You’ve probably seen him on television. Although he is not as familiar a presence on your screens as Tony Fauci or Rochelle Walensky, the current head of the CDC, lately I have seen him any number of times and also just heard him interviewed on NPR’s Science Friday program. Every time I watch him, I have been struck, not just by his uncommon articulateness, but by a certain sweetness in his character. He radiates a calm imperturbability and kindliness, even a sort of gentleness. He doesn’t bloviate like some politicians do; he doesn’t talk like a politician at all. He seems to speak to his interviewer in a sincere, authentic manner. You feel as if you can trust this man to tell the unvarnished truth.
So when I heard that he had written a book on loneliness, a topic that I had addressed in my previous blog, I decided to purchase it. Both because I was still interested in that topic, but also because I had become interested in Murthy himself. I wanted to learn more about the man. Among other things I had heard him say, almost as an aside, in one of his recent interviews that he had already lost ten of his family members to COVID! My heart really went out to him when I heard him say that in his matter-of-fact way.
When I started to read his book, which is called Together, I discovered something terrible. It couldn’t have been published at a worse time; it was already out of date. Vivek (as I prefer to call him) had actually finished writing the text of his book just as COVID hit. All he could do was to allude to the onset of COVID in his preface (which although it comes first is normally the last thing an author writes). But COVID changes everything and both qualifies and, to some extent, vitiates, some of Murthy’s principal findings and conclusions. Just to take one example, as you can already tell from his title, Vivek is big on togetherness, which is the social glue that binds to good health and mitigates loneliness. But as we have learned over the last eighteen months, enforced and involuntary “togetherness” can easily strain relationships in a family and seems to be implicated as the chief cause in the rise of domestic violence during the pandemic. In short, “togetherness” in itself is no panacea for what ails us during this time when we are already suffering acutely from the pangs of loneliness.I learned something else about Vivek from reading his book. Surgeons General –- and this is Vivek’s second tour of duty in this role (he also served as Obama’s Surgeon General from 2014 to 2017) – are normally referred to as “the nation’s doctor.” This appellation doesn’t quite capture Vivek’s view of his mission. If you were to read his book, you would quickly see that he is more like the nation’s psychotherapist. He is very psychologically-minded and sensitive to our human dramas to preserve our mental health, not just to avoid disease. In fact, the “disease” he is most concerned with in his book is the plague of loneliness, which also makes us sick in any number of ways.
And one last thing about Vivek before we take up what he has to say about loneliness and how to assuage it: He himself has had to deal with many bouts of loneliness in his own personal and professional life. He writes as someone who is upfront about his emotional vulnerabilities and insecurities. This is not your usual Surgeon General. He is someone who truly cares about human suffering and has a well of deep compassion for the struggles we all face in coping with life’s challenges.
In my previous blog, I was mainly concerned with the problem of loneliness in the elderly, but one of the things I first learned from Vivek’s book is how pervasive it is in our society as a whole, and how pernicious its effects can be.Various surveys show that about one-quarter to one-third of Americans feel lonely. For example, a study carried out by AARP and validated by UCLA found that one-third people over the age of 45 are lonely.
And what do people do when confronted with loneliness, which has only been accentuated by the pandemic? Vivek: “Many people use drugs, alcohol, food and sex to numb the emotional pain of loneliness.”
And there are many other deleterious effects of loneliness as well. Several studies have shown that loneliness is associated with a greater risk of heart disease and strokes, high blood pressure, depression, anxiety and dementia. Self-described lonely people also sleep more poorly, have more immune weakness (which makes them particularly vulnerable to COVID) and are more likely to suffer from impaired judgment and impulsivity. Finally, not surprisingly, they die at younger ages than people who are not lonely. In sum, loneliness makes us sick and kills us prematurely.
And loneliness does not only result in earlier “natural” deaths, but also leads to a higher risk of suicide. Moreover, we know that COVID has led to a spike in suicides. And that in general suicides have increased by one-third in the U.S. over the last twenty years or so. Loneliness, then, especially during COVID, makes suicide more of a danger.
Vivek doesn’t stray too often into the fraught and bitterly divided world of contemporary American political life, but it’s clear that in recent years the degree of polarization, vituperation and outright violence has reached alarming levels. And one casualty of these trends, which has not been empathized as much as it should be, is the corresponding decrease in empathy.
According to the research of Robert Putnam, the author of the book, Bowling Alone, this reflects the decline of various social networks that began in the latter third of the 20th century. During this period, religious attendance declined as did membership in community organizations – even the frequency with which people invite others to visit in one’s homes has decreased. And all this seems again to point to an erosion of empathy in the United States. Just to take one example, one study revealed that empathy scores among college students had dropped a whopping 40% between 1979 and 2009, with most of that decrease occurring in the 21st century. We just don’t seem to care as much about other people these days, and the rise of loneliness and people living on their own certainly are contributing factors to this fraying of the bonds of social connections in our time.Well, you get the picture – loneliness is an insidious and worrisome factor and trend in American life. According to Vivek, it also underlies various common forms of personal and social pathologies such as drug and alcohol addiction, crime, and violence, both domestic and outside the home. Even Bill Wilson, the co-founder of Alcoholics Anonymous, wrote that “Almost without exception alcoholics are tortured by loneliness.”
This of course suggests that “the cure for loneliness” is meaningful human connection. Without it, we suffer. Deprived of it as infants, we do not develop normal bonding with others. Deprived of it as adults, we get sick or commit various forms of anti-social activity. All this should be obvious by now. We hardly need a modern Aristotle to tell us that we are “social animals.” Aside from the occasional recluse or hermit, we all need the company and love of others. But when we look at how our society has developed in recent years, we can easily discern how much we have unknowingly sabotaged our communal social life for the allure of privatistic concerns.
I sometimes joke that human beings in the course of their evolution have made three disastrous wrong turns.
The first was the invention of agriculture. Yes, really. If you don’t believe me, take a look at Yuval Noah Harari’s bestselling book of a few years ago, Sapiens.The second is much more recent. It’s the rise of the isolated nuclear family in America and the corresponding decline in extended family networks. I discussed this in my previous blog, so don’t need to dwell on that here. However, Vivek also mentions this and comments that in countries in southern Europe, such as Italy and Greece, where extended family units are still more intact than in America, the problems of loneliness are less acute. After all, for thousands of years people lived in tribal or communal settings and humans could simply not survive on their own; ostracism meant death. But now? Vivek writes: “I think many of us feel pushed by modern society to be more independent, even as, deep down, we crave the inner connectedness that our ancestors depended on.”
The third fateful error was the invention of the Internet and, in due course, the advent of social media and cell phones. I am not kidding, although of course I do not deny all the obvious advantages that the development of the Internet has brought us. After all, who can live these days or would want to without Google and Amazon? But still, we have certainly become more aware of the dark side of the Internet with its power to surveil and spy on us, to track our every move on our iPhones, to hack into our personal, business and government networks, to carry out cyber warfare, and so on into the frightening night. Any technology is neutral in itself, but any technology can also be used for malign purposes. Years ago, in a popular novel by John Irving called The World According to Garp, the main lesson was “the world is not safe.” Do you feel as safe now as you did before the Internet took over our lives?
But what does all this have to do with loneliness? Plenty, as you will soon see, if you don’t already. Vivek’s thesis in his book – and he provides countless, often inspiring examples of this – is that the way to cure or reduce the adverse effects of loneliness is to foster various means of renewed social connection. We hunger for social companionship; without it, we atrophy or sink into apathy and isolation. We need to connect.But what kind of connections are readily available these days and with what or whom?
In these discussions, sooner or later someone is bound to bring up that famous line from E.M. Forster’s novel, Howard’s End: “Only connect.” (Another confession: I never read the book; I only saw the film.) Actually, Forster wasn’t really referring to connecting with other people, but that is how the phrase is commonly understood now. And how do we connect nowadays?
Facebook of course comes immediately to mind. Mark Zuckerberg has become the apostle of the virtues of connection. Of course, he is not talking about face-to-face encounters. He is offering Facebook as the medium. Let us connect virtually. We don’t actually have to go out to see people (especially during the pandemic when social contact is so risky). Not when they are just a click away. And that exactly is the rub.Jill Lepore is a staff writer for The New Yorker and a Harvard-based historian. I recently came across one of her articles, which turned out to be an excoriating indictment of Facebook and all the many ills it has unleashed from its own electronic Pandora’s box. She also has seen just how much it has actually contributed to what she calls, as I did in my previous blog, our current epidemic of loneliness. Here’s an excerpt:
“Our mission is to give people the power to build community and bring the world closer together” is a statement to be found in Facebook’s Terms of Service; everyone who uses Facebook implicitly consents to this mission. During the years of the company’s ascent, the world has witnessed a loneliness epidemic, the growth of political extremism and political violence, widening political polarization, the rise of authoritarianism, the decline of democracy, a catastrophic crisis in journalism, and an unprecedented rise in propaganda, fake news, and misinformation. By no means is Facebook responsible for these calamities, but evidence implicates the company as a contributor to each of them. In July, President Biden said that misinformation about covid-19 on Facebook “is killing people.”
Collecting data and selling ads does not build community, and it turns out that bringing people closer together, at least in the way Facebook does it, makes it easier for them to hurt one another. Facebook wouldn’t be so successful if people didn’t love using it, sharing family photographs, joining groups, reading curated news, and even running small businesses. But studies have consistently shown that the more time people spend on Facebook the worse their mental health becomes; Facebooking is also correlated with increased sedentariness, a diminishment of meaningful face-to-face relationships, and a decline in real-world social activities. Efforts to call Zuckerberg and Sandberg to account and get the company to stop doing harm have nearly all ended in failure.
Vivek, too, spends considerable time warning against the adverse effects of digital technology, especially its addictive qualities, which can lead to excessive use. He cites several such studies, such as one carried out at the University of Pittsburg in 2017 that showed high levels of social media use was harmful and contributed to loneliness. Here, heavy users were twice as likely to feel lonely compared to those whose use was low. Another similar study found that heavy users were more likely to be depressed. Vivek sums up his conclusion as follows:
As we learn more about these various dimensions of technology, it is increasingly clear that technology holds mixed blessings for us. Social media can help people find meaningful connections, especially when they come from communities that have traditionally been isolated or marginalized. But in the wrong circumstances, it can exacerbate loneliness by amplifying comparison, enabling bullying, and substituting lower - for higher-quality relationships.
Some years ago, on one of my visits to The Netherlands, I visited the famous Rijks Museum where you can see a number of Rembrandt’s works, including his colossal and celebrated “The Night Watch” from the Golden Age of Dutch painting. Here’s how some Dutch kids viewed it recently:
Need I say more?
I would actually love to write more about Vivek’s book because I have really said very little about all the wonderful examples he gives of how people have found ways – or at least did before the pandemic hit – to overcome loneliness and find meaningful personal involvement with others. If you were to read his book, which I encourage you to do, you will find many moving and inspiring stories in it of people he has personally interviewed who have triumphed over their own loneliness and gone on to lead very fulfilling lives. He spends a good part of the last part of his book discussing innovative ways to cultivate loving connections among students. What a shame that with schools closed for so long during this seemingly endless COVID pandemic (just when we seemed to have turned the corner, we find that we have smashed into a wall called the Delta variant) that all of these worthwhile endeavors have had to be abandoned at least for now. One hopes that they can be revived once the COVID cloud finally lifts.
But to end this blog, I think it only fitting to return to Vivek himself since I wound up having only more admiration and respect and - I would even dare to say – love for this man than I had prior to encountering him in his book.
Vivek, who is in his mid-forties, is married with two small children, and toward the end of his book, he writes a letter not just for his own children, but one that expresses his hopes for all children in future generations. Here are a few excerpts that will give you a sense of the man:
Dear Ones,
May you inhabit a world that puts people at the center, where everyone feels they belong. Where compassion is universal and kindness exchanged with whole-hearted generosity for all.
The most important thing we wish for you is a life filled with love – love that is given and received with a full heart. Love is at the heart of loving a connected life. Chose love, we tell you. Always.
You are precious precisely because you have the ability to give and receive love. That is your magic.
The greatest gifts you’ll ever receive will come through relationships. The most meaningful connections may last for a few moments or for a lifetime. But each will be a reminder that we were meant to be a part of one another’s lives, to lift one another up, to reach heights together greater than any of us could reach on our own.