Why Loneliness Is A Public Health Issue with Dr. Vivek Murthy
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So let's get back to this week's episode. Today's episode was recorded before the world. Health declared the corona virus outbreak a pandemic and before stayed 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 the 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 mental health even with just five or ten minutes a day now onto my conversation with former surgeon. General Vivek Murthy. Welcome the Doctors Pharmacy. I'm Dr Mark Hyman and that's pharmacy with an F. F. A. R. MAC place conversations that matter and if you've ever suffered loneliness or felt isolated or disconnected in your life this conversation's going to matter to you because we have extraordinary guest today. A former surgeon general United States. Dr Vivek Murthy who I've known for a number of years who actually invited me to come to me with him when he was surgeon. General and talk about the issues of food and obesity and nutrition disease and he's just always so attentive and connected. It 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 would just to get the entire clinic. Meditating every day at three o'clock in the afternoon the chief of staff was a little confused when I said that. I think it's a 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 the afternoon when I'm there but he's he's an extraordinary leader in medicine in public health and his new book together. The healing power of human connection in sometimes lonely. We're older I would probably have tight and often lonely world is really an extraordinary contribution to our understanding of what creates so much suffering and 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 he Dr Murphy is Shorter guy he was the vice admiral the US Public Health Service Commissioned Corps where he commanded a uniformed service of sixty six hundred 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. I it was. He was a key leader addressing that crisis while he was surgeon. General 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 two thousand seventeen 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 was an HIV AIDS education programme in India. I'm not sure I'm saying this right. Swazi AH which is a community health partnership in rural India the trains women as health providers educators like barefoot doctors in China but for women I guess and he he helped build the grassroots organization doctors for America that was very involved in the election of President Obama and since he's left Sir General's office he's focused on loneliness and social connection is book together. The healing power of human connection in sometimes lonely world is out April. Twenty eight Harpercollins. He's just an extraordinary guy. He's his degree from Harvard. His MD and MBA from Yale he went to residency in Boston and was on the Harvard Medical School Factory. He's a very serious dude and good friend and I really am so happy to have you on the podcast. Welcome thank you so much mark. I feel embarrassed. Thank you. And he's only twenty five. Which is what's amazing. Are you forty yet? I got a lot of I. Forty two forty two so the best is yet to come. I have a feeling just getting started. I think we're you the youngest general ever in about a century or so the very first surgeon general in eighteen hundreds. It was younger than I was. Because nobody long back then right. So that's that's unbelievable one hundred years and then just speaks to your your character your intelligence your insights on this 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 I've and the early part of my career. I focused on food as a big driver of chronic. Disease Instill 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 social issues that they're facing and begin 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 Medicine S? We're going to help the world and you really laser. Dan On the love is medicine through looking to lens of of loneliness. And and how? How did that all come about? I mean you. You basically are transitionally trained internal medicine doctor and it's nothing we really taught about in medical schools. Long how did you come to that? Well it's a good question you know. I think I hit experience. Loneliness a fair amount of my own life and you know when. I was a kid in school. I was very shy and I didn't. I had a hard time making friends in elementary school and 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 or 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 two thirty or three o'clock or whenever it was so that I can go back home and be where I felt really good. We had loving parents and an amazing sister and I felt very cared for taking care of at home so we certainly have presence in my life. Any cropped up other times during adulthood as well at transition points in my life and even during my time surgeon general and in the years afterward I also then started to see it in my patients and this is not something I expected it all because when I was in medical school and I suspect that you and many of us had the same experience. loneliness was all part of the curriculum emotional. Wellbeing was not cleanliness. On now this is not part of that matter. Neither was nutrition. I still remember our nutrition. Education in medical school was one class once a week in the evenings that was optional Like six weeks like vitamin deficiency diseases like rickets scurvy. There wasn't a whole lot of training. But certainly this subject of our emotional health and the power important to social connection. There was very little But when I started seeing patients a couple of things that struck me one is people would come in with with real serious illnesses and they would have. The illnesses are critical. Time in people's lives better make big decisions and they have to. They find themselves were reflecting on the rest of their life To see you know Gosh You know have I live the life I wanna live and those critical moments? You need people around you to help you figure out what path to take to support you and be there with you but so many of the patients alone and I remember I used to. Sometimes we're in the hospital by themselves. They were there by themselves and I would ask. Sometimes I'd say hey you know we. 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 want us to call to come in so that we you can talk through with them as well and so often. The answer was no. There's so many to call. Wow even at the time of death mark. I noticed that on so many occasions that the only ones to witness people's last moments where myself and other doctors and nurses that was a medical stuff. And so he. I remember that quite vividly. 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 the peculiarities of the of my medical experiences win. But what happened? That really changed. Things for me is when I began my time in office. I began with a listening tour traveled all of these cities and towns all across America with 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. Thing What. I didn't expect to hear that within those stories where these threads of loneliness 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 two moms and dads in big cities and members of Congress. I start to realize that not only is loneliness far more common than you were hearing this 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 just only could you start with Congress. I because we're doing but the truth is I realized nobody was spared that that we 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 So it's so intense I think that You know we're really wired as social beings. 'cause a human being by him or herself in the world is usually dead. Historically if you didn't have a tribe or group the helped you navigate survive the world. You would just die and yet something's changed in the last hundred plus years and you sort of say it's really different in this modern day. Loneliness is different than anything that has happened in other generations. And how how does it actually affect us? I mean what does the science behind mowing this effect on our health and our our longevity and what do we know about that well? It starts with with what you just touched. On understanding how loneliness impacts our body starts with how 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 are with you could take turns keeping watching night To make sure that they 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 helping in child rearing so you could be. People did take care of each other 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 actively more risk than of starvation or being pursued by a Predator it put us in his trusty And in some ways. That's actually a very healthy response. Is that stress state would raise our threat level and focus inward and push us to quickly get back to the tribe as quickly as possible. Yuck and that's an in a sense. What loneliness is like like loneliness like hunger? Thirst is a signal that our bodies ending. We're lacking something that we need for survival. If we react quickly to that and fill the gap you know with social connection healthy social connection in their life than feeling goes away. And we're and we're okay The problem though is when that state of threat which is effectively a physiological stress state persists for a long period of time. Like we know that stresses not good for us we went in. But it's only in the case of it being there for a long period of time or an excessive amount redemptive in a small small amounts can actually be quite good like before we give a big speech we're taking exam Were you know take on any big tasks or go out on a date that we're really excited about. We might feel some stress and then my push us perform better and to actually bring out the best in ourselves. 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 Lisa higher rates of heart disease and other illnesses and so- loneliness when it's chronic when its longstanding puts us in a chronic stress state. And it's from that that we see so many of the negative consequences other practical implications who are health of not having connections some of the day-to-day helped. We might need going to the doctor. Taking your medicines having someone to remind us and inspire us to eat healthily or to go and work out of a reason for right to have a reason for living we may miss out on these things too. So are the healthiness of our lifestyle deteriorate as well But we see overall as and when you look at the data at the impact of wellness 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. Fifteen cigarettes a day. It's a greater than the mortality impact of sedentary living and obesity. I think is surgeon general. How much time I spent on those three issues on smoking. Obesity and physical activity compared to how much I spent on lonely. There was no comparison. Way We gotta stop because what you just said was was remarkable that loneliness is a bigger risk factor for shorten lifespan and smoking obesity. Relax of exercise. Well it seems to be just like headline news. It seems to be just as powerful as smoking. Fifteen cigarettes a day and and even greater than the impact of obesity which is pretty. I mean. Smoking is pretty deadly. So this is something. That's not talked about something that we don't I mean I'm I'm in a big healthcare system. We talked about the office of experience and improve patients and doctors experienced this issue of loneliness. Being risk factor. I just it just not in our training in. It's not in our even approach as a culture to figure out how to solve some big issues like depression and the opioid epidemic. And you know why people eat. You know it's not only about what people eat. It's y e you know right often say you know you don't have to focus on what reading what's eating you and. I think people 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 get it back to a place where we do have connection and not social media which actually to more isolation more disconnection more separation feelings of isolation you see you know the the instagram models and this and that it's just it makes you feel bad about yourself. It's not really true. Social Connection Pick one thing you said even earlier also and then I'll get to what's driving this but something setting is really important. Which is 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 tests. Loneliness is in your right but also even if we just think about the people in our lives. We may not recognize loneliness. Is that common? But there are two big reasons for that. One is because there's a huge stigma around eight. Yeah there's a sense of shame that people have because they feel like if they see that I'm lonely that's like saying I'm not likeable or I'm not loveable. Desirable Yeah It's like saying I'm a loser. Nobody wants to feel that way. I certainly didn't when I was younger and felt lonely. I didn't never told anyone about that. But the there's another reason that loneliness is hard to see. And that's because we stereotypically might think of loneliness is the person who's sitting in the corner at a party and not interacting with anyone but that would me as a kid. Yeah Party so is true. But but the other reason we don't see it is because it looks like other things so loneliness can look like depression and again look like anxiety It can often lead to addiction or increase risk for addiction in fact that founder of a 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 looking at the OPIOID epidemic. There's a reason that the opioid epidemic has been labeled Part of the larger group of illnesses called deaths of despair because it is often a sense of hopelessness and isolation that can lead people to experience emotional pain and human beings. Once we experience emotional pain we will seek to relieve that pain and the question. Those moments is. What are we reaching for? So are we reaching for alcohol really reaching for drugs? Are we reaching for Food Right? Are we reaching for exercise? People work out when they feel stressed during pain. That helps them. Are we reaching for work? Some people drowned themselves in work. When the stresses of their personal army right and this is the thing is that there are socially acceptable ways to sometimes feel with your pain even though it hurts 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 this statistics backup the fact that a very large number of people that we know are likely struggling with loneliness if you look at the conservative numbers Will you'll find. Is that probably somewhere around? Twenty to twenty two percent of adults in the United States are struggling with loneliness. Those are the lower numbers. Plenty of other studies Including one recently by Cigna the health insur which is pegged those numbers significantly higher and it's not just the US percent well in this study the most. Recently they found that it's in the sixties more than sixty percents of adults who actually they're struggling with loneliness now. This is either because loneliness maybe increasing. Maybe people are just more comfortable now. Starting to admit that they're struggling with loneliness. Maybe studies 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 comment And it's also consequential for our help that is invisible and it's invisible invisible and you talk about how in your book together. The healing power of human connection in a sometimes only world which I encourage everyone to get a copy of whether you're lonely or not because likely you know someone is unlikely things in this book going to help you get more connected things that matter in your life and also help you engage with your community 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 an impact on the individual but you know in a broader context that affects our kids ability to function learning school. It affects productivity in the workplace in effectiveness on a on a sort of commercial level of competitiveness. It affects this incredible polarization division of versus. You Know I. I remember hearing this Guy Peter. Orangeade coup was budget director under Obama. Talk at Cleveland Clinic about the voting in Congress and in the sixties you know you could see a sort of a cloud of votes Republicans Democrats. It was all mixed. It was a big Ben Diagram where there was tons of overlap and voting across party lines and then he showed a graph now and it was 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 In 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 I 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 daytime Surgeon General. I I found myself thinking about all the different issues. We touched on from the OPIOID epidemic violence to eat cigarettes. You name it and you Bola Sika richer. Glad you know having to do with corona virus right now so frightening difficult very difficult and disturbing situation right now. I think it's only going to get worse before it gets better. But what are 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 when 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 it our connection with each other is actually one of the most powerful and important resources that we have not just for our health but it affects our performance in the world in school in the workplace that impacts where we talked 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 why how it affects us. You know if we can't when we are connected to each other are threat. Levels are lower levels of stress are Lewin when we are lonely it increases our threat level. Actually shifts are focused internally towards ourselves. Because if you're in a threats that you wanNA focus on yourself for your safety and survival but it's hard to optimize our output and 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 we're so focused on ourselves we're missing what's happening in the outside world you can see that playing out in the workplaces and schools and an in. Congress as well absolutely and you can see what a price we pay as a society because the political dysfunction impacts us all but also when people aren't happy in the workplace that impacts productivity and retention impacts creativity in the workplace that impacts a you know a businesses and organizations bottom line but in schools with concerns memo's especially as a dad who has two young kids are three and two Is I think about what experience they're going to have in school and I asked myself. Well is the job as school to teach people how to read write and do arithmetic or is it also to teach kids how to build a foundation for healthy life and other ways including in terms of their social and emotional wellbeing readings school? That are the most important things in life. How healthy relationships how to take care of your health and how to manage your money. That's right so these things these are the foundations that matter. And when we don't have in one of these key important foundations what we realize. Is that everything else we build on. It is built on Shaky Foundation and I realized that when we have strong relationships in our lives we are better. We are better at work. We're better at play. Were better in terms of our health. Were better in terms in our relationships and we bring to our family into our friends when we don't 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 away. When I thought about this issue I felt like if we can try. 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 and we can truly create a people centered life and 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 in low income people are connected to each other. There's actually a data on how much difference it makes in overall society and the success of our country that successive of our citizens health health of them. All all the things that really we care about are centered around this issue and your book is called alone is called together and the reason is because in the he'd tell some amazing stories about people who saw this in their communities and are trying to break through this incredible sort of edifice of loneliness. It's around so many so many people so he tells a little bit about some of the hopeful stories and some of the things that absolutely you know because it's kind of depressing. We're lonely lonely. Ruining everything which is true. How do we get out of it? One of the stories that you can share about how that's happening. Yes I 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 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 think we all want but the other thing. That's fascinating about it to me. Is that in building connected? Life does not require us to purchase expensive medicines and does not require us to have special medical equipment. Doesn't require fancy inexpensive 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 at the White House. For an event Durr when we were working at the OPIOID epidemic and I was facilitating a conversation. with a group of people about the epidemic and what was driving it. And he's in that moment. I remember sitting on that stage where it struck me that we were talking about medication. 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 is struck me in that moment that with so many people That I met on the road felt like they were lacking where 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 and medicine it is it is and of all the medicines I prescribe in you. Prescribe and so. Many doctors prescribe in the hospitals to treat our patients. Those are important. Those are good but they're few things that come close to. The power of genuine human relationships can do and those are powered by love and some of the stories that I came across where really fascinating 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 right so what ended up happening is is by accident of life. He was appointed to serve an 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 toastmasters club to get more comfortable with Public. Speaking really worth a lot of issues and then ran for city council again and then era the the mayor's seat opened up and he thought you know maybe maybe. I should run for mayor because was really interesting. Is he had been. He'd been seeing these signs around town these posters Which had talked about which we're posters about kindness instead. Be Kind until we talked about the importance of kindness. But there was no name stand below at there's no sponsoring organization there's no U. R. L. 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 we'll our community needs. We need more kindness. That's the glue that holds us together and without that all these programs that were funding and structuring etc. 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 city of kindness. Wow and he was scared about this. He thought I'm going to get laughed out of town. People are GonNA think I'm not a serious candidate. I mean he made fun of for being soft. My political platform is kindness. How about that Exactly what he found when he got up to announce his candidacy and to say that he is goal was to make Anaheim kinder city he saw heads nodding in the audience of people murmuring approval and he realized that so many of us even though we may not lead with it. We want more kindness. One love we want more connection in their 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 one million acts of kindness program in the school system to get the schools students throughout Anaheim to con 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. The what he did which is incredibly powerful as he didn't just set up a new program. He Changed Culture in the city and when change culture which are the values ideas that means a hole 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 something you can't legislate you have to create the structures to do that. I think I I Sort of had a very similar inside to you. Is that the cause of so much of our disease and disease is disconnection and 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 we're we're helping each other be accountable. He produce a program. It was more effective anything else to public health committee in the world ever seen and spread across the world. And I kind of realized that it's not just infectious disease is contagious. It's chronic illness which affects out of ten of us and as you know is sort of driving our economy into the ground and his burning so many people in pre so much suffering in a lot of the reason for like you said is is the disconnection that drives people to behaviors and into things. That actually aren't good for them. Food or whatever and then he worked with Brick Warren to create the plan which with with Dr Ayman which was a faith based wellness program but it was founded on the idea of small groups that were the infrastructure church that we just put the information and they were able to help each other. Get better that getting helping basically a team sport. And we've taken out at Cleveland Clinic and Secular Way It's not a faith based program we now Are the top in our small center for functional. Medicine has ten doctors. Is the number one in group visits in the entire organization and the next biggest group down from US has about four hundred doctors and we have like ten and we and the reason is I i. I was very vocal about making sure that we we actually did this. Because this is how people change. And we see that people will have a longing to belong to connected and and that's how they make meaning otherwise that's how they get motivated to do anything and that's really missing from our culture and society. How do you You Know How how do you? How do you see that that we can spread this further? How do you? How do you take the ideas and your book and make them sort of something? We spread nationally and even globally Well I think there are a couple of things we can do. I think I by recognizing how common loneliness is but also recognizing the power of human connection. Elevate our health. Our performance and our wellbeing. I think that first step Can help us to rethink our priorities. Both are individual parties. Where we're putting our time but also organizationally like where as workplaces in schools and government where 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 you're born with affects 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 to begin with so there a couple of things in the in the book that I go through that are I believe helpful in building that connected life? One of them unexpectedly a service. It turns out that when we serve others we actually break some of these very negative patterns of loneliness that get 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 when you're focusing on 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 have to offer to the world and that's actually reassuring that lowers your your sense of So service is a powerful way to connect with others and also to reconnect in a sense with ourselves our own sense of self worth and value the second thing that they can help us on an individual level. He said 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 ten minutes a day that we're spending with people we love? That could be spending in person. It could be speaking to them a phone. We know or through video conferencing but are we spending five to ten minutes with some that. We love every day and this might seem very simple. You'd be surprised how many people can go for days without having a meaningful conversation with somebody. The third thing with the controversy reminding when my wife we have because life's busy crazy running around. We have a a little ritual called. What's up below which is just chit chatting about the logistics for life of overdoing that day but sit down with each other with having coffee in the morning or at the end of the day and it can be five minutes or can be. We can go for a half an hour. But it's what's up below zero service and we go in and we just listened to each other and we get each other like what's happening in your world. What do you care about what's upsetting you? It's thrilling you. What's whatever going on and it's just great such deep powerful moment of like being seen and seeing somebody else 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 you know. I do that with my children I do. It's it's a very powerful simple thing of just say dropping into place below the surface level of life that we all do it 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 ten minutes talking about your calendars and your schedules and get groceries. Who's GonNa get the car fixed and nightfall into that with my wife because there are a lot of logistics in life we gotta 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? He's been so you know technology's really interesting. 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 guilty of this is we have allowed technology particularly our phones to dilute the quality of our interactions. The other people because we bring our phones off into the dinner table and we might convince yourself. Hey I'm not really paying attention to it. I've got an unsilent. 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 young even if it's on vibrate and face down it actually changes how people feel about the conversation in a negative way and so the restaurant called hearth which is in New York City and they have a box on every table. Please open me and you open it up and said he has an invitation to put your phones and the ox and as a game. I play my friends who are really has to put their phone box. The first person to take it out pays the bill so simple fun things you can do that actually help you. Stay more connected. I love that absolutely. That's a great idea. Just like that I think there. Are you know in the book but I will try to do. Is I try to share some stories that lay out some individual steps we can take our lives but also the stories that talk about what schools and workplaces can do an are doing already in some cases to create a culture of connection Because at the end of the day mark like if we want to create real connection if we want to build a people centered life and people center society. It's going to involve more than programs. It's GONNA require us to shift. Culture meant to ask ourselves. What's really important now? If we got one group of one hundred people together on any street corner in America my guess is if you ask 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 my mom or my dad but if you look at how they behave how where we put our time and energy and ware. Frankly society nudges us to cement her time and energy and it's not usually with the people we love most. It's in investing in places where we can acquire greater power reputation and well than traditional marks of achievement in modern society. I'm not saying that those aren't important. Organization be pursued. It's a question of where are the priority list and your facebook feed or instagram. Feed or your email or write with those feats in particular like I think about like our childhood and about their 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 at 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 been enough that they're not good looking enough that they're not popular enough or funny enough that ultimately that they're not enough and that has actually very powerful in insidious effect on our connection with other people And this is one of the things that is not often well. Appreciated which is at 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 herself 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 living life by having time to reflect and time to think and much of that white space in our life that many people use to ponder and reflect on things on that has disappeared. It's evaporated as now in five minutes you'll have between events or when you're waiting at the bus off. We can just let her devices and look at the news their gender inbox but ultimately if our if we are not able to support particularly among our kids. I- healthy sense of self if we're not able to convey to them and help them understand what it is that makes them worthy invaluable and that it's not what they're wearing or how much money their parents have in their pockets or how popular they are on what parties are getting invited to. Then we are going to run into a situation where people feel less and less adequate and then they will trust 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 We can't inhabit our own skin. People feel lonely. That's why workplaces often struggled with loneliness because for years we've told people that you know 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 to get work done and keep your friendships in your personal life outside and the truth is not a natural way of living. You know we don't operate like that is human beings and we have to be somebody that we're not in the workplace that increases our likelihood of being lonely. They're too yes true. I mean we we. We certainly a 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 present with them. It's just so powerful healing. Forget any other medicine right. I think that's that's one of the real gifts and I just want to come back to the whole service concept because I don't know if people I understand what that means when we look at how we're designed There is a sort of altruism gene. Then we have e o Wilson Talks about the social conquest of the Earth is book that we cannot survive in isolation and that we're hard wired to support each other help each other connect with each other an eight each other and the biology of. It's very fascinating. When you look at the areas of the brain that gets 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 You know it was just. It was just a awful horrible scene with three hundred thousand people. Dead three thousand wounded. I mean the military who was eighty second airborne said they never seen anything like this in their entire careers in the wars in Iraq and Afghanistan. And we're in the middle of it but I was working twenty hours a day and it was. It was horrible conditions. No food or water is really tough and 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 was in for anything my bank account. I was volunteering and it was. I felt most connected and most so filled so it really mattered. And and I really think you know. We need to have a society where we are helping each other in an art connecting with each other and and it doesn't require anything other than to look around. Unc WHO's in need or you know what needs to get done in your community and trying to be that person who can be service because it will not only help you with their own emotional physical and mental health. But it's going to create a culture like you said of kindness and love and that's what we need in America today around the world globally because we're sort of the opposite way and I think that's why your book is so critical and Anchorage copy of together. The healing power of human connection sometimes only world because if all of us took this book and implemented in our own lives in our workplace in our schools in our families and communities. I think this country would turn around fast. I certainly hope so. That's that's my dream that we will together be able to build a more connected and more fulfilled society and what are the. What are the challenges? Some people have to actually doing this in their life because it sounds like everybody would wanna do this but how how. How do people those obstacles? It's a great question. I think there are few key obstacles that come 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 work. I'm 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 struggled with loneliness especially in the early years When their kids are one two three four years old before they're in school You know it can be very all consuming as a parent to to really take care of your children and isolates you from others. But I think if this that somehow investing in our connections is a luxury that itself on Delta and I think one of the reasons why people don't do it more I think the second reason is that again. There's a of shame that people have and even admitting to others that they need some more human contact with. They need some time with their friends. They don't WanNa seem desperate or needy or somehow you know again not likeable or or can outcasts 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 things is a structural issue as well which is if you look at how our lives are designed with paying spending so many hours at work and many people have to commute any of those hours is. There's a question of of time that comes up which is where. Where am I gonNA find the time to go and interact with other people and to take a vacation with my best friends which I haven't done a long time or to finally make time to go away with my spouse you know for a weekend and those questions feel really burdensome? I mean you'd think if you'll really tiring when you think about God 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 at 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 the five or ten minutes that you spend with some of the you love can be really powerful. I'll tell you about something I did in my own life. That helped me Which is a I. 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 in half the patients I was taking care were all young people in their twenties who had gastric cancer other malignancies that were in their end stage and I remember the end of that thinking. God I just I need to think about my life and I don't know that could be me and am I spending my time the way I wanna be spending 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 change A year or two I was actually out in Colorado For a fellowship retreat point where. I was struggling to figure out what I wanted to do with my life and was also kind of isolated you know. It was in the throes of Early parenthood also and it was all consumed with 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 and but where rarely ever see and we talked about how we wish we got together more often but we just don't and then moment I said why don't we do this. I said why don't we build them away together as Japanese term? Actually have a whole story about a my in the book. But it's an intentional community. So I said why. Don't we just say because we know we're not gonNA see each other? You know probably six nine months. Why don't we say that every month the we are going to get on Via conference together and that we're going to have to our conversation and let's also say that we're going to be real with each other than we're going to talk about the issues that we are struggling with the stuff that really matters to things like health and Finances and our relationships with family. People don't get into sticky stuff that we all are struggling with. And so we've been doing that for the last year and it's been so incredibly grotto healing so anyway. The point is that there are reasons to not connect but once we realized the power of even a small amount of time spent connecting with others once. We realized 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 to were living truly connected life and I think that he's what holds the key to greater health and also get our folks true. Thank you for doing this writing this book. I think it's it's still Microsoft's with its 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 we'll help heal so much the suffering in the world so thank you for writing this book. I want everybody to get a copy. it's together the healing power of human connection. Sometimes only world. I can let you can learn more about to go as website which is a murky dot COM v. I v. e. k. m. U. R. T. H. Y. dot com for slash. Together Dash Book Please get it anywhere. You get your books. If you love this conversation please share with your friends family and Social Media Liba comment. We'd love to hear from you. Subscribe wherever you get your podcast and we'll see you next week on the Doctors Pharmacy. Thanks so much more so much fun to do this. I wanted 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'll love the podcast. I really appreciate you sharing with your friends and family second. I WanNa tell you about a brand new newsletter. I started called marks picks every week. I'm innocent out a list of a few things that I've been using. Take my own health. The next level is can 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. Dr Hyman Dot Com for slash picks. That's Dr Hyman Dot Com for slash picks. I'll only email you once a week. I promise I'll never send you anything else besides my own recommendations so just go to Dr Hyman dot com pore size picks P I C K S. 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 helping your journey seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner you can visit ifm dot org and search. They're fine 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?