Vivek H. Murthy - Together The Healing Power of Human Connection in a Sometimes Lonely World

O n December 15, 2014, I began my tenure as the Nineteenth Surgeon General of the United States. I expected that my focus as the nations doctor would encompass issues like obesity, tobacco-related disease, mental health, and vaccine-preventable illness. Thats what Id told the US Senate at my confirmation hearings some ten months earlier, and there was plenty of data to support these as important focus areas. But the surgeon generals position, which oversees more than six thousand uniformed Commissioned Corps officers working throughout the federal government to protect, promote, and advance the health of the nation, comes with high expectations. For more than a century, the physicians holding this office have addressed national health crises ranging from yellow fever and influenza outbreaks to the aftermath of hurricanes and tornados to the terrorist attacks on 9/11. Over the past few decades, the nations doctor also has become Americas most trusted voice on public health issues such as smoking and HIV/AIDS. It mattered to me that the issues I selected as focus areas also mattered most to the people I served.

I hadnt grown up in the public eye or as a creature of politics. I was a child of medicine. Much of my youth was spent in my father and mothers medical office, where my father practiced medicine and my mother managed everything else. My sister and I spent many afternoons after school helping out with paperwork, filing charts, cleaning the office, and greeting patients as they came and went. It was there that I found my inspiration to go into medicine. I saw the way people arrived looking anxious and left more peaceful and reassured, with my parents as partners in their healing. Medicine for my parents was all about relationship, and they built those connections by listening. Insurance companies would protest their spending more than the approved fifteen minutes with their patients, but my parents understood that to truly listen, you have to meet people where they are, emotionally and physically, however long that takes.

That was the kind of medicine I strived to practice. That was the kind of leader I wanted to be. And so, as I began my tenure, I decided to listen before setting my agenda and laying out my plans. That meant taking time. And it meant showing up where Americans lived. Lets go talk to people and see what they need, I told my new team.

We spent the next few months on a listening tour of America. We were welcomed into communities from Alabama to North Carolina, from California to Indiana. We sat down in small group meetings and large town halls, spending time with parents, teachers, pastors, small business owners, philanthropists, and community leaders.

Everywhere we went, we asked a simple question: How can we help? The answers in some cases confirmed what I suspected were major pain points: the opioid epidemic and rising rates of obesity, diabetes, and heart disease, to name a few. Other responses took me by surprise. Teachers in Washington State, for example, told me that children were vaping during class. Kids werent allowed to chew gum or smoke in class, yet there were no rules prohibiting the use of e-cigarettes in school. It turned out, the schools were waiting for guidance from the local government, which in turn was waiting for the federal government.

These conversations played a central role in guiding the agenda I pursued during my time in office and beyond. They moved me to produce the first surgeon generals report on the addiction crisis and to launch a national campaign to address the opioid epidemic. And it was those teachers, along with parents, scientists, and policymakers, who inspired me to issue in 2016 the first federal report on e-cigarette use by youth.

But one recurring topic was different. It wasnt a frontline complaint. It wasnt even identified directly as a health ailment. Loneliness ran like a dark thread through many of the more obvious issues that people brought to my attention, like addiction, violence, anxiety, and depression. The teachers and school administrators and many parents I encountered, for example, voiced a growing concern that our children were becoming isolatedeven, or perhaps especially, those who spent much of their time in front of their digital devices and on social media. Loneliness also was magnifying the pain for families whose loved ones were struggling with addiction to opioids.

One of the first times I recognized this connection was a chilly morning in Oklahoma City when I met a couple named Sam and Sheila, who had tragically lost their son Jason to an opioid overdose. We met at their local treatment facility more than a year after Jasons death. The pain that both carried was visible in their exhausted faces. Once they started talking about their son, it didnt take long for their eyes to well up. Their wounds were still raw. Losing Jason had been unimaginably painful. But what made it even worse was that, at their hour of greatest need, they found themselves without the people theyd counted on for years.

When bad things happened to our family before, Sheila said, our neighbors would show up to help or express their support. But when our son died, no one came by. They thought we might be embarrassed that he died of a disease they believed was shameful. We felt so alone.

Sam and Sheila were far from alone in their loneliness. In Phoenix, Anchorage, Baltimore, and many other cities, I listened to men and women who told me that the hardest part of addiction to alcohol and drugs was the profound loneliness they experienced when they felt like their family and friends had given up on them. This loneliness, in turn, made it harder for them to stay on the path of treatment and recovery. Its not easy handling a substance use disorder, they would tell me. Everyone needs some support.

The people of Flint, Michigan, felt much the same way, though for different reasons. I went to Flint at the height of their water crisis and visited the home of a couple whose daughters had toxic levels of lead in their bodies from the citys contaminated water. It was bad enough that they felt theyd failed to protect their daughters, but as the weeks went by with no agreement on how to fix the citys water supply, they also felt forgotten by their government and their country. This was loneliness as abandonment; the feeling of being left behind, cast out, ignored by society.

In some cases, loneliness was driving health problems. In others, it was a consequence of the illness and hardships that people were experiencing. It wasnt always easy to tease out cause and effect, but clearly there was something about our disconnection from one another that was making peoples lives worse than they had to be.

As much as I learned about how prevalent loneliness is, I also learned a great deal about the healing power of human connection. In Oklahoma, for example, I met a group of Native American teenagers who felt lost in their identity and forgotten by the outside world, so they developed the I Am Indian program to strengthen a sense of culture and belonging among their peers and reduce their risk of alcohol and drug addiction. I saw the power of connection in a support network formed by parents in New York whose children struggled with addiction. Having a community of fellow parents who truly understood what they were going through made it easier to cope when a child relapsed or when they blamed themselves for what was happening. In Birmingham, Alabama, where obesity and chronic disease were on the rise, I met a community of people who gathered to run, walk, and swim together. Even those who felt too ashamed and discouraged to exercise alone came out because their friends were participating. In Flint, too, human connection became part of the solution when community members organized to go door-to-door to educate neighbors about how to properly install filters and avoid the lead in their citys drinking water.