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Together: The Healing Power of Human Connection in a Sometimes Lonely World

Yale Medicine Magazine, 2020 - Summer


YSM graduate and former Surgeon General Vivek Murthy makes a compelling point about a negative amplifier of many health conditions: unwanted solitude.

In 2018, a year after completing his term as U.S. Surgeon General, Vivek Murthy, MD ’03, MBA ’03, crossed paths with two old friends at a retreat in Colorado. The three men found themselves immersed in long and unguarded conversations. “We realized that we were all struggling with similar questions: what to do for work; how to do right by our families; and how to address the loneliness in our lives.” Murthy proposed regular meetings, and ever since, the three friends have talked by video every month.

Murthy recognized that he was lonely on occasion despite having the companionship of a wife and two children. As he points out, humans require social networks that range from intimate to peripheral; and recent studies have shown that a quarter to a third of Americans feel isolated. Murthy noticed this sense of disconnection during his four years as surgeon general. As he addressed problems like obesity, opioid addiction, and depression, he observed that “loneliness ran like a dark thread through many of the more obvious issues.”

Soon after reuniting with his friends, Murthy began work on his new book, Together: The Healing Power of Human Connection in a Sometimes Lonely World. Murthy frames loneliness as a helpful warning sign. Human survival has depended on sharing information and working alongside others within social groups. Yet paradoxically, loneliness can reinforce isolation by triggering hypervigilance and eroding self-image. The way out, said Murthy, is to help others. People can pick up groceries for a neighbor; entertain the children of a parent working at home; or call a friend simply to ask how they’re doing. “When we serve other people,” said Murthy, “we overcome and short-circuit a number of the harmful patterns that we adopt when we are chronically lonely.”

Some people find community at work; but Murthy said that “we can’t assume that if we keep people together, somehow we’ll build connections.” Creating community requires structure. As surgeon general, Murthy invited one team member each week to talk about something meaningful in their life. When he worked in a Boston hospital, he used Friday meetings partly to discuss a poem.

It may not be obvious, but togetherness also requires solitude, Murthy writes. When he worked in the hospital, he would stop at a bench on the way back from picking up lunch and just sit for three or four minutes. Or he’d go to the chapel. “I would feel renewed. We are hard-wired to connect to each other, and we are also hard-wired to connect deeply with ourselves.”

Murthy sees the heart as a metaphor for the power of the pause. In the cardiac cycle, the diastole (the relaxation phase) allows the coronary blood vessels to refill. “Pausing, it turns out, is what sustains the heart.”

Murthy recalls what two of his School of Medicine professors taught him about how to find time for a pause. When Margaret “Peggy” Bia, MD, FW ’78, washed her hands between patients, she thought of something she was grateful for. Auguste Fortin VI, MD, MPH, would stop at the door to a patient’s room, take a breath, and remind himself of the person he wanted to be when he entered.

As a result of COVID-19, large segments of society have been paused off and on since Murthy’s book appeared in late April. For some people, Murthy said, the coronavirus pandemic has highlighted “a preexisting well of loneliness in their lives.” But he sees potential in this disruption. “It creates an opportunity to put in new practices, and perhaps to approach your life in a way you didn’t before. This could be the time, if we choose to use it, to build people-centered lives.”

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