with. And then there are community connections, if you will, the relationships we have with people who might be part of the same church or synagogue group, or they might be a part of an organization that we volunteer with people who might be part of the same church or synagogue group, or they might be part of an organization that we volunteer with. As human beings, we need all three types of connection in our life. But truly, it's those intimate connections that most often make us feel like we are seen and heard, like we're understood. They make us feel at home. Well, just to bring things full circle, L.M. Sikasas, who's a technology theorist you may be familiar with, wrote this great essay early in the pandemic about doom scrolling. And he basically argues that what we need in times of uncertainty, like the one we're living through, is not more information, which probably won't give us the certainty that we're craving, but more friendship, which helps sustain us through the uncertainty.

Would you agree with that? Absolutely. The more we learn about human relationships, the more we learn about how powerful they are as a source of healing, as a buffer for stress and anxiety. You know, we, the thing, this is to me, one of the most powerful things about relationships is that we have survived over thousands of years because of the relationships we had with one another. You know, the person who tried to go in on his or her own, you know, thousands of years ago when we were hunters or gatherers, like, you know what happened to that person? They died, right? They got eaten by a predator or they starved because of an inconsistent food supply. It was the people who built trusted relationships that truly survived. And John, you know, when I think about, again, to come back to our kids and I, so much of

our life set around our kids when we're parents. And for me, it's changed the filter through which I think about the world. But when I think about what I want for my children, more than anything else in the world, right? It's that I want them to be happy. I want them to be fulfilled, right? I want them to have deep meaning like in their life. But that is not going to come necessarily from the job they have or how much ends up in their bank account or how many awards they have to put up on their wall. And to me, that's the thing that I worry about with modern society, right? Because modern society tells us that our self-worth comes from whether or not we are successful, but it defines our success as our ability to either accrue wealth, power, or fame.

Those three things are what we define as being successful. And you have all three, wow, you're super successful. Think about the movies that we make and the books that we write about individuals that we hold up as successful. They're often people who have achieved fame, power, or wealth. But the reality is, when I think about people, John, that I have cared for in the hospital over the years, people who are at the end of their life, the people who are actually reflecting on the most meaningful moments of their journey, very few of them talk about how wealthy they are or how much power they had. Very few of them talk about how famous they were, how many followers they had on social

media. What they would talk about in those final moments of life, John, were their relationships, the people they loved, the people they missed, the people whose life they were grateful to be a part of. It's so clear, John, that in those final moments of life, when everything but the most meaningful strands of life fall away. The way it rises to the surface are our relationships. And I just don't think that we have to wait till the end of our life to come to that realization. I think COVID has given us an opportunity to reset, to reassess, and to understand what

really and truly matters in life. And that is our relationships as one another. And that's why that's what I want for my children, is for them to lead a truly connected life. And that is our relationships as one another. And that's why that's what I want for my children is to, for them to lead a truly connected life. It's why I think we have, I think, not just an opportunity, but an imperative to invest in our relationships as individuals, but also as a society to figure out how our institutions can support relationships. Like, how do we design workplaces that support healthy relationships between colleagues? How do we design schools that give kids a foundation for building healthy relationships from the earliest of ages? And how do we create neighborhoods which model for our

children that community is more than the family that you're born into? It can be your neighbors and those with whom you share, you know, common grounds. So this to me is to me, is the great challenge of our moment, but also the great opportunity. And if we seize that to build a more connected world, I think we will be more fulfilled. I think we will be healthier. They will be happier. And that, to me, is the best definition of success that we can hope for. Well, I think that's a wonderful place to leave it and a beautiful thought. Last quick question.

I'm asking all the right guests. What's your favorite way to unplug? How often do you get to do it? My favorite way to unplug is actually to tell stories to my children. I make up stories. I tell them imaginary stories. Yeah, I've been doing that too now. That's great.

And so I love just lying down in bed with one of them on each side, holding them close, and then taking them through this wonderful, fantastic, imaginary tale. And they love it. I love that. Dr. Vivek Murthy, thank you so much. This was wonderful. I really appreciate the conversation. Thank you so much, John.

I'm so glad to chat with you about this. Take care. You too. Thank you. editor. Kyle Seglin and Charlotte Landis sound engineered the show. Jordan Katz and Kenny Siegel take care of our music. Thanks to Tanya Sominator, Michael Martinez, Ari Schwartz, Madison Hallman, and Sandy Gerard for production support. And to our digital team, Elijah Cohn, Nar Melkonian, and Amelia Montooth, who film and share our episodes as videos every week.