The Dr. Hyman Show - Why Loneliness Is A Public Health Issue with Dr. Vivek Murthy

Episode Date: April 29, 2020

When we think about health, we usually think about diet and exercise. We think about the things we are doing for our physical body to promote wellness. But what about the things we can’t see? Relationships are a big one. For example. committing just ten to fifteen minutes a day to talking to someone we love is a powerful way to keep ourselves happy and connected, especially now during this time of coronavirus quarantine. Today on The Doctor’s Farmacy, I talk with Dr. Vivek Murthy about nurturing greater connection and what it means for our health.  Dr. Murthy served as the 19th Surgeon General of the United States between 2014-2017. As the Vice Admiral of the US Public Health Service Commissioned Corps, he commanded a uniformed service of 6,600 public health officers globally. During his tenure, Dr. Murthy launched the TurnTheTide campaign, catalyzing a movement among health professionals to address the nation’s opioid crisis. He also issued the first Surgeon General’s Report on Alcohol, Drugs, and Health, calling for expanded access to prevention and treatment and for recognizing addiction as a chronic illness, not a character flaw. In 2017, Dr. Murthy focused his attention on chronic stress and loneliness as prevalent problems that have profound implications for health, productivity, and happiness. His book Together: The Healing Power of Human Connection in a Sometimes Lonely World was just published on April 28th. *For context, this episode was recorded in February 2020. This episode is sponsored by Simple Mills and Branch Basics. There are definitely not many baking mixes out there I trust. Simple Mills is an exception because they use real-food ingredients. Having a few boxes of Simple Mills mixes on hand is an easy kitchen hack for healthier baking on those days you just need a little extra help. Now until May 29th, 2020 you can get 20% off at simplemills.com using the code DRHYMAN20.  Branch Basics makes a biodegradable, non-GMO, fragrance-free, multi-purpose concentrate that can clean everything in your house safely. You can honestly use it for anything - in the kitchen or bathroom or even for laundry or cleaning your wood floors. Right now Branch Basics is offering 15% off their Starter Kit, just go to branchbasics.com and use the code HYMAN15 at checkout.  Here are more of the details from our interview:  How Dr. Murthy came to focus on loneliness (9:04) The science behind loneliness and its impact on our health (14:24) Why we don’t always see the loneliness that exists around us (19:22) Loneliness and its connection to addiction (20:45) Building connection through love and kindness (29:51) Steps we can take in our individual lives to combat loneliness and build a connected life (37:36) Shifting culture to a society that focuses on people over reputation, power, and wealth (42:27) Our connection to other people is built on having a strong connection to ourselves (44:01) Why we often struggle with loneliness in the workplace (45:22) Getting over the obstacles that keep us from investing in connection in our own lives (48:54) Learn more about Dr. Murthy at www.vivekmurthy.com and get a copy of his book, “Together: The Healing Power of Human Connection in a Sometimes Lonely World” at https://www.vivekmurthy.com/together-book Follow Dr. Murthy on Facebook @drvivekmurthy, on Instagram @drvivekmurthy, and on Twitter @vivek_murthy

Coming up on this week's episode of The Doctor's Pharmacy. Our connection to other people is ultimately built on having a strong connection to ourself. Hey everyone, it's Dr. Mark. A few years ago, I got really sick. I almost died actually. It was a perfect storm of a few different things that got me to that point and one of the most dangerous was mold toxicity. I found out that my house, an old converted barn, had a major mold problem. It was really scary to think about my own safe haven home slowly poisoning me. I started to think about what other toxins might be hiding in my home and what could I do to be proactive about it without ever having to get sick again. I realized that even though I thought I was pretty conscious

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You can honestly use this stuff for anything. I use it in the kitchen, the bathroom, even for laundry and cleaning wood floors. It's amazing. It's also an incredible way to cut down on waste. Just use a little concentrate with some water in a refillable bottle. The best part of it is it works even better than that gross toxic stuff. If you're ready to overhaul your cleaning routine, check out Branch Basics. Right now, they're giving a special offer to my audience for 15% off of their starter kit. Just go to branchbasics.com and use the code HYMAN15.

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One of the best parts of being at home more often is making really good food. And recently, my wife and I made a special treat, almond flour bread to have with some fresh raspberries and coconut butter for breakfast or maybe to dip into olive oil alongside a big salad for dinner. Now I know you might be thinking that making almond flour bread at home takes a lot of ingredients and time, but it does not. We used the Simple Mills Artisan Bread Mix to start and finish, and it's done, boom, 25 minutes. There are definitely not too many baking mixes out there I trust, and Simple Mills is an exception because they use real food ingredients. Their bread

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You won't believe how good this almond flour bread is and the brownies are another favorite of ours for an occasional decadent treat with a cold glass of macadamia milk. Now, I know you'll enjoy them as much as I do. So let's get back to this week's episode. Today's episode was recorded before the World Health Organization declared the coronavirus outbreak a pandemic. And before stay-at-home orders were issued across the United States. As many of us are social distancing and separate from one another, I think you'll find this conversation more important than ever. And remember that just because we're separated doesn't mean we can't stay connected.

Connecting with family and friends over video or phone calls has been really meaningful to me during this time and can make a huge difference for our mental health, even with just five or 10 minutes a day. Now on to my conversation with former Surgeon General Dr. Vivek Murthy. Welcome to the Doctor's Pharmacy. I'm Dr. Mark Hyman and that's Pharmacy with an F. F-A-R-M-A-C-Y. A place for conversations that matter and if you've ever suffered loneliness or felt isolated or disconnected in your life this conversation is going to matter to you because we have an extraordinary guest today, a former Surgeon General of the

United States, Dr. Vivek Murthy, who I've known for a number of years, who actually invited me to come to meet with him when he was Surgeon General and talk about the issues of food and obesity and nutrition and disease. And he just always is so attentive and connected. He came to Cleveland Clinic to talk about the opioid epidemic, and I tried to get the leadership there to do what he did in the Surgeon General's office, which is to get the entire clinic meditating every day at 3 o'clock in the afternoon. The chief of staff was a little confused when I said that, but I think it's really what we all need to be doing.

I usually sneak off in my little room in my office and just try to do meditation in the afternoon when I'm there. But he's an extraordinary leader in medicine, in public health. And his new book, Together, The Healing Power of Human Connection in a Sometimes Lonely World, or I would probably have titled it An Often Lonely World, is really an extraordinary contribution to our understanding of what creates so much suffering and dis-ease and actually disease. Because if you're looking at the causes, the root causes of chronic illness, it's often related not just to food, which is my lane, but to loneliness. And people don't understand that that's actually a big driver of so much. And we're going to talk

about that. Dr. Murthy is an extraordinary guy. He was the Vice Admiral of so much. And we're going to talk about that. He, Dr. Murthy, is a extraordinary guy. He was the Vice Admiral of the U.S. Public Health Service Commission Corps, where he commanded a uniformed service of 6,600 public health officers globally. He launched the Turn the Tide campaign, which was to help our nation's health care providers focus on our opioid epidemic. And he was a key leader in addressing that crisis while he was Surgeon General. He issued the first Surgeon General's report on alcohol, drugs, and health,

calling for expanded access to prevention and treatment and recognizing addiction as a chronic disease, not a character flaw, which many people still think it is and stigmatize it. He's then focused from 2017, his attention on chronic stress and loneliness as huge problems that affect our health, our productivity, and our happiness. He co-founded a number of organizations, Visions, which is an HIV AIDS education program in India. I'm not sure I'm saying this right, Swasya,

which is a community health partnership in rural India that trains women as health providers and educators. Sort of like Barefoot Doctors in China, but for women, I guess. And he helped build the grassroots organization Doctors for America that was very involved in the election of President Obama. And since he's left Surgeon General's office, he's focused on loneliness and social connection. His book, Together, The Healing Power of Human Connection in a Sometimes Lonely World is out April 28th. Harper Collins, he's just an extraordinary guy. He has a degree from Harvard, his MD and MBA from Yale. He went to residency in Boston and was on the Harvard Medical School faculty.

He's a very serious dude and a good friend. And I really am so happy to have him here on the podcast. Welcome, Vivek. Thank you so much, Mark. I feel somewhat embarrassed after that introduction, but thank you. And he's only 25, which is what's amazing. Are you 40 yet? I got a lot. I'm 42. Okay, 42. So the best is yet to come, I have a feeling. He's just getting started. I think, were you the youngest Surgeon General ever? In about a century or so. The very first Surgeon General in the 1800s was younger than I was.

That's because nobody lived very long back then, right? That's that's unbelievable in a hundred years and that just speaks to your your character your intelligence your Insightfulness about some of the biggest things that are affecting our public health today and I I'm just so glad you laser focused on this issue of loneliness because, you know, in the early part of my career, I focused on food as a big driver of chronic disease. And still it's what I'm focusing on.

And functional medicine to take care of the individual. But I realized that I could not really get my patients better unless I deal with the social issues that they're facing. And I began to realize that there's another medicine that's just as powerful as food, and that's love and social connection. So I would say love is medicine, food is medicine. That's how we're going to help the world. And you really lasered in on the love is medicine through looking to the lens of loneliness. And how did that all come about? I mean, you basically, you know, are traditionally trained internal medicine doctor. And, you know, it's not something

we really taught about in medical school is loneliness. How did you come to that? Well, it's a good question. You know, I think I had experienced loneliness a fair amount in my own life. And when I was a kid in school, I was very shy, and I had a hard time making friends in elementary school. And each day going to school and being dropped off by my parents, I had that pit in my stomach of nervousness. And it wasn't because I was scared about exams or teachers. I was actually just worried I was going to be alone again. And I just couldn't wait for the bell to ring at 2.30 or 3 o'clock or whenever it was so that I could

go back home and be where I felt really good because I had loving parents and an amazing sister. And I felt very cared for and taken care of at home. So it was certainly a presence in my life. And it cropped up many other times during adulthood as well, at transition points in my life and it cropped up many other times you know during adulthood as well at transition points in my life and even during my time as Surgeon General and in the years afterward I also then started to see it in my patients and this is not something I expected at all because when I was in medical school and I suspect that you and many of us had the same experience loneliness is not part of the curriculum nope emotional well-being was not a class one oh one no yeah this is not part of the curriculum nope emotional well-being was not a class loneliness 101 no yeah this was not part of um for that matter neither was nutrition you know

like i still remember our nutrition education in medical school was one class once a week in the evenings that was optional for like six weeks yeah and it was probably on like vitamin deficiency diseases like rickets and scurvy yeah there wasn't a whole lot of training but certainly on this subject of our emotional health and the power and importance of social connection there was very little but when i started seeing patients there were a couple things that struck me one is that people would come in with with real serious illnesses and they would have, you know, and illnesses are critical times in people's lives

where they've got to make big decisions, and they have to, they find themselves reflecting on the rest of their life to see, you know, gosh, you know, have I lived the life I want to live? And at those critical moments, you need people around you to help you figure out what path to take and just to support you and be there with you. But so many of the patients were alone.

And I remember I used to sometimes ask them. They just were in the hospital by themselves. They were there by themselves. And I would ask sometimes, I would say, hey, we've got to make a pretty difficult decision now on whether to go to surgery or not, or whether to start chemotherapy or not. Is there somebody you want us to call to come in

so that you can talk it through with them as well? And so often the answer was no. There's nobody to call. Even at the time of death, Mark, I noticed that on so many occasions that the only ones to witness people's last moments were myself and the other doctors and nurses. That was the medical staff. And so I remember that quite vividly but even despite all of that I was not planning to talk about loneliness or work on it when I was searching general because I didn't know if that was just my own experience and maybe my own the peculiarities of the of my medical experience as well but what

happened that really changed things for me is when I began my time in office I began with the listening tours yeah traveled to all of these cities and towns all across America with a simple question How can we help and I tried to just sit back and listen to what people said and what they said was fascinating because I did hear stories I expected about addiction about obesity about Depression and anxiety what I didn't expect to hear that within those stories were these threads of loneliness Mmm, and people wouldn't say, you know, hi, I'm Mark, I'm lonely. But they would say things like this. They would say,

I feel invisible. I feel like we're struggling all alone here. I feel like people have forgotten about us. I feel like people just don't even see us. And if we died, no one would even know it. People would say things like that quite often. And it led me to realize over time, as I heard more and more of those stories from everyone, from farmers in rural areas to moms and dads in big cities to members of Congress, I started to realize that not only is loneliness far more common than we thought. But you were hearing this from members of Congress. Oh, yeah. And they wouldn't say it publicly.

But interestingly, behind closed doors, they would say, yeah, you know, this has been a struggle for us. I had one member of Congress, in fact, tell me, he said, if you're going to build a campaign to address loneliness, could you start with Congress first? People were either affected directly or through the people they loved. And that all of us, at some level in modern society, are vulnerable to losing our connections. It's so intense. And I think that we're really wired as social beings. Because a human being, by him or herself in the world, is usually dead. Historically, if you didn't have a tribe or a group that helped you navigate and in the world, is usually dead. Historically, if you didn't have a tribe or a group that helped you navigate and survive the world, you would just die. And yet, something's changed in the last 100 plus years. And you sort of say it's really different. This modern day loneliness is different than anything that has happened in other generations. And how does it

actually affect us? I mean, what is the science behind loneliness and its effect on our health and our longevity? And what do we know about that? Well, it starts with what you just touched on. Understanding how loneliness impacts our body starts with how we were thousands of years ago. And we, over time, evolved to really need each other. So thousands of years ago, when we were hunter-gatherers, there was safety in numbers. So if you had a trusted group of people that you were with, you could take turns keeping watch at night to make sure that there weren't predators that attack. You could also pool your food so that you had a stable food supply over time instead of

starving for many days at a time. You can also do other things like help in child rearing. So people could take care of each other's kids and share the responsibilities, which can be quite taxing if it's just you alone managing a growing family. And so we over time came to depend on other people for our safety. So much so that when we were separated from the tribe, when we were effectively more at risk then of starvation or being pursued by a predator, it put us in a stress state. And now in some ways that's actually a very healthy response because that stress state would raise our threat level

and focus us inward and push us to quickly get back to the tribe as quickly as possible. And that's in a sense what loneliness is like. Like loneliness, like hunger or thirst is a signal that our body is sending us that we're lacking something that we need for survival and if we react quickly to that and Fill the gap, you know with social connection healthy social connection in our life Then that feeling of loneliness goes away and we're and we're okay Hmm the problem though is when that state threat, which is effectively a physiological stress state, persists for a long period of time.

We know that stress is not good for us, but it's only in the case of it being there for a long period of time or an excessive amount. It's adaptive and it's small. Yeah, small amounts can actually be quite good. Like before we give a big speech or take an exam or take on any big task or go out on a date that we're really excited about, we might feel some stress, right? And that might push us to perform better and to actually bring out the best in ourselves. But when we're chronically stressed, that actually is when our body starts to break down. That's when we have elevated levels of cortisol and other stress hormones flowing in our body. We have increased levels of inflammation and that over time damages tissues, blood vessels, and leads to higher rates of heart disease and other illnesses.

And so loneliness, when it's chronic, when it's longstanding, puts us in a chronic stress state. And it's from that that we see so many of the negative consequences. Now, there are other practical implications to our health of not having connections. Some of the day-to-day help we might need, going to the doctor, taking our medicines, having someone to remind us and inspire us to eat healthily or to go and work out. To have a reason for living.

Right, to have a reason for living. We may miss out on these things too. So the healthiness of our lifestyle may deteriorate as well. But what we see overall is when you look at the data, at the impact of loneliness on our health, what you find is that loneliness is associated with a reduction in our lifespan. And that mortality impact is similar to the mortality impact of smoking 15 cigarettes a day. It's greater than the mortality impact of sedentary living and obesity. I think as Surgeon General, how much time I spent on those three issues, on smoking, obesity, and physical activity,

compared to how much I spent on loneliness. Wow. And there was no comparison. Wait, we got to stop there for a minute. Because what you just said was remarkable. That loneliness is a bigger risk factor for a shortened lifespan than smoking, obesity, or lack of exercise. That's like headline news.

It seems to be just as powerful as smoking 15 cigarettes a day and even greater than the impact of obesity. Which is pretty deadly. I mean, smoking is pretty deadly. So this is something that's not talked about. I'm in a big healthcare system. We talk about the office of experience and improved patients and doctors' experience. This is something that's not talked about. I'm in a big healthcare system. We talk about the office of experience and improved patients and doctors' experience. But this issue of loneliness being a risk factor, it's just not in our training. And it's not in our even approach as a culture to figure out how to solve some of our big issues like depression and the opioid epidemic and why know why people eat you know it's not

only about what people eat it's why people eat you know that's exactly right i often say you know you don't have to focus on what you're eating but what's eating you yeah and i think people don't don't understand that connection and i i think the question is you know what's happened to our society that's led to this and how do we get it back to a place where we do have connection and not social media, which actually leads to more isolation, more disconnection, more separation, feelings of isolation. You see, you know, the Instagram models and this and that. It just sort of makes you feel bad about yourself.

It's not really true social connection. Yeah. So let me pick up on one thing you said even earlier also, and then I'll get to what's driving this, but something you said, I think is really important, which is that we weren't really trained to think about this or to recognize how important it was. And I think part of the challenge is that we don't see loneliness around us very much. And there are two reasons for loneliness. There isn't, you're right. But also also even if we just think about the people in our lives we may not recognize that loneliness is that common but there are two big reasons for that

one is because there's a huge stigma around loneliness shame yeah there's a sense of shame that people have because they feel like if they say that i'm lonely that's like saying i'm not likable or i'm not lovable or i'm not desirable in some way yeah um it's like saying i'm a loser and nobody wants to feel that way. I certainly didn't when I was younger and felt lonely. I never told anyone about that. But there's another reason, though, that loneliness is hard to see. And that's because we stereotypically might think of loneliness

as the person who's sitting in the corner at a party and not interacting with anyone. That would have been me as a kid. Actually, I never got invited to the party, so it probably wouldn't have been me. Yeah, I wasn't at the party. I was at home. It's true.

But the other reason we don't see it is because it looks like other things. So loneliness can look like depression. It can look like anxiety. It can often lead to addiction or increase our risk for addiction. In fact, the founder of AA, one of the most interesting things I found that he said, it can often lead to addiction or increase our risk for addiction. In fact, the founder of AA, one of the most interesting things I found that he said is that loneliness, he felt, was at the root cause of so many people's struggles with alcoholism

and needed to be addressed in order for them to get into and stay in recovery. And that is something I found also when looking at the opioid epidemic. And there's a reason that the opioid epidemic has been labeled, part of the larger group of illness is called deaths of despair. Because it is often a sense of hopelessness and isolation that can lead people to experience emotional pain.

And then as human beings, once we experience emotional pain, we will seek to relieve that pain. And the question in those moments is what are we reaching for? So are we reaching for alcohol? Are we reaching for drugs? Are we reaching for food that's not good for us? Right. Are we reaching for exercise? Some people work out when they feel stressed or in pain and that helps them. Are we reaching for work? Some people drown themselves in work when the stresses of their personal life or disconnection are hard. Yeah, that would be me.

Right. And this is the thing, is that there are socially acceptable ways to sometimes deal with your pain, even though it hurts you in the long run. And alcohol, I think, and work are two examples of those. But for those reasons, when you look around you, you might think, oh, maybe I don't know that many people are lonely But I will tell you that the statistics Back up the fact that a very large number of people that we know are likely struggling with loneliness If you look at the conservative numbers

What you'll find is that? Probably somewhere around 20 to 22 percent of adults in the United States are struggling with loneliness. Those are the lower numbers. But there are plenty of other studies, including one recently by Cigna, the health insurer, which have pegged those numbers as significantly higher. And it's not just the U.S. What percent? Well, in the Cigna study, most recently, they found that it's in the 60s. It's more than 60% of adults who actually say they're struggling with loneliness. Now, this is either because loneliness, maybe loneliness is increasing. Maybe people are just more comfortable now starting to admit that they're struggling with loneliness. Maybe the studies are getting better. Who knows what the reasons are? And it could be potentially all of those. But the point is that

we are talking about more people who struggle with loneliness and have diabetes in the United States, more people struggling with loneliness than adults who smoke in the united states so this is both common and it's also consequential for our health and it's invisible and it's invisible yeah yeah it's invisible it's incredibly striking and you talk about it how in your book together the healing power of human connection in a sometimes lonely world which i encourage everyone to get a copy of whether you're lonely or not because likely you know someone is and likely um the things in this book are going to help you get more connected to things that matter in your life and also help you engage with your community in different ways to build love and connection which is what this is all about so you talk about in the book how loneliness also has not

just impact on the individual, but, you know, in a broader context that affects our kids' ability to function and learn in school. It affects productivity in the workplace and effectiveness on a sort of commercial level of competitiveness. It affects this incredible polarization and division of our society. I mean, I, you know, I remember hearing this guy, Peter Orszag, who was a budget director under Obama, talk at Cleveland Clinic about the voting in Congress. And in the 60s, you know, you could see a sort of a cloud of votes for Republicans, Democrats. It was all mixed. It was a big Venn diagram where there was tons of overlap and voting across party lines. And then he showed a graph now, and it was just a complete separation. And we're seeing that mirrored like I've never seen before in history in terms of lack of ability for our government to function.

But then it's spreading out in terms of divisiveness and conflict among all kinds of groups, racial groups, and all these different divisions in society that are really, I think, crippling our ability to actually have a great society. And so can you talk more about how loneliness is driving some of these trends and what we can do about it?

Yeah. This is one of the reasons that I wanted to focus on this issue because when I came out of government, when I finished my time as Surgeon General, I found myself thinking about all the different issues we had touched on from the opiate epidemic to violence to e-cigarettes, you name it, Ebola, Zika. I bet you're glad you're not having to deal with coronavirus right now. That's so frightening. This is a difficult, yeah, a very difficult and disturbing situation right now. And I think it's sadly only going to get worse before it gets better.

But one of the things I wanted to do is I wanted to ask myself the question, what's at the root cause of many of these deeper issues? And can I do something to make a small contribution to addressing that deeper root cause? And what I kept coming back to again and again, guided both by the conversations I had with people around the country and the science that I was reading,

was that our connection with each other is actually one of the most powerful and important resources that we have, not just for our health, but that affects our performance in the world, in school, in the workplace, that impacts whether we talk to each other or not in communities, and even has an impact on our politics. And that's why I wanted to work on this. And here's how it affects us. You know, if we can't, when we are connected to each other, our threat levels

are lower, our levels of stress are lower when we are lonely It increases our threat level and actually shifts our focus internally towards ourselves Because if you're in a threat state you want to focus on yourself for your own your safety and survival But it's hard to optimize our output It's hard to be the best person we can be and bring our full Self to the task if you will if we're in a constant state of stress And if we're so focused bring our full self to the task, if you will, if we're in a constant state of stress and if we're so focused on ourselves that we're missing what's happening in the outside world. You can see that playing out in the workplaces and schools and in Congress as well, absolutely.

And you can see what a price we pay as a society because political dysfunction impacts us all. But also when people aren't happy in the workplace, that impacts productivity and retention. It impacts creativity in the workplace. That impacts businesses and organizations, bottom line. But in schools, what concerns me most, especially as a dad who has two young kids who are three and two, is I think about what experience they're going to have in school. And I ask myself, well, is it a job of school to teach people

how to read, write, and do arithmetic? Or is it also to teach kids how to build a foundation for a healthy life in other ways, including in terms of their social and emotional well-being? You know, I would say there's three things you never learn in school that are the most important things in life.

How to have healthy relationships, how to take care of your health, and how to manage your money You know, I would say there's three things you never learn in school that are the most important things in life. How to have healthy relationships, how to take care of your health, and how to manage your money. Yeah, that's right. So these things, these are the foundations that matter. And when we don't have, and one of these key important foundations, what we realize is that everything else we build on it

is built on a shaky foundation. And I realize that when we have strong relationships in our lives we are better we are better at work we're better at play we're better in terms of our health we're better in terms in our relationships and what we bring to our family and to our friends when we don't when we feel lonely all of those things are more fragile and they're more likely to to collapse on us and so that's why when I Thought about this issue. I felt like if we can try if we can make a shift as a society from being one that is focused on

wealth reputation and power To one that is focused on people if we can truly create a people-centered life and a people-centered society, then I think we can capture the great power of social connection and experience the joys and the benefits that it has to bring to our health and ultimately to all of our lives. And there's good data on this. It's not just like a warm and fuzzy, touchy-feely thing to sort of help end loneliness and get people to connect it to each other. There's actually great data on how much a difference it makes in overall society and the success of our country,

the success of our citizens, the health of them. All the things that really we care about are centered around this issue. And your book isn't called Alone, it's called Together. And the reason is because in it you tell some amazing stories about people who solve this in their communities and are trying to break through this incredible sort of edifice of loneliness that surrounds so many so many people so can you tell us a little bit about some of the hopeful stories and some of the things that absolutely you know because it's kind of depressing is we're all lonely and everybody's lonely it's ruining everything

which is true how do we get out of it and what are the sort of stories that you you can share about how that's happening yeah so to me this is actually a deeply inspiring topic for exactly that reason because there are so many stories that we don't read about or hear about in the papers every day but if people who in their own lives are building connection and building community and helping to create i I think, what all of us want. But the other thing that's fascinating about it to me is that in building a connected life does not require us to purchase expensive medicines. It does not require us to have special medical equipment. It doesn't require fancy and expensive programs. It only requires what we

already have inside of us, which is our desire and our ability to give and receive love with each other. I remember being at the White House for an event when we were working on the opioid epidemic, and I was facilitating a conversation with a group of people about the epidemic and what was driving it. And it's in that moment, I remember sitting on that stage, where it struck me that we're talking about medication-assisted therapy and counseling and all of the other things that we need to put in place to help people struggling with opioid use disorder. And it struck me in that moment that with so many people that I met on the road felt like they were lacking were relationships. And at the heart of those relationships and communities were love.

And I really do believe that love is the oldest medicine that we have. There you go. Love is medicine. It is. It is. And of all the medicines I prescribe and you prescribe and so many doctors prescribe in the hospitals to treat our patients, those are important. Those are good. But there are few things that come close to the power of what genuine human relationships can do, and those are powered by love.

Some of the stories that I came across were really fascinating in this regard. I came across a mayor, Tom Tate, from Anaheim, California, who is the last person you would think of as leading a social movement in his community because he's a self-described introvert, really didn't like to hang out with other people very much, and also was deathly afraid of public speaking. And he was a mayor. Right, so what ended up happening is just by, you know, accident of, you know, of life, he was appointed to serve on the city council because there was a vacancy,

and the mayor knew him and appointed him. So he took that on, found he enjoyed it, actually joined a Toastmasters club to get more comfortable with public speaking, really had to work through a lot of issues, and then ran for city council again. And then the mayor's seat opened up. And he thought, you know maybe maybe i should run for mayor because what was really interesting is he had been he'd been seeing these signs around town these posters which had talked about which were posters about kindness it said be kind and we talked about the importance of kindness but there was no name stamp below it there's no sponsoring organization there's no url to go to to learn more it was literally just a poster with the importance of kindness, but there was no name stamp below it. There's no sponsoring organization. There's no URL to go to to learn more.

It was literally just a poster with the message of kindness. And he kept thinking to himself, this feels right. This feels like what our community needs. We need more kindness. That's the glue that holds us together. And without that, all these programs that we're funding and structuring, et cetera, well-intended as they are, are not going to work as well if people aren't connected to each other

and invested in each other. So he decided to run for mayor on a platform of making Anaheim a city of kindness. Wow. And he was scared about this. He thought, I'm going to get laughed out of town. People are going to think I'm not a serious candidate. I'm going to be made fun of for being soft.

My political platform is kindness. How about that? Exactly. But you know what he found? When he got up to announce his candidacy and to say that his goal was to make Anaheim a kinder city, he saw heads nodding in the audience. He saw people murmuring approval. And he realized that so many of us, even though we may not lead with it, we want more kindness. We want more love. We want more connection in our lives and in our communities. So he eventually won that race. He became the mayor of Anaheim. He created all of these programs from neighborhood programs to get neighbors to connect more deeply with each other to a one million acts of kindness program in the school system to get the schools,

students throughout Anaheim to basically engage in random acts of kindness and then to come together and share those experiences. And talking to him was such a beautiful experience because I came to see that through this focus on kindness, that what he did, which was incredibly powerful, is he didn't just set up a new program. He changed culture in the city. And when you change culture, which are the values and the ideas that people hold to be important, then you have a huge ripple effect on not just the programs they support, but on how they live their lives. And that's what he saw throughout Anaheim. That's incredible.

And, you know, it's something you can't legislate, right? You have to sort of create the structures to do that. And I think I sort of had a very similar insight to you, is that the cause of so much of our disease and dis-ease is disconnection. And through my work in Haiti with Paul Farmer, looking at what he did to treat infectious disease using community health workers, essentially neighbors and peers and friends, to help each other through making sure they took their medications and they knew what to do and were helping each other be accountable.

He produced a program that was more effective than anything else the public health community in the world had ever seen and was spread across the world. And I kind of realized that it's not just infectious disease that's contagious. It's chronic illness, which affects six out of ten of us. And as you know, it's sort of driving our economy into the ground and is burdening so many people and creates so much suffering. And a lot of the reason for it, like you said,

is the disconnection that drives people to behaviors and into things that actually aren't good for them, like food or whatever. And then I worked with Rick Warren to create the Daniel Plan with Dr. Amen, which was a faith-based wellness program, but it was founded on the idea of small groups or the infrastructure of the church that we just put the information in and they were able to help each other get better that, you know, getting healthy is basically a team sport.

And, um, we've taken that now to Cleveland clinic in a secular way. Uh, it's not a faith based wellness program. We, we, we now, um, are the top in our small center for functional medicine, which has 10 doctors is the number one in group visits in the entire organization. And the next biggest group down from us has about 400 doctors. And we have like 10. And the reason is I was very vocal about making sure that we actually did this because this is how people change. And we see that people will have a longing

to belong and a longing to connect and and and that's how they make meaning out of their lives that's how they get motivated to do anything and that's we're really missing from our culture and society and how do you um you know you know how how do you how do you see that that um we can spread this further um how do you how do you take the ideas in your book and make them something we spread nationally and even globally? Well, I think there are a couple things we can do. I think first by recognizing how common loneliness is,

but also by recognizing the power of human connection to elevate our health, our performance, and our well-being. I think that first step can help us to rethink our priorities, both our individual priorities, where we're putting our health, our performance, and our well-being. I think that first step can help us to rethink our priorities, both our individual priorities where we're putting our time, but also organizationally, like where as workplaces and schools and governments, we're allocating resources. The second thing is I think we can think about what steps we can take in our individual life to actually create more connection. The truth is whether you're feeling lonely right now or whether you're not,

you undoubtedly know people who are lonely and all of us are at risk of loneliness at various points in our lives. Loneliness isn't something that you're born with and affects you for your entire life. We go through natural periods of connection and disconnection in our life. And the question is, how do we prepare for that?

How do we deal with it? How do we build a strong foundation of connection to begin with? So there are a couple of things in the book that I go through that are, I believe, helpful in building that connected life. One of them, unexpectedly, is service. It turns out that when we serve others, we actually break some of these very negative patterns of loneliness that get in basically launched within us as a part of our evolutionary history. Those patterns being the focus on self and also the elevated threat level that we experience when we're lonely. Because when you help somebody else, first of all, that takes you away from a focus on yourself and

you're focusing on another person. But the second thing is it's also disarming. Like when you're helping other people, you're also reminded of what value you have to offer to the world. And that's actually reassuring. That lowers your sense of threat. So service is a powerful way to connect with others and also to reconnect, in a sense, with ourself, our own sense of self-worth and value.

The second thing though that can help us on an individual level is to think about where we're spending our time when it comes to social relationships. So number one, are we making sure that we have at least five to 10 minutes a day that we're spending with people we love? That could be spending in person. It could be speaking to them on the phone

or through video conferencing. But are we spending five to ten minutes with someone that we love every day and this might seem very simple but you'd be surprised how many people can go for days without having a meaningful conversation uh with somebody the third thing with uh can i interpret for a second yeah yeah so just remind me like when my wife we have a because life's busy crazy and running around we have a little ritual we do called what's up below huh which is you know not just chatting about the logistics of our life what we're doing that day but you know to sit down with each other whether it's having coffee in the morning or at the end of the day and it can be five minutes or it can be we can sometimes go for a half an hour an hour but it's what's up below like not just on the surface and we go in and we just listen to each other and we get each other and like what's happening in

your world what do you care about what's upsetting you what's thrilling you what's whatever going on and it just creates such a deep powerful moment of like being seen and seeing somebody else it's like every it just it just it's so powerful and we don't do that and you can do that with a friend you can do that with yes you know i do that that with, you know, I do that with my children. It's a very powerful, simple thing of just, say, dropping in to a place below the just surface level of life that we all live in all the time. Yeah. That's such a beautiful example. And what I love about that is, Mark, I imagine with you and your wife, you could easily get caught up in the logistics of life and spend that 10 minutes just talking about your calendars and your schedules and who's going to get groceries and who's going to get the car fixed.

And I fall into that with my wife as well because there are a lot of logistics in life that we've got to work through. But even just that five minutes can make an extraordinary impact. And that comes down to also another point about the quality of time that we spend. So technology is really interesting. And we can have a conversation about technology and how it's impacted our connection with one another. But one of the things that I think that many of us do now, and I certainly have been guilty of this, is we have allowed technology, particularly our phones, to dilute the quality of our interactions with other people because we bring our phones off into the dinner

table or, and we might convince ourselves, hey, i'm not really paying attention to it i've got it on silent i've put it face down i'm not really paying attention to it but we actually know from studies that when there's a phone even within sight even if it's on vibrate and face down yeah it actually changes how people feel about the conversation in a negative way and so there's a restaurant called hearth which is in new york city and they have a box on every table says please open me and you open it up and instead in a negative way. That's true. And so thinking... There's a restaurant called Hearth, which is in New York City, and they have a little box on every table that says, please open me. And you open it up,

and it has an invitation to put your phones in the box for dinner. And there's a game I sometimes play with my friends. Everybody has to put their phone in the box. The first person to take it out pays the bill. So, you know, there's several fun things you can do that actually help you stay more connected i love that absolutely that's a great idea so just like that i think there are you know in the book of

what i would try to do is i try to share some stories that lay out some individual steps we can take in our lives but also stories that talk about what schools and workplaces uh can do and are doing already in some cases to create a culture of connection. Because at the end of the day, Mark, if we want to create real connection, if we want to build a people-centered life and a people-centered society, it's going to involve more than programs. It's going to require us to shift culture and to ask ourselves what's really important. Now, if we got a group of 100 people together on any street corner in America,

my guess is if you asked them to name their top three priorities, the people would be at the top of that list. People might say it's my daughter or my son or my spouse or my mom or my dad. But if you look at how- They behave. Yeah, how where we put our time and energy

and where frankly society nudges us to spend our time and energy it's not usually with the people we love most it's in investing it in places where we can acquire greater power reputation and wealth the traditional marks of achievement in modern society i'm not saying that those aren't important or those there shouldn't be pursued it's a question of where are they on the priority list and i worry your facebook feed or Instagram feed or your email or- Right, and with those feeds in particular, like I think about like our childhood

and about the childhood that my kids will be experiencing. And in modern childhood, I think the messages, the cultural messages about what matters are just coming at you a thousand times faster. And I meet so many young people who are feeling, because of this culture of comparison on social media, that they are not thin enough, that they're not good looking enough,

that they're not popular enough or funny enough, that they're not enough. Ultimately that they're not enough. And that has actually a very powerful and insidious effect on our connection with other people. And this is one of the things I think that is not often well appreciated, which is that our connection to other people is ultimately built on having a strong connection to ourself. Now,

what does it mean to have a strong connection to ourself? It means to know that we have a sense of worth and value. It means to recognize that we are human beings who have something meaningful to add to the world. And that requires a combination of self-knowledge and self-compassion. Now, how do we develop self-knowledge? Well, we develop it partly by living life, but not only by living life, by having time to reflect and time to think. And much of that white space in our life that many people used to ponder and reflect on things on, that has disappeared. It's evaporated as now in the five minutes you have between events or when you're waiting at the bus stop, we just pull out our devices and look at the

news or check our inbox. But ultimately, if we are not able to support, particularly among our kids, a healthy sense of self, if we're not able to convey to them and help them understand what it is that makes them worthy and valuable, and that it's not what they're wearing, or how much money their parents have in their pockets, or how popular they are and what parties they're getting invited to, then we are going to run into a situation where people feel less and less adequate. And then they will seek to be the people that they think other people want them to be. And when we do that, that's a recipe for loneliness. When we try to be something we're not, when we can't inhabit our own skin, people feel lonely. That's why workplaces often struggle with loneliness

because for years we have told people that, don't bring feelings to the workplace and check all of that at the door. And you're not here to make friends, you're here to get work done and keep your friendships and your personal life outside. And the truth is that's just not a natural way of living. We don't operate like that as human beings.

And if we have to be somebody that we're not in the workplace, that increases our likelihood of being lonely there too. That's true. I mean, we certainly get trained as doctors to not emotionally connect with our patients, right? And I fought that from day one. And when you sit and really get someone and you listen to them and what matters and what they care about, and you really are present with them, it's just so powerfully healing. Forget any other medicine. Right. And I think that's, that's a, it's one of the real gifts. And I think I just want to come back to the whole service concept concept because I don't know if people understand what that means. When we look at how we're designed, there is a sort of altruism gene that we have.

E.O. Wilson talks about the social conquest of the earth, his book, that we cannot survive in isolation and that we're hardwired to support each other, help each other, connect with each other, and aid each other. And the biology of it is very fascinating. When you look at the areas of the brain that get stimulated by altruism or service or helping others, it actually is the same area of the brain that gets activated with heroin or cocaine or sugar. And I remember going to Haiti, and it was just an awful, horrible scene with 300,000 people dead, 300,000 wounded. I mean, the military who was there, the 82nd Airborne said they'd never seen anything like this in their entire careers,

and the wars in Iraq and Afghanistan. And we were in the middle of it, and I was working 20 hours a day. And it was horrible conditions and no food, no water. I mean, it's just really tough. And yet I was really happy in this weird way because I was just serving. I was helping. I was serving. It wasn't for me. It wasn't for my ego. It wasn't for anything. My bank account. I was volunteering. And it was, it was a time that I felt most connected and most fulfilled. So it really mattered. And, and I really think, you know, we need to have a society where we are helping each other and are connecting with each

other. And, and it doesn't require anything other than to look around you and see who's in need or, you know, what needs to get done in your community and trying to be that person who can be of service because it'll not only help you with your own emotional, physical, mental health, but it's going to create a culture, like you said, of kindness and love. And that's such what we need in America today, around the world globally, because we're sort of rearing the opposite way. And I think that's why your book is so critical. And I encourage everybody to get a copy of Together,

The Healing Power of Human Connection in a Sometimes Only World, because if all of us took up this book and implemented it in our own lives, and implemented it in our workplace, in our schools, in our families, in our communities, I think this country would turn around pretty fast. I certainly hope so. That's, that's my, it's my dream that we will together be able to build a more connected and more fulfilled society. And, and, um, what are the, what are the challenges some people have to actually doing this in their life? Cause it sounds like everybody would want to do this, but how, how,

how do people get over those obstacles? It's a great question. I think there are a few key obstacles that come up. Number one, sometimes people feel that focusing on connections in their own life is somehow self-indulgent, that they should be focusing on doing more at work, on getting that promotion, on building up their bank account, on taking their kids to activities. Busy parents, I think, are very interesting because I think a lot of them struggle with loneliness, especially in the early years when their kids are one, two, three, four years old before they're in school. It can be very all-consuming as a parent to really take care of your children, and that can isolate you from others. But I think this

feeling that somehow investing in our connections is a luxury, that it's self-indulgent, I think is one of the reasons why people don't do it more. I think the second reason is that, again, there's a sense of shame that people have and even admitting to others that they need some more human contact, that they need some time with their friends. They don't want to seem desperate or needy or somehow, you know, again, not likable or, or an outcast in some way. So people have a hard time, not just acknowledging to other people, even acknowledging it to themselves. And I think the last thing is,

is a structural issue as well, which is that if you look at how our lives are designed, with paying, spending so many hours at work, and many people have to commute many of those hours, there's a question of, of time that comes up, which is where am I going to find the time to go and interact with other people and to take a vacation with my best friends, which I haven't done in a long time, or to finally make time to go away with my spouse for a weekend. And those questions feel really burdensome. I mean, they can feel really tiring when you think about it. Oh, my God, that's so hard. Let me just keep going with life. But this is where I think it's so powerful and important to recognize that the dividends that come from just a small amount of time spent in connection can last for hours, days, weeks, or even longer.

And that's why the five or ten minutes that you spend with someone that you love can be really powerful. I'll tell you about something I did in my own life that helped me, which is that, you know, I made a decision after residency training when I had just gone through several years of caring for incredibly sick people, including people who were very young, I remember being on the oncology service and half the patients I was taking care of were all young people in their twenties who had gastric cancer or other malignancies that were in their end stage. And I remember at the end of that thinking, God, I just, I need to think about my life. And I don't know, like that could be me. And am I spending my time the way I want to be spending it? So I made a decision that I would make it a point to go home and visit my parents and my sister more often. And that's when the frequency of my visits actually changed. A year or two ago, I was actually out in Colorado for a fellowship retreat at a point where I was struggling to figure out what I wanted to do with my life

and was also feeling kind of isolated. I was in the throes of early parenthood also, and it was all consumed with the care of our kids, which was wonderful and such a blessing, but really not having much in terms of relationships outside. And I ran into these two friends there who I love, but who I rarely ever see. And we talked about how we wish we got together more often, but we just don't. And then in that moment, I said, why don't we do this? I said, why don't we build a moai together? Moai is a Japanese term. I actually have a whole story about a Moai in the book, but it's an intentional community. So I said, why don't we just say,

because we know we're not going to see each other, you know, probably for another six, nine months. Why don't we say that every month that we are going to get on video conference together and that we're going to have a two hour conversation. And let's also say that we're going to get on video conference together and that we're going to have a two-hour conversation. And let's also say that we're going to be real with each other, that we're going to talk about the issues that we are struggling with, the stuff that really matters to us. Things like health and finances and our relationships with family, which people don't get into often because they're sticky, but it's the stuff that we all are struggling with. And so we've been doing that for the last year. And it's been so incredibly gratifying. So anyway, the point is that there are reasons to not connect.

But once we realize the power of even a small amount of time spent connecting with others, once we realize that we don't need anything else to do that, we just need our intention and a willingness to show up, to listen, to be vulnerable and open with other people in our life then we can start building that road toward living a truly connected life and i think that is what holds the key to greater health and also greater fulfillment so true thank you for doing this writing this book i think it's it's those micro steps whether it's five minutes a day whether it's finding some old friends and reconnecting like you did, whether it's finding a place to be of service in your community.

You don't have to have some big, giant community that you're building overnight, but those micro steps make a huge difference and will help heal so much of the suffering in the world. So thank you, Vivek, for writing this book. I want everybody to get a copy. It's Together, The Healing Power of Human Connection, a Sometimes Only World. You can learn more about it.

Go to his website, which is vivekmurthy.com, V-I-V-E-K-M-U-R-T-H-Y.com, forward slash together dash book. Please get it anywhere you get your books. If you love this conversation, please share it with your friends and family on social media. Leave a comment. We'd love to hear from you. Subscribe wherever you get your podcasts. And we'll see you next week on The Doctor's Pharmacy. Thanks so much, Mark. So much fun to do this together. Hi everyone, it's Dr. Mark Hyman. So two quick things.

Number one, thanks so much for listening to this week's podcast. It really means a lot to me. If you love the podcast, I'd really appreciate you sharing with your friends and family. Second, I want to tell you about a brand new newsletter I started called Mark's Picks. Every week, I'm going to send out a list of a few things that I've been using to take my own health to the next level. This could be books, podcasts, research that I found, supplement recommendations, recipes, or even gadgets. I use a few of those. And if you'd like to get access to this free weekly list, all you have to do is visit drhyman.com forward slash pics.

That's drhyman.com forward slash pics. I'll only email you once a week, I promise. And I'll never send you anything else besides my own recommendations. So just go to drhyman.com forward slash pics. That's P-I-C-K-S, to sign up free today. Hi, everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not

constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.