When former U.S. surgeon general Vivek H. Murthy began writing a book about loneliness, he had no idea large swaths of the United States — and the world — would be living in social isolation when “Together: The Healing Power of Human Connection in a Sometimes Lonely World” came out.
Murthy isn’t as isolated as many others, living now in Miami with his parents, his wife and children (age 2 and 3), his grandparents, sister and brother-in-law. Like many other parents, he spends his days trying to figure out how to prepare meals and do puzzles and feeling like a bad parent.
“We’re often left with the feeling that we are falling short as we observe the kids’ screen time going up, but then we remind ourselves that we all have to be more forgiving with ourselves during this time of upheaval,” he said in a Zoom interview, adding that he’s also getting used to being parented again himself, sharing a photo of his parents cutting his hair like they did when he was a child.
His book takes a thorough look at the “loneliness epidemic” that began long before the coronavirus pandemic and has worrisome implications for both mental and physical health. A 2018 study of 20,000 adults found that half of Americans felt alone or always alone, and that those 18-22 felt far more lonely (48.3 percent) than those over the age of 72 (38.6). Studies have also found that being socially isolated increased the risk of death by as much as 26 percent.
But none of these studies specifically addressed the situation the world faces now, where being isolated is not a choice or a consequence of circumstance (such as living alone after children move out of the house.) but is being mandated for entire communities, or states, or entire countries for public health reasons.
In his book, Murthy expressed reservations about connecting through social media and screen. But this pandemic makes things different — cyber-connection is all many people have, sharing their lives through social media and video chats, playing games together through apps like Houseparty. He said that technology is good as a tool, particularly now, but it’s not a replacement for real connection.
The problem with technology, he believes, is that it creates the illusion of constant conversation and connection — someone is always around on text, Snapchat or Facebook. People need to get used to the idea that silence isn’t a bad thing, and that being alone can be a positive experience.
“The idea of being alone, it seems unnatural, but the reality is that for generations we’ve experienced periods of aloneness, and the difference between solitude and loneliness has to do with how you perceive that aloneness,” he said. “If you use that time where you’re alone in ways that bring you joy and peace, then that solitude can have a really positive effect on your life. If instead that time of being alone accentuates to you why you’re insufficient or indicates to you that maybe something is wrong with you or convinces you somehow that you are ‘lame’ because you don’t have somewhere to go on a Friday night, then being alone can actually be quite destructive.”
Murthy said he was shy and often felt alone while growing up, particularly at school, so he knows what it’s like to feel “lame.”
“I had a hard time just starting conversations and approaching other kids that I didn’t know,” he said. “Lunch time every day was challenging because I would feel worried about if I would have someone to sit next to, and worried that maybe there wouldn’t be anybody to sit next to. That anxiety as a really young child really stuck with me and made an impression on me.”
At home he felt loved and accepted. But he said he was embarrassed to tell his parents that he didn’t have anyone to play with at school. In a common theme heard from many people in the book — Murthy says that he thought admitting to being lonely equaled being unlikeable or that he was unlovable in some way.
As an adult, his interest in the topic started when he crossed the country as surgeon general in 2013, listening to people talk about their concerns. Health-care costs and the opioid addiction epidemic came up frequently, but so did social isolation.
In 2017, after President Trump replaced him as surgeon general, Murthy wrote a piece for the Harvard Business Review about the “loneliness epidemic.” The piece — and the phrase — struck a chord and was covered by the national media and plastered all over social media.
Murthy said that what surprised people, including both medical experts and the general population, was loneliness and social isolation were common concerns he heard from people of all ages, not just elderly populations. A 2018 study found that there are several spikes of loneliness, first in the late 20s, again in the mid-50s and finally in the late 80s.
After losing the surgeon general’s post, Murthy said he struggled with feeling disconnected. During his time as surgeon general, he had focused intensely on work and neglected friendships and relationships beyond his immediate family.
“I felt somewhat embarrassed, frankly, to go back and just pick up where I left off with friends. I felt like some sense of guilt having just dropped so many of those relationships,” he said. “The irony is I was writing a book on loneliness at a time where I was experiencing it quite deeply. And I had to really think about how to address that.”
He said he began to implement some of the lessons he’d learned through his research, particularly the Japanese idea of Moai, a tradition in which a child is connected to a group of people beyond their family with the idea of creating a lifetime support group. He decided to create his own Moai, reaching out to two friends he’d known for years, but in recent times rarely saw and reconnected with them. They agreed to video conference once a month for at least two hours and that they would be honest about what was going on in their lives — whether it was their relationships, money, work, whatever. In between, they make an effort to text and call each other when hard decisions come up. The idea was that they had a support group outside their immediate family.
Even though technology helped Murthy keep his Moai intact, in the book, Murthy worries that social media and technology takes over the “white space” in people’s lives — those moments where people have interacted: the bus stop, in the doctor’s office, before class starts, at the office coffee pot. Instead of having a moment of quiet, or a chance to start a conversation with someone, even before the pandemic hit, it’s become all about the screens.
“I think sometimes in the focus on deep friendships and on romantic relationships, we can lose sight of how important the small connections we make are with strangers and with people that we may encounter for just a few seconds or a few minutes, whether it’s the barista at our coffee shop or the stranger next to us on the subway,” he said. “But those interactions make a real difference in our lives.”
The goal of writing the book, he said, was to draw attention to the changing priorities of society. Instead of putting wealth, power and reputation as life goals, he said, we, as a collective community, should take this moment to reflect on the power and importance of relationships, and how we show up in the world, whether at home, school or the workplace.
It all goes back to creating that accepted and loved feeling he felt in childhood, Murthy said, and learning how to help others create that feeling.
“I’m so excited about the time when we can finally, ultimately reconnect again, but I’m also cherishing the opportunity [now] to reach out to people and ask them how they’re doing,” Murthy said. “One of the things that happens in our regular lives is that when we’re in moments of pain or feeling alone, we may hesitate to reach out to others because we may think — they’re not going through the same experiences I am.
“But this is one of those moments where you know that everyone is struggling at some level, maybe for different reasons and in different ways, but we’re all struggling. And when we realize that, it makes it easier to reach out and to be vulnerable, to be more open and honest about how you’re doing. And when you do that, they’re more likely to open up and do the same.”