Speaker 1: I have turned much of my focus to mental health
Speaker 1: and well being because I believe this is the foundation
Speaker 1: on which we build everything else. Like our mental health
Speaker 1: is like the fuel that allows us to show up
Speaker 1: at work, for our families and our communities, in our schools.
Speaker 1: Our mental health is not good, it's hard to really
Speaker 1: thrive in the rest of our lives, and rebuilding that
Speaker 1: foundation is really what I want to dedicate my time
Speaker 1: and effort to.
Speaker 2: Doctor Barbaik Murphy is a physician. He's a Vice admiral
Speaker 2: and the current Surgeon General of the United States. He
Speaker 2: was the nineteen surgeon general and now he is again
Speaker 2: a surgeon General the twenty first, and he has served
Speaker 2: under Presidents Obama, Trump, and Biden. We've all heard about
Speaker 2: the surgeon general the warning labels on alcohol, for example,
Speaker 2: But what does the nation's top doctor actually do, How
Speaker 2: does one become surgeon general, and what are his most
Speaker 2: pressing concerns. Doctor Murphy joins me today to discuss these
Speaker 2: topics and others. And I must tell you I really
Speaker 2: didn't know that you are part of the armed forces
Speaker 2: of the United States.
Speaker 1: Yea, So many people don't realize that the surgeon channel
Speaker 1: is actually the head of one of our eight uniform
Speaker 1: services in the US government, and the service that I
Speaker 1: have the privilege of leading is called the US Public
Speaker 1: Health Service, right, and we have about six thousand nurses
Speaker 1: and doctors and pharmacists and physical therapists all over the country.
Speaker 1: We deploy them million times of emergency, one of the
Speaker 1: hurricanes and tornadoes and other natural disasters to help support
Speaker 1: local health care and public health.
Speaker 2: So you must have been very busy with all the
Speaker 2: fires in not only Hawaii, but on the West coast
Speaker 2: and in the northeast. You've been very, very busy. And
Speaker 2: you are a young man. Vivek is how old?
Speaker 3: I'm forty six now forty.
Speaker 2: Six years old and very handsome by the way, and
Speaker 2: dress in his beautiful uniform. I hear you even walked
Speaker 2: in the morning in your uniform.
Speaker 3: Well, yeah, I walk miles.
Speaker 2: Do you walk to work?
Speaker 3: Oh it's not far. It's like a little over a mile,
Speaker 3: not far at all.
Speaker 2: But you look very dapper and very nice. And doctor
Speaker 2: Murphy's come with some of his colleagues. What should they do?
Speaker 1: Oh, my gosh, I have an incredibly talented team, and
Speaker 1: I've been bussed to have folks who help with communications
Speaker 1: with our engagements with outside organizations. They also help with
Speaker 1: the design of our products and our website, and with
Speaker 1: running our operation, which is, while it's small and nimble,
Speaker 1: we operate in a fairly large bureaucracy of the United
Speaker 1: States government, and so the team helps me navigate all
Speaker 1: of that as we build out, you know, our initiatives
Speaker 1: on mental health and in other areas, and as we
Speaker 1: design projects and collaborations. The Public Health Service which I
Speaker 1: run is much smaller. It's six thousand officers who function
Speaker 1: across medical and health disciplines.
Speaker 2: Yeah, I mean it's and do you do you actually
Speaker 2: tell people where to go? So, I mean it's it
Speaker 2: must be very complicated. Well, it is complicated, but many
Speaker 2: people that you have to send to Hawaii.
Speaker 1: Set for several dozen people to Hawaii to help specifically
Speaker 1: actually with the mental health challenges there, because, as you know,
Speaker 1: when natural disasters happen, a lot of times we rightly
Speaker 1: focus on the immediate destruction, but the mental health challenges
Speaker 1: they last for a long time. Even after the last
Speaker 1: house is rebuilt, last piece of debris cleaned up, people
Speaker 1: will struggle, and in fact, sometimes those mental health challenges
Speaker 1: increase after all the public attention has gone away.
Speaker 3: People are left in dwelling.
Speaker 2: Just to clarify for the audience, what are the different
Speaker 2: divisions of the United States Armed Forces?
Speaker 1: There are eight, So there are eight I would say
Speaker 1: the uniform services. Some of them are armed and some
Speaker 1: are not. So the United States Public Health Service, for example,
Speaker 1: this is a uniform service that's focused on health. It's
Speaker 1: the only one that's solely focused on advancing the health
Speaker 1: of the country. Many people are familiar with the Army
Speaker 1: and the Navy, and the Coast Guard, with Space Force,
Speaker 1: with other services. Air Force, yes, Air Force as well,
Speaker 1: and there's no other national Oceanic and Atmospheric administration, So
Speaker 1: you put all them together in different ways. They serve
Speaker 1: to help protect our country, whether it's from outside threats,
Speaker 1: from health challenges we may face, or other situations.
Speaker 2: One of your biggest initiatives, and I know what you
Speaker 2: really want to talk about, and I do too because
Speaker 2: I have godchild who in England who started a company
Speaker 2: called Hillo Tomo. Do you know about that?
Speaker 3: No, I don't know.
Speaker 2: It's all about exactly your initiative, which is combating the
Speaker 2: epidemic of loneliness and isolation that is growing in all
Speaker 2: over the world actually right now. So I'm very happy
Speaker 2: to talk to you about what you are doing to
Speaker 2: help combat this loneliness and this sense of isolation that's occurring.
Speaker 2: What is this a direct result basically, well.
Speaker 1: I think to really understand that, we have to recognize
Speaker 1: that loneliness has been building for years. It's not something
Speaker 1: that happened overnight. The pandemic made it worse, but it
Speaker 1: was a crisis even before the pandemic, as silent crisis,
Speaker 1: if you will. And there's several things that happening over
Speaker 1: the last several decades that have led to that. So
Speaker 1: one is that over the last half century, our participation
Speaker 1: in the organizations that used to bring us together, like
Speaker 1: recreational leagues, service organizations, faith organizations, has steadily declined. The
Speaker 1: other thing that's happened is that as we've come to
Speaker 1: use technology more, which has been really wonderful and efficiency producing,
Speaker 1: it's also made it unnecessary for us to see people
Speaker 1: as much. So, for example, I don't need to go
Speaker 1: to the grocery store or to a retail store to
Speaker 1: buy things. I can just buy things online. Now that
Speaker 1: can save me some time. One of the consequences we've
Speaker 1: realized is we have less interaction with one another. We
Speaker 1: also move around a lot more, we change jobs, we
Speaker 1: leave home for school. Those are communities we leave behind. Again,
Speaker 1: some benefits there, but there's a cost. And finally, I
Speaker 1: think that the phenomenon of social media for many people
Speaker 1: has actually led to an antisocial effect, which is that
Speaker 1: many of them have found that they're substituting what used
Speaker 1: to be in person connections for online connections, where there
Speaker 1: are less known, they have less of a strong, you know,
Speaker 1: sort of I think, personal connection with other people, and
Speaker 1: that has left many people lonelier and more isolated than before.
Speaker 1: The thing that concerns me most, Martha, is when you
Speaker 1: look across the age spectrum at who's most affected. We
Speaker 1: find that one in two adults are living with measurable
Speaker 1: levels of loneliness in America, but the numbers are even
Speaker 1: greater among young people. And depending on the study you
Speaker 1: look at, somewhere between seventy to seventy five percent of
Speaker 1: young people say that they are in fact struggling with loneliness.
Speaker 2: And it makes me very unhappy to hear that. I
Speaker 2: remember when I was just out of college, starting a
Speaker 2: good job on Wall Street, I would get about one
Speaker 2: hundred phone calls a day from different people. And I
Speaker 2: really liked that because I got to talk to people
Speaker 2: in a job but also at home, and that verbal
Speaker 2: communication was so important to me. Now, if I count,
Speaker 2: if I count ten phone calls a day, that's a lot.
Speaker 2: I hate it. And my colleagues here at the office,
Speaker 2: they text from one desk to another. Huh, that's what
Speaker 2: they do. They text, And that's what's happening everywhere. I mean,
Speaker 2: my granddaughter texts me instead of picking up the phone.
Speaker 2: I always write, please call me. I get a text.
Speaker 2: Busy right now, I'll text you later, you know. And
Speaker 2: she's twelve. Yeah, and I know that she's I know
Speaker 2: she's not with anybody, but she's gotten into this bad
Speaker 2: I think it's a horrible habit. By the way, because
Speaker 2: I might be very old fashioned, but text, how much
Speaker 2: do you text versus call?
Speaker 1: Well, so I'll tell you I've changed in the last
Speaker 1: couple of years, in part because of a lot of
Speaker 1: this work we've been doing on loneliness. I used to
Speaker 1: primarily send people texts. I wasn't leaving people voicemails either.
Speaker 1: I had to call them out with. If I couldn't
Speaker 1: reach them, I just text them or email them. But
Speaker 1: I had his friend actually who whenever we used to
Speaker 1: play phone tag and he didn't reach me, he would
Speaker 1: actually leave me along voicemail, and I actually realized I
Speaker 1: really enjoyed just hearing his voice. And I also started
Speaker 1: to pick up the phone more often when people called,
Speaker 1: even if it was busy, because I would just say, hey,
Speaker 1: can I call you back, like I'm about to walk
Speaker 1: into a meeting, And even that five seconds or ten
Speaker 1: seconds of hearing their voice made a difference.
Speaker 2: Well, not only does it help you, and also I
Speaker 2: mean help them to get a voice, but you know
Speaker 2: that you're going to call back, You're making a note
Speaker 2: to yourself that you're going to actually correspond with that person.
Speaker 2: That's right and words.
Speaker 1: And the thing is that there's a whole evolutionary scientific
Speaker 1: basis to the fact that you and I feel better
Speaker 1: with phone calls, which is that, like you know, thousands
Speaker 1: of years ago, when we were as we were evolving,
Speaker 1: we came to not just process the words that somebody
Speaker 1: was saying, but their facial expression, the tone of their voice,
Speaker 1: their body language, all of that went into us understanding
Speaker 1: who they were are connection.
Speaker 2: And now you don't some people you just don't see them. Yeah,
Speaker 2: you're definitely onto a major problem here, and I congratulate
Speaker 2: you on doing that, because I think people have to
Speaker 2: know this, And as you say, especially children. I mean
Speaker 2: eleven and twelve, the two grandchildren that I care most about.
Speaker 2: Luckily they have school. Luckily they have a school to
Speaker 2: go to. During COVID, the girl did not like being alone.
Speaker 2: She wanted to see her friends. The boy, I'm so happy,
Speaker 2: he said, I can get all my homework done by
Speaker 2: eight thirty in the morning, and then I can do
Speaker 2: whatever I want to do, which is kick a soccer
Speaker 2: ball and read. And he's okay with that, uh huh.
Speaker 2: But she's not. And she needs that social life, that
Speaker 2: correspondence with others in physical ways. You know.
Speaker 1: The truth is every kid needs that at some level,
Speaker 1: some many more than others, but they all need it.
Speaker 1: And I think that's one of the reasons the pandemic
Speaker 1: was so tough for them. But it's also one of
Speaker 1: the reasons I worry, Martha that even when many kids
Speaker 1: are in school today, they are on their phones and
Speaker 1: they're not actually interacting as much with each other. I've
Speaker 1: had so many young people when I do roundtables around
Speaker 1: the country tell me, hey, I want to talk to
Speaker 1: other people. That lunchtime everyone's on their phone, and I
Speaker 1: mean new classes are on their phone.
Speaker 2: But why do schools allow phones? Well, during class, they
Speaker 2: shouldn't allow them.
Speaker 1: So I do believe that there need to be stronger
Speaker 1: limitations and restrictions on phones in school. I think many
Speaker 1: schools have not necessarily known what the right policies are.
Speaker 1: Some of them have policies, but they're not sure how
Speaker 1: to enforce them. I think many teachers, rightly, I think,
Speaker 1: have felt like, hey, I don't want to be the
Speaker 1: enforcer on top of everything else I'm doing, so then
Speaker 1: the question of how to enforce it comes to play.
Speaker 1: But I think that these are issues that we have
Speaker 1: to find solutions to because one of the challenges is
Speaker 1: that with having your cell phone on you all the time,
Speaker 1: is not only that you don't connect with other people,
Speaker 1: but it's also that it impairs your attention and in
Speaker 1: a learning environment. And so I think about a few
Speaker 1: key areas that we need to protect in our lives
Speaker 1: from our phones and technology. One of them is our sleep,
Speaker 1: and too often our phones invade our bedrooms and they're
Speaker 1: taking stealing out hours away from sleep. The second is
Speaker 1: in person interaction, where they often distract us and impair
Speaker 1: and I think we can our connections with others. So
Speaker 1: when you're talking to friends, when you're having dinner and
Speaker 1: catching up with the family, do that without your phones.
Speaker 1: The third is where we learn, and that's where I
Speaker 1: think keeping schools in particularly to be an area where
Speaker 1: the use of technology is limited, specifically your phones, is important.
Speaker 1: The final area is actually physical activity. You know, one
Speaker 1: of the consequences of spending three and a half hours
Speaker 1: a day on your devices, which is the average amount
Speaker 1: that adolescents spend each day. Yeah, but there's certain things
Speaker 1: you're not doing, and one of those, you know, I
Speaker 1: worry is that the cost comes from your time to
Speaker 1: be physically active. These are as, I think of it
Speaker 1: pillars for health and well being.
Speaker 2: Can you have an effect on this? You can you
Speaker 2: impose some rules or encourage schools to clamp down on
Speaker 2: the use of phones and put your phone in a
Speaker 2: cubby hole in the morning and you'll get it back
Speaker 2: in the afternoon. Yeah.
Speaker 3: So it's a great question.
Speaker 1: So we while most of the rules around schools are
Speaker 1: made locally in the United States by local school districts.
Speaker 1: What thing our office can do and what we have
Speaker 1: done is to push forward strong recommendations to schools of
Speaker 1: what they can do. And already since we issued our
Speaker 1: advisory on Social media and Youth mental health in May
Speaker 1: of this year, we've actually seen more schools taking actions.
Speaker 1: I was actually just said at when school in Indiana,
Speaker 1: for example, that they told me when I went to
Speaker 1: visit that after advisory came out, they finally put in
Speaker 1: strong rules around not using your phone during schools. And
Speaker 1: what they said, it's very interesting. They've found that the
Speaker 1: volume has gone up in a good way. They hear
Speaker 1: more kids talking to each other in school. The second
Speaker 1: thing they've noticed is they see more kids playing with
Speaker 1: one another, playing Jenga, they mentioned, than other games with
Speaker 1: one another. This is what childhood should be about. Should
Speaker 1: be about playing, about connecting with one another, about discovering
Speaker 1: their relationships. And I think to do that we need
Speaker 1: to protect some of our time without our devices in school.
Speaker 2: Well, you were the nineteenth US Surgeon General and now
Speaker 2: the twenty first search in general. Your role has how
Speaker 2: did it change from nineteenth to twenty.
Speaker 1: First COVID was happening when I took office the second
Speaker 1: time around, it was in March of twenty twenty one.
Speaker 1: We were about a year into the COVID pandemic. The
Speaker 1: other thing that was different, and this in a in
Speaker 1: this saddening way, is that the mental health crisis in
Speaker 1: our country was worse. The polarization that we were experiencing
Speaker 1: in division was worse than even it was when I
Speaker 1: was searching general the first time. So all of this
Speaker 1: was deeply worrisome to me, and it was one of
Speaker 1: the reasons why, even though I did a lot of
Speaker 1: work on COVID in the beginning, I have turned much
Speaker 1: of my focus to mental health and well being because
Speaker 1: I believe this is the foundation on which we build
Speaker 1: everything else. Like our mental health is like the fuel
Speaker 1: that allows us to show up at work, for our
Speaker 1: families and our communities, in our schools. Our mental health
Speaker 1: is not good. It's hard to really thrive in the
Speaker 1: rest of our lives, and rebuilding that foundation is really
Speaker 1: what I want to dedicate my time and effort to.
Speaker 2: What is your education? What enabled you to get a
Speaker 2: job as Surgeon General of the United States.
Speaker 1: Funny thing, Martha is that I actually never thought I
Speaker 1: would serve in this role. I never aspired to. But
Speaker 1: I also actually never thought I would work in government.
Speaker 2: Yeah, ever, you hadn't thought about it, right, Is that.
Speaker 3: I had not? No.
Speaker 1: I was happily building a life outside of government. I
Speaker 1: was at the time I was asked to serve in
Speaker 1: this role. I was working as a doctor. I was
Speaker 1: teaching medical students and residents. I was building a technology company.
Speaker 1: Oh actually at the time, because I was very interested
Speaker 1: in how technology could be used to advance research and health,
Speaker 1: and I was starting to get involved in doing some
Speaker 1: work around advocacy for a better healthcare system because I
Speaker 1: had been working as a doctor for enough years at
Speaker 1: that point that I realized there were just fundamental things
Speaker 1: that were broken about our system that weren't serving patients well.
Speaker 1: And I wanted to be a voice for correcting those
Speaker 1: and for organizing other doctors to use their voice to
Speaker 1: do the same. So that's what I was doing beforehand.
Speaker 1: My birthday, actually in twenty thirteen, received this call out
Speaker 1: of the blue from a two O two area code number.
Speaker 1: And I knew enough to know that twoo two was Washington,
Speaker 1: d C. Know which number it was and to compound things,
Speaker 1: I had actually just come off of a red eye
Speaker 1: flight from la I was living in Boston at the time.
Speaker 1: I just wanted to go to bed, honestly, and my
Speaker 1: hands were full of by dry clean that I just
Speaker 1: picked up the dry cleaners, but the phone rings and
Speaker 1: I almost didn't pick it up, and that ended up
Speaker 1: being a call from the White House asking me if
Speaker 1: I wanted to be considered for the position of Search
Speaker 1: in General. And I'll tell you, Martha, at that time
Speaker 1: that even though I didn't think that government was really
Speaker 1: a place for me, what I did realize was there
Speaker 1: was something actually very unusual about this job, which is
Speaker 1: that it was an independent job where you are even
Speaker 1: though you're appointed by a president, your job is not
Speaker 1: to execute the agenda of a president or a political
Speaker 1: party or anyone else. Your agenda is devised by you
Speaker 1: based on science and the public interest. And so to me,
Speaker 1: I like that independence. I liked the idea of being
Speaker 1: able to focus on the issues that I thought were
Speaker 1: most important to the public. And at the end of
Speaker 1: the day, I'm grateful.
Speaker 2: To commander in chief, your commander.
Speaker 3: Ultimately, yes, yeah, absolutely, it is.
Speaker 2: Yeah, but doesn't sit your agenda.
Speaker 3: He does not.
Speaker 1: And one thing I'm grateful for is that this is
Speaker 1: true not just for President Biden, but it was true
Speaker 1: with President Obama as well. Is both of them understood
Speaker 1: the role well enough and had enough respect for the
Speaker 1: sacred nature of the role and also for the importance
Speaker 1: of science as a driver for what the Search and
Speaker 1: General's agenda is. That they never came to me and said,
Speaker 1: you need to do this, or you should focus on this,
Speaker 1: because this is my agenda. They always gave me the
Speaker 1: opportunity and freedom to identify what I thought was most
Speaker 1: important for the country to focus on that, and I'm
Speaker 1: grateful for them.
Speaker 2: So who was the twentieth So.
Speaker 1: The twentieth Search in General was Jerome Adams, who was
Speaker 1: appointed by President Trump to be Search in General. He
Speaker 1: served in particular during that first year of the COVID
Speaker 1: nineteen pandemic, and he used to be the Health commissioner
Speaker 1: in the state of Indiana prior to serving as Search
Speaker 1: in General, and he worked incredibly hard travel all over
Speaker 1: the country during COVID, even before there's a vaccine available,
Speaker 1: So he was putting himself at risk, but he did
Speaker 1: it because it was his job, and he wanted to
Speaker 1: serve as search in general. With ebola and with Zeca viruses, well,
Speaker 1: there's a lot of times where things are changing rapidly
Speaker 1: and you're figuring things out, and as you do that,
Speaker 1: sometimes your recommendations change. So there were times in the
Speaker 1: first year of the pandemic in the Trump administration with
Speaker 1: doctor Adams where they were rapidly evaluating new data and
Speaker 1: sometimes their recommendations were changing. I think sometimes people would
Speaker 1: look at that and say, well, if you said do
Speaker 1: something on day one, and then day thirty you're saying
Speaker 1: to do something different, that must mean that you don't
Speaker 1: know what you're doing. But that's actually the nature of
Speaker 1: what you want the scientific discovery process to be. With
Speaker 1: this is things happened so fast, they happened really fast. Yeah,
Speaker 1: and this is with COVID in particular, was a time
Speaker 1: where we were not only trying to learn from what
Speaker 1: was happening in the US, but we were gathering data
Speaker 1: from all around the world.
Speaker 2: I was doing a sculpture at the time, a lot
Speaker 2: of sculptures, but I was you know, this is this
Speaker 2: is stay at home of that first hundred days. I
Speaker 2: started a sculpture which was in the shape of a
Speaker 2: giant egg, and all my colored eggs from my chickens
Speaker 2: were blown out and being placed on this giant sculpture.
Speaker 2: And I didn't know how many eggs it would take
Speaker 2: to cover this giant egg. But on the eggs I
Speaker 2: was writing when things happened during COVID, you know, when
Speaker 2: when somebody famous died, or when somebody contracted COVID, or
Speaker 2: when some new vaccine was being promoted. And so I
Speaker 2: wrote these whole town, these eggs, and it was just
Speaker 2: incredible to change of things happening, as you say, so fast.
Speaker 2: And when I look back on those on those eggs,
Speaker 2: now it's the history of COVID and the dates I
Speaker 2: put dates on them, and I would people would die
Speaker 2: and the number of people hospital Oh my gosh, it
Speaker 2: was the most awful time in recent recent history, that
Speaker 2: that kind of national awful time. But I can I
Speaker 2: can understand. I mean, your job was so difficult, and
Speaker 2: doctor Adam's job, of course is so it was so
Speaker 2: difficult because he had believers and disbelievers around him.
Speaker 1: How did you manage during that first year of COVID?
Speaker 2: I know, so productive because I was able. I was
Speaker 2: living on my farm, so I didn't have to go
Speaker 2: to the store. I could just eat out of the
Speaker 2: garden and eat from the chickens and all the eggs.
Speaker 2: And you know, in Bedford, New York, so close to
Speaker 2: New York, and I built one. I had an extra
Speaker 2: house on the property. We turned that into a TV
Speaker 2: studio and so we did three television shows, big shows,
Speaker 2: thirteen episodes each show that year, and we were tested
Speaker 2: every day. We had the tester at the gate for
Speaker 2: people to come in. They had to be tested and
Speaker 2: wait for the tests.
Speaker 3: To come back.
Speaker 2: We were all very careful and we really were extremely productive.
Speaker 2: And we didn't come to New York because this office
Speaker 2: was closed. It was a miserable time. But in the
Speaker 2: first hundred days, I kept five people at my house
Speaker 2: and I cooked one hundred different meals and we recorded everything.
Speaker 2: It was kind of interesting. They and everybody had a
Speaker 2: good time. And I allowed every night. I have a
Speaker 2: wine cellar that I don't I'm not a serious wine collector,
Speaker 2: but I had some pretty good wind center. Everyone was
Speaker 2: allowed to choose a different wine every every night, one wine,
Speaker 2: and we brought it up and we looked it up online.
Speaker 2: What one night it was a two thousand dollars bottle
Speaker 2: one night. It was a nineteen ninety nine bottle of
Speaker 2: Why you Know? And everyone we laughed so much and
Speaker 2: we played cards. We were not isolated at all because
Speaker 2: we had five of us living there. We actually had fun.
Speaker 2: But we knew how serious this all was, and we
Speaker 2: could we could do this. And I constant conversations with
Speaker 2: my daughter with their kids in the city who were
Speaker 2: much more isolated because of where they were. But it
Speaker 2: was it was an interesting time, but we were very productive.
Speaker 3: And that's a mind that five of you always have. Yeah,
Speaker 3: going through that.
Speaker 2: And not only that, there was no chance to get depressed,
Speaker 2: no chance to get feel isolated any way, because we couldn't.
Speaker 2: But so few people had that opportunity. I mean people
Speaker 2: who a family of three in New York stuck in
Speaker 2: an apartment with a little baby or something. It's horrible.
Speaker 1: Yeah, I think it was incredibly hard for any families,
Speaker 1: and I think for people who had to go to
Speaker 1: work in settings where they may not have been a
Speaker 1: lot of.
Speaker 2: Precautions as well. Public service workers.
Speaker 1: Many of them were putting their felt they were putting
Speaker 1: their lives at riskum and this as there were but
Speaker 1: they had come back and take care of their families,
Speaker 1: and it was a very hard time.
Speaker 2: But it also got me really to be a believer
Speaker 2: in the vaccines, to take care and just through the
Speaker 2: stuff that they had to do, and believe in science.
Speaker 1: And in many ways, I think what we saw, even
Speaker 1: dispet all the challeges on the way, is we saw
Speaker 1: vaccine developed in a remarkably short period of time, with
Speaker 1: the right safety checks taken to make sure it was
Speaker 1: okay for the population.
Speaker 2: Did your office have a lot to do with that?
Speaker 1: Well, So the vaccine was developed during the last year
Speaker 1: of the Trump administration, so this was before I came
Speaker 1: back to serve as a surge general the second time.
Speaker 1: But I do think it's important to credit them for
Speaker 1: the work they did in getting the vaccine developed so quickly.
Speaker 1: The Biden administration then took that baton and then really
Speaker 1: ran a historic vaccination campaign around the country that vaccining
Speaker 1: more people in a short amount of time than I
Speaker 1: believe any other vaccination campaign that we've had. To me,
Speaker 1: that was a great example of how two administrations could
Speaker 1: actually do a good job, you know, in concert with
Speaker 1: one another, even though they were subsequent obviously, but they
Speaker 1: both had an important piece of the puzzle that they
Speaker 1: helped put together to get us through COVID.
Speaker 2: Was it hard to transition from what did you do
Speaker 2: in between? Yeah?
Speaker 1: So in between I was actually doing a portfolio of things.
Speaker 1: I spent some time writing a book, ironically on loneliness
Speaker 1: and isolation. I didn't know the pandemic was coming, but
Speaker 1: it came out in the first month of the pandemic.
Speaker 2: I was also last night I was talking to a biochemist. Yeah,
Speaker 2: I mentioned that I was going to be speaking to you. Oh.
Speaker 2: He wrote an amazing book. Oh that's isolation.
Speaker 1: It was a labor of love, and it was really,
Speaker 1: in many ways personally motivated as well, because I myself
Speaker 1: have struggled a lot with loneliness over the years as
Speaker 1: a child. In particular child I'm not Actually I have
Speaker 1: a wonderful sister who's a year older to me, and
Speaker 1: I never felt lonely at home.
Speaker 3: This is important.
Speaker 1: My parents loved me unconditioning and my sister did, and
Speaker 1: I knew that, which was a saving grace for me.
Speaker 1: But when I left home and went to school, that's
Speaker 1: when things broke down for me. Because I was very shy.
Speaker 1: I was introverted as well, it was hard for me
Speaker 1: to make friends, even though I wanted to, And so
Speaker 1: I would go to school each day and the day,
Speaker 1: you know what, the time I dreaded the most in school, Martha,
Speaker 1: it was lunchtime, walking into the cafeteria, not knowing if
Speaker 1: there were somebody to sit next to or not, before
Speaker 1: I'd be alone. And it's funny in recent years, I've
Speaker 1: talked to some of my friends from elementary school and
Speaker 1: I've told them a little bit about how I was feeling,
Speaker 1: and all of them said, oh, wow, I felt the
Speaker 1: same way, but I thought I was the only one.
Speaker 1: It turns out many of us were struggling with loneliness,
Speaker 1: but we thought we were the only one, and that
Speaker 1: turns out to be the case for many people during
Speaker 1: adulthood as well. So that's why for me there was
Speaker 1: a big personal motivation to write this because not only
Speaker 1: had I been affected by personally, had I taken care
Speaker 1: of many patients over the years who struggled with loneliness.
Speaker 1: But when I was searching on the first time around
Speaker 1: and travel the country, I encountered so many people, students,
Speaker 1: retired folks, younger parents who were all saying to me
Speaker 1: that they felt in visi, they felt if they disappeared
Speaker 1: tomorrow and no one would care, and they felt profoundly alone.
Speaker 2: Well, you wrote that your advisory our epidemic of loneliness
Speaker 2: and isolation the beginning of this year, in twenty twenty three.
Speaker 2: That's right, And how do people get this?
Speaker 1: So you can find this just on our website Surgeon
Speaker 1: General dot gov and that'll take you to our priorities.
Speaker 1: And this is one of our key ones, loneliness and isolation.
Speaker 1: And in it, what we laid out was both the
Speaker 1: extent of the problem, you know, noting in particular that
Speaker 1: when into adults are struggling with loneliness, and even more
Speaker 1: kids are and young adults, but we also laid out
Speaker 1: what we can do about it as individuals, as organizations,
Speaker 1: schools and workplaces, as neighborhoods, and as government. So my hope,
Speaker 1: even though loneliness itself is a profound challenge, I wanted
Speaker 1: people to understand why it's so important for us to address,
Speaker 1: because this isn't just one more health issue in the
Speaker 1: long list health issues for the country to deal with.
Speaker 1: But what we realize is that when people struggle with
Speaker 1: loneliness and isolation, when they're disconnected, their chances and risk
Speaker 1: of depression, anxiety, and suicide all go up, but the
Speaker 1: risk of physical illness goes up too. They have a
Speaker 1: twenty nine percent increase in the rate of a risk
Speaker 1: of heart disease, thirty one percent increase in the risk
Speaker 1: of stroke, fifty percent increase in the risk of dementia
Speaker 1: among older people, and the risk of premature death goes
Speaker 1: up as well. We actually noted also that the mortality
Speaker 1: impact Martha that you see with being disconnected from others
Speaker 1: is similar to the mortality impact we see with smoking daily.
Speaker 1: It's even greater than the mortality impact we see with obesity, and.
Speaker 2: So is an epidemic.
Speaker 3: It truly is.
Speaker 1: And this is one of the reasons I wanted people
Speaker 1: to know that loneliness is more than a bad feeling.
Speaker 1: It's a public health concern that we've got to take seriously.
Speaker 1: And the good news is we can do a lot
Speaker 1: about it. You know, we don't have to wait for
Speaker 1: Congress to pass a law, you know, to address the loneliness.
Speaker 1: There are things we can do in our day to
Speaker 1: day lives to help strengthen connection and rebuild our relations.
Speaker 2: So you have to get that message out absolutely and
Speaker 2: how were you doing that?
Speaker 1: So you were doing it through a lot of podcasts
Speaker 1: like this, through going to events and talking to people,
Speaker 1: to visiting communities across the country. But we're also next
Speaker 1: week actually or actually to a few days, we're going
Speaker 1: to be launching a college campus tour as well. We
Speaker 1: were going to universities around the country to talk about
Speaker 1: the loneliness crisis, but also to talk optimistically about how
Speaker 1: we can come together to now rebuild social connection. And
Speaker 1: this is a place market where I actually think that
Speaker 1: even though young people are struggling the most with loneliness
Speaker 1: and isolation, I really think that a movement of young
Speaker 1: people to rebuild connection can help lead our country forward
Speaker 1: in shifting how we engage with one another, in rebuilding
Speaker 1: and knitting back into our culture. The importance of relationships, Mark,
Speaker 1: I think the reason we became lonely is not because
Speaker 1: one day we decided relationships weren't important. I don't think
Speaker 1: that happened. I think we've always known at some deeper
Speaker 1: level that our relationships are important. But I think what
Speaker 1: happened is that we just allowed our relationship to drift
Speaker 1: away as technology came in and our time got sort
Speaker 1: of occupied with work and other things. We allowed more
Speaker 1: and more things to reduce the time that we spent
Speaker 1: in person with one another, and as people fell lower
Speaker 1: and lower on our priority list, we became lonelier. But
Speaker 1: we thought we were the only ones. Part of my
Speaker 1: goal and this advisor, is for people to realize, if
Speaker 1: you're struggling with loneliness and isolation, you're not alone. You're
Speaker 1: not alone. You're not the only one. Many of us are,
Speaker 1: and that's why it's important for us to talk about
Speaker 1: it and to start addressing it.
Speaker 2: Yeah, when the computer became a common tool, I remember
Speaker 2: saying to everybody, oh my gosh, this is the best thing,
Speaker 2: because it's going to enable us to get our work
Speaker 2: done faster, to make time, to spend time with our families,
Speaker 2: to let us go on more vacations, to really enjoy
Speaker 2: life a little bit more. How wrong I was, you know,
Speaker 2: it really made it. It was such a different result
Speaker 2: because what it did was become all consuming and that
Speaker 2: computer that handheld you know, first it was the desk top,
Speaker 2: then it became the tablet, then it became the iPhone.
Speaker 2: So important to us and we carry it around like
Speaker 2: the most treasured thing with us all the time has
Speaker 2: to be charged, it has to be this, it has
Speaker 2: to be that, And it really did take away a
Speaker 2: lot of free time because, as you say, kids don't
Speaker 2: go and play sports, they rather look on their phone.
Speaker 2: What are they looking at? They're looking at Instagram, They're
Speaker 2: looking at tiktoks, they're looking at inanity sometimes, right, Yeah.
Speaker 1: And the truth is, like I don't entirely blame kids
Speaker 1: for this, because some people say.
Speaker 2: Hey, you can't you know, you can't blame that. Yeah.
Speaker 1: I think what's happened is the environment has changed around
Speaker 1: them and many of these devices, as you know, Mark
Speaker 1: that the devices themselves, and social media in particular, have
Speaker 1: been designed to capture all of our attention, oh yes,
Speaker 1: and to maximize how much time we spend on it.
Speaker 1: Like what I care about when I think about my kids,
Speaker 1: and I care about a lot of this person for
Speaker 1: almost as a parent of a five and seven year old.
Speaker 1: Thankfully they're not on social media attech yet, but that
Speaker 1: day is coming and I know it. But do you
Speaker 1: think a lot of times when our kids are on
Speaker 1: these devices about the fact that we want them to
Speaker 1: spend their time, Well, we care about time. Well, spent,
Speaker 1: not quantity of time to spend as much, but they're
Speaker 1: designed to maximize quantity of time spent, and that's what
Speaker 1: I worry about, and it's one of the reasons why
Speaker 1: end the advisory. One of the things I called for
Speaker 1: government to do is to put real safety standards in
Speaker 1: place that are actually enforced, that have teeth, so that
Speaker 1: when parents are introducing their kids to social media, they
Speaker 1: understand that it has been vetted that safety measures have
Speaker 1: been put in place that are adequate. Many companies will
Speaker 1: say now that they put safety measures in place, but
Speaker 1: what I care about as a parent is are they enough.
Speaker 1: Are they working to keep my child safe? Or are
Speaker 1: they manipulating my child to spend more and more time
Speaker 1: on them, exposing them to harmful content, exposing them to
Speaker 1: harassment from others. And unfortunately, that is the common experience
Speaker 1: that many kids are going through today. It's just not right,
Speaker 1: but it's also fixable, but it has to be addressed
Speaker 1: with urgency.
Speaker 2: Well, do you have a rule of thumb for when
Speaker 2: children should get their eyes phone?
Speaker 1: That's a great question. So here's how I think about it.
Speaker 1: The challenge with getting a phone today is that it
Speaker 1: comes with a whole bunch of other stuff. Many parents
Speaker 1: get a phone for safety reasons, whether child to be built,
Speaker 1: call in case and emergency, right, But with that you're
Speaker 1: buying access to the internet more broadly, to social media
Speaker 1: in particular. So here's how I think about it. I
Speaker 1: for my own kids, my plan is to delay the
Speaker 1: use of social media until past middle school, and then
Speaker 1: to reevaluate when they're in high school based on whether
Speaker 1: there are safety standards in place, based on what the
Speaker 1: data says at that time about their safety, and based
Speaker 1: on their maturity. Now, I know that's not going to
Speaker 1: be easy because there's a lot of peer pressure to
Speaker 1: get on your devices and on social early. So my
Speaker 1: wife and I are planning to partner with as many
Speaker 1: other parents as we can in this, knowing that there's
Speaker 1: strength and numbers, and our kids and won't be the
Speaker 1: only kids who are delaying use but for safety purposes.
Speaker 1: There are more and more parents for getting their kids
Speaker 1: what people some people call dumb phones, right, which are
Speaker 1: phones that don't necessarily all the bells and whistles in
Speaker 1: terms of social media access, but they can make phone
Speaker 1: calls text in a case of emergency, you can reach
Speaker 1: your parent if you're a child and vice.
Speaker 2: Versa, but no access to the other stuff exactly.
Speaker 1: And I think that's actually very very inappropriate of middle
Speaker 1: ground strength.
Speaker 2: I didn't even know about dumb phones.
Speaker 1: Look, I know there's a lot of pressure here, and
Speaker 1: this is one of those things where I think the
Speaker 1: thing that worries me as a parent, Martha is I
Speaker 1: think we've put the entire burden of managing all of
Speaker 1: this technology and social media in particular on the shoulders
Speaker 1: of parents, and we've said good luck, and we just
Speaker 1: walked away as a society. And I just think that
Speaker 1: that is wrong, and the vast majority of.
Speaker 2: Parents offering the guidance that they really need.
Speaker 1: Yeah, and the support, Like you know, when I was
Speaker 1: old enough to drive, my parents didn't need to go
Speaker 1: and check the breaking system on every car, investigate the transmission,
Speaker 1: tests out the frame with hammers themselves, and make sure
Speaker 1: we're strong enough. They were safety standards in place so
Speaker 1: that they knew if they bought a car that it.
Speaker 3: Meant those safety.
Speaker 1: A parent should be able to expect the same thing
Speaker 1: from the technology that their kids use.
Speaker 2: That's a very good point. I don't know if you
Speaker 2: know this, but at Mount Sinai. We have a Martha
Speaker 2: Stewart Center for Living and we've long focused on the
Speaker 2: impact of isolation and with older people. I mean it's
Speaker 2: been especially in a city scape like New York the loneliness.
Speaker 2: Is it more prevalent in a crowded city or less
Speaker 2: prevalent loneliness?
Speaker 1: Yeah, it's really interesting. I think it honestly depends on
Speaker 1: the culture of this city. I think when you have
Speaker 1: a city where people are look. People have said this
Speaker 1: to me about New York City while there. I think
Speaker 1: the Department of Public Health here has recognized loneliness as
Speaker 1: a problem. They're trying to build tools, you know, for
Speaker 1: people to engage more with one another, hotlines for people
Speaker 1: to call who are on crisis. The truth is, you've
Speaker 1: got a lot of people together, but a lot of
Speaker 1: times they're not paying attention to each other. Right, they're
Speaker 1: walking there, We're on our phones even when we're walking
Speaker 1: down the streets. Right, So when we're in cafes, we're
Speaker 1: doing our own thing. We're just not We're on the subway,
Speaker 1: you know, we're catching up on emails, looking at social
Speaker 1: on the phone. We're passing by each other, but we're
Speaker 1: not engaging with one another, and I think that can
Speaker 1: leave the people to a profound sense of loneliness. You know,
Speaker 1: in rural areas, I think the challenge of isolation is real,
Speaker 1: you know, and a lot of times you may have
Speaker 1: a lot less interaction. But one of the things that
Speaker 1: we have realized is what matters, Martha, is the quality
Speaker 1: and not the quantity of your connections. If you have
Speaker 1: two or three people in your life who know you,
Speaker 1: who you can go to during a crisis, who you
Speaker 1: can show up for during a crisis, that can be
Speaker 1: more invaluable to you than having one hundred friends who
Speaker 1: are your contacts on social media, but who you don't
Speaker 1: really feel you can be yourself with, who you can't
Speaker 1: be vulnerable with. But the good news, I think is
Speaker 1: that as huge as a problem is, it is small
Speaker 1: steps actually, Martha, that can make a huge difference.
Speaker 2: Are those small steps.
Speaker 1: So here are some simple things I would offer to individuals.
Speaker 1: If you were to spend fifteen minutes a day reaching
Speaker 1: out to someone that you cared about. It could be
Speaker 1: just to say, hey, I'm thinking about you. I want
Speaker 1: to know how you're doing. It could be a phone call,
Speaker 1: could be swinging by their home if you live in
Speaker 1: the same neighborhood, it could be a text to say
Speaker 1: I'm thinking about you. That can make a difference in
Speaker 1: how you feel. The second thing is if you take
Speaker 1: the time that you have with people actually give them
Speaker 1: the benefit and the blessing of your full attention by
Speaker 1: putting your device away during that short time you're with them,
Speaker 1: that can have the effective stretching time. It can make
Speaker 1: fifteen minutes feel like it's an hour. Start a bridge club, Yeah,
Speaker 1: and activities help a lot too, right, And so whether
Speaker 1: it's a bridge club, whether it's a volunteer activity. It
Speaker 1: turns out that when we serve other people, that's actually
Speaker 1: one of the most powerful antidotes of loneliness. And service
Speaker 1: doesn't always have to be volunteer an organization. It could
Speaker 1: be recognizing there's somebody at my workplace who's having a
Speaker 1: hard time and just offering to help them out, or
Speaker 1: lending a listening year.
Speaker 2: I want to touch base, that's great. Yeah, I want
Speaker 2: to touch base. And I worry about some of my friends.
Speaker 2: You know, they don't have to worry about me as
Speaker 2: much as I have to worry about them. Yeah, it's
Speaker 2: something that I take seriously.
Speaker 1: Well, I think it makes it a big difference. I mean,
Speaker 1: I imagine if your friends, you know, have a need and
Speaker 1: you're reaching out to them, which it sounds like, is
Speaker 1: what's happening. It means a lot to them to know
Speaker 1: that you're thinking of them.
Speaker 2: Oh yeah, I think so. It's a tough challenge. I'm
Speaker 2: so happy that you're bringing it to the forefront. I
Speaker 2: think it's very important and I hate that it's called
Speaker 2: an epidemic, but I can see why.
Speaker 1: Yeah, and unfortun you know, Marthy, turns out we're not
Speaker 1: the only country also dealing with this.
Speaker 2: No, England is right now. I mean, I did tell
Speaker 2: you My godson, Augustine Booth Clibburn started a company with
Speaker 2: his partner, who was a Saudy prince. They started this
Speaker 2: company called Hello Tomo. When he told me about it
Speaker 2: about five years ago, I said, what the heck are
Speaker 2: you doing? I just had a call at a Cambridge
Speaker 2: and he's starting this company dealing He says, there's so
Speaker 2: much loneliness in our country and we're trying to make
Speaker 2: an app so that people can connect via our app,
Speaker 2: Hello Tomo. And he sold it for a lot of
Speaker 2: money to a much bigger company very involved in loneliness,
Speaker 2: epidemic and isolation, and he's now working for that larger company.
Speaker 2: But he said, he just aproached me yesterday because I
Speaker 2: reached out and said, just tell me a little bit
Speaker 2: about what your job entails now. He said, you know,
Speaker 2: I'm I'm in charge of reaching out around the world
Speaker 2: to other people who are working for this much larger company.
Speaker 2: But we're on zoom and he said, I'm not seeing
Speaker 2: these people in the flesh, and I'm feeling isolated now
Speaker 2: and they're trying to help all the other people around them,
Speaker 2: but they're on zooms and they're on you know, and
Speaker 2: not seeing anybody. Yeah, he says, it's like it's like
Speaker 2: a nightmare for him that he's not talking to anybody
Speaker 2: in person. Do you know this company, Lyra. You have
Speaker 2: to look it up. You have to look it up
Speaker 2: and see what exactly they're doing. But he's he was
Speaker 2: one of the new Entrepreneurs forty under forty in England,
Speaker 2: you know, for the Forbes thing. And it's so interesting
Speaker 2: to see that that he's experiencing what he's trying to solve.
Speaker 1: And I'm really impressed that he recognizes as an issue
Speaker 1: more than five years five. Oh, yes, you know a
Speaker 1: lot of other workplaces are dealing with the same challenge
Speaker 1: of like how especially after the pandemic, with so many
Speaker 1: people who started working virtually.
Speaker 2: Okay, well tell me about that, because I want to
Speaker 2: know what you think about a three day work week
Speaker 2: as opposed to a five day work week. I mean,
Speaker 2: it was it nineteen and I think it was nineteen
Speaker 2: thirties when we became a five day a week workplace
Speaker 2: after six days and no pay was cut. The president
Speaker 2: did not cut pay, or but or somebody somebody didn't
Speaker 2: cut the pay. And I thought, the five day work
Speaker 2: week seems reasonable. And what do you think of this
Speaker 2: three day work week that's that everybody's following?
Speaker 3: Now, that's well, I hadn't heard of the three day
Speaker 3: work week. Overall.
Speaker 1: What I have heard about is companies that are devising
Speaker 1: policies to bring people back for two or three days
Speaker 1: a week and then let them work virtually for a
Speaker 1: couple of days a week. And look, I think I
Speaker 1: recognize that people are trying to strike a balance. Or's
Speaker 1: some families and individuals for whom having that flexibility to
Speaker 1: work virtually can be very powerful in terms of saving
Speaker 1: on commute times, being able to make it home to
Speaker 1: have dinner with your kids, you know, or pick them
Speaker 1: up from school like those are really valuable and powerful.
Speaker 1: There's also you have to bounce out, I think with
Speaker 1: certain the cost of never being together, which creates its
Speaker 1: own loneliness, and.
Speaker 2: Going to create a company. It's very difficult.
Speaker 1: Yes, And then I'm glad you mentioned creativity because one
Speaker 1: of the interesting things that one of my former business
Speaker 1: school professors studied and taught me was was that when
Speaker 1: people struggle with loneliness and disconnection in the workplace, it
Speaker 1: actually negatively impacts their creativity, their engagements, their retention, as
Speaker 1: well as their overall productivity. And that's so that matters
Speaker 1: a lot. But you don't it's hard to much harder
Speaker 1: to forge those relationships when you don't at least have
Speaker 1: some in person time. Now for some companies that might
Speaker 1: mean being in person a couple of days a week
Speaker 1: for others, and maybe more or less frequently. But but
Speaker 1: this is where I think it's really important to recognize
Speaker 1: that there is a cost to being virtual, all virtual
Speaker 1: all the time. You lose those connections, and those matter
Speaker 1: tremendously to our satisfaction and to our overall productivity.
Speaker 2: The college tours sounds very good. Are you going to
Speaker 2: be going to your alma maters Harvard and Yale?
Speaker 3: No, unfortunately, not on the coledge this college tour.
Speaker 1: We'll be starting actually at Duke University and then going
Speaker 1: to many other places from there. It'll be a chance
Speaker 1: for us to talk about the power of social connection.
Speaker 3: We're going to have.
Speaker 1: Actually, we've set up an experiential sort of afternoon with
Speaker 1: the students where we'll be actually engaging with them in
Speaker 1: some actual exercises that through a shake and build connection.
Speaker 1: We're actually putting forward a challenge to them as well,
Speaker 1: with something we call our five or five challenge, which
Speaker 1: is we're asking them to take five days, and each
Speaker 1: of those five days to reach out to someone and
Speaker 1: experience human connection, and to do so doing one of
Speaker 1: three things. Either expressing gratitude to someone, lending support to someone,
Speaker 1: or asking for help. And it could be something as
Speaker 1: simple as calling a friend to say, hey, you know
Speaker 1: that thing that you did for me last month when
Speaker 1: you're help me when I needed to move That meant
Speaker 1: a lot to me. Thanks for doing that. It could
Speaker 1: be asking somebody you know lending support. If you had
Speaker 1: a friend who had a hard time, you know, let's
Speaker 1: say they broke up with someone recently and they're struggling,
Speaker 1: just calling them to say, hey, I'm just checking on you.
Speaker 1: I just want to know how you're doing in the
Speaker 1: last month. Was has been pretty rough on you? That
Speaker 1: could also be asking for help. This is something that
Speaker 1: is tough for us to do now. But calling someone
Speaker 1: and even to a good friend, to say, look, I
Speaker 1: am struggling, I'm having a hard time. Do you think
Speaker 1: you could help me out? Maybe could we hang out
Speaker 1: or you know, I might need help? You know doing this,
Speaker 1: you know activity in my life. Can you come with me?
Speaker 1: That might be hard to do. But two things happen
Speaker 1: when you ask for help. One is you get help
Speaker 1: more often than not, and people are more willing to
Speaker 1: help us than we realize. Studies show we'd be often
Speaker 1: underestimate people's willingness to help us. But the other thing
Speaker 1: that happens when you ask for help is you tell
Speaker 1: the other person that it's okay to ask for help.
Speaker 1: They are probably somebody who might be struggling with thinking
Speaker 1: I have a need, Is it okay for me to
Speaker 1: ask for help? So we can be examples, you know,
Speaker 1: in asking for help and make it easier for other
Speaker 1: people to do the same. But in these three ways,
Speaker 1: you know, again expressing gratitude, lending support, or asking for help.
Speaker 1: We're asking people to do this each day over the
Speaker 1: course of five days, and then to let us know
Speaker 1: how they feel afterward, to tag you know, three other
Speaker 1: friends and ask them to take that challenge. And by
Speaker 1: doing so, we're hoping to create the experience of connection
Speaker 1: and hopefully make this more part of people's day to
Speaker 1: day lives.
Speaker 2: Well, I certainly hope your message of connection resonates. I
Speaker 2: really do, thanks, because I think we need it so
Speaker 2: much and it's very hard to believe that we are
Speaker 2: in trouble like this culturally and politically, at such odds
Speaker 2: with so many other things. Really, previous surgeon generals have
Speaker 2: tackled smoking, they've tackled drinking, and so these awareness campaigns
Speaker 2: really have a tremendous impact, don't they.
Speaker 1: Well, I like to think they do. They're not the
Speaker 1: entire solution, but they can be catalysts for a lot
Speaker 1: of the actions that we need to solve.
Speaker 2: Small was the whole clampdown on smoking, and is that
Speaker 2: the surgeon General.
Speaker 1: Yes, so in nineteen sixty four that was Surgeon General
Speaker 1: Luther Terry.
Speaker 2: I remember, I remember that whole campaign. I was so
Speaker 2: happy because I hate it smoking so much, even though
Speaker 2: I had to learn how to smoke for a tarriage
Speaker 2: and commercial. Really yeah, I was when I was like sixteen.
Speaker 2: They made me learn how to smoke inhale and I
Speaker 2: had to blow smoke out of my mouth and I thought,
Speaker 2: oh god, this is the worst thing on earth.
Speaker 1: Yeah, that was important, and you know, that was a
Speaker 1: multi year campaign. But either smoking rates Martha in the
Speaker 1: United States at that time or around forty two percent.
Speaker 2: I know, it was horrible.
Speaker 3: It was terrible.
Speaker 1: And now thankfully we're under thirteen percent.
Speaker 3: But not enough, not enough, A lot of program.
Speaker 2: Boy, there there's so many people smoking, you know, everywhere.
Speaker 2: And what about drinking. Drinking someone a doctor just told
Speaker 2: me that in the there's there's this big list of
Speaker 2: dangerous things to take into your body, and the most
Speaker 2: dangerous of all out of forty things is alcohol.
Speaker 3: Yeah, so alcohol is.
Speaker 2: Most dangerous, I mean, above heroin.
Speaker 1: Well so, I think a lot of this depends on
Speaker 1: how you're using these substances. The thing about alcohol is
Speaker 1: that you know. But in twenty sixteen when I when
Speaker 1: I issued when I was searching on the first time,
Speaker 1: I issued a report on alcohol, drugs and health. Yeah,
Speaker 1: and the alcohol was a part of it because I
Speaker 1: think many people had I think somehow erroneously felt that
Speaker 1: alcohol is not a big deal because it's legal. It's not,
Speaker 1: it doesn't have any health risks associated with it. But
Speaker 1: you know, sadly, we have, you know, many people who
Speaker 1: are addicted to alcohol. We have many people who drink excessively,
Speaker 1: and alcohol leads to significant amount of disease and death
Speaker 1: each year in our country and causes us a tremendous
Speaker 1: amount in terms of lives loss, but also in terms
Speaker 1: of money spent on health care costs and economic productivity losses.
Speaker 1: In fact, when we detail the overall cost of addiction
Speaker 1: in the country, the hundreds of millions of dollars, the
Speaker 1: majority of that actually was related to alcohol, not to
Speaker 1: other drugs. And so it's important for us to recognize that.
Speaker 1: I think many people also don't recognize that kids are
Speaker 1: still drinking like underage that continue. There was a problem
Speaker 1: when I was growing up, it continues to be a
Speaker 1: problem today. Thankfully, there's been some improvement there, and based
Speaker 1: on recent data in terms of underage shrinking, that's a
Speaker 1: good thing. But this is a place where we have
Speaker 1: to be vigilant. I worry that similar thing has happened
Speaker 1: with smoking. Many people think that smokes on a problem anymore,
Speaker 1: that we solve that problem. It was only problem fifty
Speaker 1: years ago. We still have millions of people who are
Speaker 1: struggling with smoking. We still lose nearly half a million
Speaker 1: people to tobacco related disease each year.
Speaker 3: In the United States.
Speaker 2: And opioids, the.
Speaker 1: Opiate epidemic is is deeply concerning because we are seeing
Speaker 1: continue to increases in the rate of overdose steps. We
Speaker 1: are we've seen that number starting that growth curves start
Speaker 1: to level off over the past year or two, but
Speaker 1: still at dangerously high levels. And one of the challenges
Speaker 1: mark that is people when they thought about opiods, they
Speaker 1: used to think about heroin. They would think about oxy cootone,
Speaker 1: the pills that people were taking. But now increasingly what
Speaker 1: we're seeing is that there's an even more powerful form
Speaker 1: of opio it's called fentanyl, which is now poisoning even
Speaker 1: more dangerous. Yes, the supply of opioids such that many
Speaker 1: people don't even know they're taking products that contain venttional
Speaker 1: but because it is so strong, it can overwhelm your
Speaker 1: respiratory system and lead people to stop breathing and ultimately
Speaker 1: can lead to death. And so that is a big
Speaker 1: part fentanyl of what is driving the opioid overdose crisis today.
Speaker 2: Well covid, can you talk about long covid? What is
Speaker 2: that about?
Speaker 1: So long covid is is a syndrome where people experience
Speaker 1: prolonged symptoms long after their initial episode of COVID has
Speaker 1: a resolved. And those symptoms could be shortness of breath,
Speaker 1: it could be fatigue, it could be overall muscle aches
Speaker 1: and pains. It could be dizziness and vertigo. There's a
Speaker 1: whole host of symptoms that can go along with long COVID.
Speaker 1: President Biden actually directed the administration of the Department of
Speaker 1: Health Human Services to stand up an initiative to understand
Speaker 1: more clearly what drives long COVID, where the risk factors
Speaker 1: for it, most importantly, how do we treat it, how
Speaker 1: do we address it?
Speaker 2: Is there is there a treatment?
Speaker 1: So right now there isn't a definitive sure if you
Speaker 1: will for long covid It's a lot of patients with
Speaker 1: long COVID end up working with clinicians who try to
Speaker 1: manage some of their individual symptoms. But we need a
Speaker 1: more comprehensive understanding of how to diagnose and treat and
Speaker 1: prevent long COVID. The good news is that there's a
Speaker 1: lot now more attention and money going into addressing that.
Speaker 1: The bad news is they can't come quickly enough because
Speaker 1: there are many people in the United States and around
Speaker 1: the world who are suffering with long COVID.
Speaker 3: I know many of them.
Speaker 1: I've had the chance to sit and talk with them
Speaker 1: and understand what it's like. It is debilitating for many
Speaker 1: of them, has taken away their quality of life, and
Speaker 1: you can imagine that with that have come mental health
Speaker 1: strain and mental health challenges as well.
Speaker 2: A big challenge. What about obesity? Is that still considered
Speaker 2: a very serious disease here in the United States.
Speaker 1: Absolutely, our rates of obesity have unfortunately continued to go
Speaker 1: the wrong way. More than forty percent of adults in
Speaker 1: America are living with obesity. Equally, if not more concerning,
Speaker 1: around twenty percent of our kids are now abyese. This
Speaker 1: is a dramatic change from over the last twenty years. Yes,
Speaker 1: and we're talking about obesity. There are even a greater
Speaker 1: number who are actually obese or overweight, right. So what
Speaker 1: we reason we get so concerned about obesity is because
Speaker 1: it puts people at risk for high blood pressure, for
Speaker 1: other forms of heart disease, for diabetes. And then there
Speaker 1: are other concerns as well with obesity. You imagine your
Speaker 1: body is carrying a lot of weight that puts more
Speaker 1: strain on your joints. You think about the development of arthritis,
Speaker 1: you know in other musclo skeletal conditions which can impact
Speaker 1: your quality of life. So these are profound challenges and
Speaker 1: I worry that part of what is driving them is
Speaker 1: that we are is our food environment has changed dramatically
Speaker 1: over the last half century. We have much more highly
Speaker 1: processed foods and foods with high levels of refined sugars,
Speaker 1: which we know contribute to the obesity epidemic.
Speaker 2: So, as a doctor, what advice do you wish we
Speaker 2: would all hear?
Speaker 1: There are a few basic pillars which if we focus on,
Speaker 1: can give us a good shot at living a healthy life.
Speaker 1: One of those pillars is around sleep. Getting seven to
Speaker 1: nine hours of sleep a night really matters for your
Speaker 1: health physical and mental. The second is around our physical activity,
Speaker 1: just being able to even if you don't have time
Speaker 1: to go to the gym every day and work out,
Speaker 1: just walking, making sure that you're walking whenever you can,
Speaker 1: to stay physically active, that matters. The third has to
Speaker 1: do with your nutrition. We all probably could do more
Speaker 1: when it comes to drinking more water and eating more
Speaker 1: fruits and vegetables and reducing our intake of highly processed foods.
Speaker 1: And finally, there's our relationships, which are just as important
Speaker 1: as the other three. Spending a little time each day
Speaker 1: connecting with people we love and care about, reaching out
Speaker 1: to friends, being there to support coworkers. That can go
Speaker 1: a long way toward making us feel like we have
Speaker 1: a true social network and a social safety net, which
Speaker 1: all of us need, whether we say it or not,
Speaker 1: not all of us have.
Speaker 2: Well, thank you so much. This has been such an
Speaker 2: interesting conversation for me, and I know for all of
Speaker 2: our listeners, doctor Murphy, you are fantastic and all of
Speaker 2: you out there can listen to house calls with doctor
Speaker 2: Vivek Murphy whenever you listen to podcasts. Well, thank you,
Speaker 2: thank you, thank you so much very much, and good
Speaker 2: luck on the college tour.
Speaker 3: Thank you. I'm very exciting.
Speaker 2: I might enroll now for is there any other degree
Speaker 2: that you could possibly get.
Speaker 3: I think I'm all tapped out and a degree, so.
Speaker 2: Well, good luck and thank you so much. And you're
Speaker 2: doing a great job for the United States and all
Speaker 2: of us here in the United States and elsewhere.
Speaker 1: I appreciate that much. I really enjoyed this conversation. Thanks,
Speaker 1: thank you.