Dr. Vivek Murthy on Loneliness, Staying Human, and What True Success Looks Like

DR. VIVEK MURTHY:

In a world that's full of really challenging rapidly moving forces, including AI and other technology, how do we hold on to the parts of ourselves that make us truly human? Our compassion, our empathy, our courage and our love? And how do we see these not as things that are optional, not as sources of weakness, but as real sources of strength? That is the conversation I want us to have.

TED ROOSEVELT V:

Welcome to Good Citizen, a podcast from the Theodore Roosevelt Presidential Library. I'm Ted Roosevelt. My guest today is Vivek Murthy. He served as both the 19th and the 21st Surgeon General of the United States. During his tenure, Dr. Murthy addressed the epidemic of loneliness in America, arguing that loneliness is more than just an emotional state — it is a public health concern with significant physical impacts, as serious as obesity and smoking. He found that something we're missing today is a sense of purpose. So we've been taught that the markers of success are wealth, status, and achievement. But maybe the society we've built is working against the very things that make life meaningful, like service and community. In this thoughtful conversation, you'll find that Dr. Murthy is warm, disarming, and deeply thoughtful. We talk about technology and parenthood and what they're not teaching about in medical school.

And you'll hear about his new podcast, Staying Human. Now as surgeon general, he had two main jobs, inform the public about critical health issues and command the US public health service. What Vivek did with that role is a little surprising. I'm going to let him take it from here.

DR. VIVEK MURTHY:

This is not a job that I actually expected, and I never thought that would work in government. But one of the things that actually that freed me up to do is it allowed me to actually come in with fresh eyes and to say, "You know what? I'm not doing this role so I can climb my way up the ladder. Let me innovate. Let me try things that are different."

TED ROOSEVELT V:

One thing you did right off the bat was a listening tour to find out what health issues Americans were really worried about. And that's interesting to me because this seems like a top down job where you gather the science and then disseminate it out to people, but you took more of a bottom up approach in talking to people first. Why did you do that?

DR. VIVEK MURTHY:

I realized that I needed to start with listening to people. It was something I was taught very early in medical school. How you connect with another human being, how you understand what their needs are, how you try to show up for them during times of crisis, you got to start by listening. This was really pushed into my — under consciousness in the second or third week of medical school when I was doing one of these practice sessions with volunteers to pretend that their patients in a sense are model patients. It's a chance to practice interview skills. And I was so focused, I remember, on the — trying to remember the right questions and make sure I was getting through my list that I wasn't fully listening to what the patient model was saying in front of me. And so I had a mentor finally watched this for like 10 minutes, I think couldn't take it anymore, and came up to me and whispered into my ear, "Vivek, if you just listen to the patient long enough, they will tell you what they need." And I realized that over the years that that wasn't just about taking care of patients, that was actually a life lesson that so often we are so focused on how we're going to project ourself, how we're going to build our brand, how we're going to express our thoughts, how we're going to command influence, that we actually don't often pause long enough to actually listen deeply to what people are saying.

And that shaped my agenda over my two terms as surgeon general.

TED ROOSEVELT V:

So what did you learn in those conversations and what was most surprising in those conversations that maybe you think the healthcare community or prior surgeon generals had missed?

DR. VIVEK MURTHY:

So I think there were a few things that popped out. People were worried about high rates of heart disease and diabetes and obesity. People were concerned about the addiction crisis, particularly with opioids. But the things that actually surprised me is I started to, one, I hear more and more stories about loneliness, about people struggling to connect with other people. And they wouldn't, by the way, Ted, come out and say, "Hey, I'm lonely." But they would say things like, "People are all around me, but at the end of the day, I feel like I have to carry all of life burdens by myself."

Or college students on campuses with thousands of other students would say, "I don't really feel there's anybody who really gets me or who I can be myself with. " I hadn't realized just how widespread the issue of loneliness and isolation actually was. And one thing we know for sure is that when you're alone by yourself trying to face all the life's challenges, and even day-to-day adversity can feel completely overwhelming, but when you're together with others, when you know that there are people who have your back, even if it's just one or two people, then even some of life's greatest adversities can feel not easy, but at least manageable.

TED ROOSEVELT V:

Was it clear that it was a medical issue?

DR. VIVEK MURTHY:

In the beginning, I didn't think of it as a health issue because I never learned about it in a medical school or in residency training. But here's what changed for me. When I started hearing these stories more and more from people all across the country as Surgeon General, that's when I started to dig in to their research on this topic. And that's where I was really quite surprised, in fact, to understand that loneliness is not just extraordinarily common, but it's also consequential for our health. So when we're socially disconnected from others, it increases our risk of depression, anxiety, and suicide, but it also increases our risk of physical illness. So we're talking about a near 30% increase in the risk of stroke and heart attacks, a 50% increase in the risk of dementia among older people, and an overall effect on mortality. So it's a life shortening impact that was comparable to smoking and obesity.

Now, we think about smoking and obesity as really important public health issues, but what the data and stories were telling me, clearly, was that loneliness and isolation were public health issues that were just as important.

TED ROOSEVELT V:

Was it hard for you to start that messaging in a way that resonated with people like, "Oh, this is what the surgeon general should be focusing on?"

DR. VIVEK MURTHY:

I would say that people were quite surprised. I didn't really find resistance per se. I found surprise and curiosity and then ultimately a deep resonance as people felt that this is something that they've quietly been struggling with in the shadows and we're glad to finally have the curtain pulled back on it so we could speak more openly about this because unfortunately there's a lot of shame around loneliness that prevents people from talking about it. In our very extroverted society, we make people feel often that if you're lonely, that means something must be wrong with you, that you must be a failure in some way, you're broken.

TED ROOSEVELT V:

I'm wondering what you noticed, if anything, from a gender perspective. On the one hand, young women seem to be more socially engaged than young men, and yet I know they're suffering from high rates of mental health challenges, and then you have young men who are killing themselves at very high rates. And I think there's some interrelation there, but should we look at this broadly as a human condition or is it helpful to break it down from a gender perspective to understand some nuances?

DR. VIVEK MURTHY:

Well, I certainly do think that men and women are affected in somewhat different ways when it comes to their mental health. I find, for example, that social media seems to take more of a toll on young girls. And I actually think that the rates of loneliness among men and boys are ... I think it's actually underestimated because I think there's a reluctance, a greater reluctance for men to admit that they may be struggling with loneliness. You're absolutely right that men take their life at a markedly higher rate than women do. Although women attempt suicide at a higher rate as well, there are some critical factors that we all need for our health and wellbeing, for our deeper fulfillment that have been eroding in people's lives, our engagement in service, our sense of purpose in life. One of the things, Ted, that really disturbed me as a father was a data that came out not long ago that showed that the majority, more than 50% of young people, ages 18 to 24, say they have little to no sense of purpose or meaning in their life.

And this to me is so deeply concerning because we can have the best technology in the world, we can have the best government services in the world, we can have companies that are doing incredibly well in terms of their balance sheets and bottom lines, but if we have people who are feeling increasingly alone where we don't have a culture of service and people don't have a sense of purpose and meaning of their life, there is no way that we are going to be able to thrive as a society.

TED ROOSEVELT V:

It's so interesting because one of the things I've been thinking about a lot lately is our leaders, whether they're corporate leaders, political leaders, even healthcare leaders, are often asking adjacent questions to the central question, which is, is it going to grow GDP? Is it going to, in the healthcare space, extend life? But we're not asking what I think is the fundamental question, which I believe you are asking, which is, does it make us happier? Does it give us purpose? And I wonder if in your journey you have felt like there's an opportunity to introduce that question or raise that question in the rooms where decisions are being made, where we're prioritizing what we're going to spend money, time, and energy on.

DR. VIVEK MURTHY:

The short answer is yes. What I find is that when I raise this broader issue of the deeper root causes of our unhappiness and like a fulfillment, might talk about the fact that the triad of success, that young people were talking to me all the time about money, power, and fame, the three elements that they're being told that they need to pursue in life in order to be successful. There's nothing wrong independently with any of those elements, but that's not a substitute for the triad of fulfillment, which are relationships, purpose, and service. And we've allowed the ladder to erode while focusing more and more on the former, and that's just a recipe for disaster. The challenge I've found that many folks face in leadership positions, whether it's policymakers or leaders in organizations, is sometimes they just don't know where to begin to address a deeper challenge when it comes to disconnection, lack of purpose, and the erosion of a service ethic. It can feel easier to say, "You know what? I'm going to fund a program to invest specifically in this service or in that good." But if we're not in a position where we're willing to grapple with these deeper root causes of our unhappiness and discontent, then we're just going to spend a lot of time putting band-aids on wounds that are going to be temporary fixes, but aren't going to help us get where we want to go.

TED ROOSEVELT V:

I'm reminded of when I was at business school, the class was asked the question by a professor at one point about what success meant for the students. And I suggested that success should be measured by happiness at the end of your life. And it was like I rolled a bomb into the classroom. People got so upset with that answer. It was like, "Oh, you're going to be on a beach doing drugs, not accomplishing anything." And what I'm curious about is sort of how much of this is structural where it's actually a feature of the society that we've built, that social media is actively encouraging these goals that are not goals that are going to lead to happiness versus something that can be changed. Is the yearning big enough to change what seems to be the structural impediments in place right now?

DR. VIVEK MURTHY:

So I think increasingly the answer is yes to that because the amount of discontent is growing, but I think it's reaching a breaking point where people are looking for an alternate path. They're looking for a different way to live. They don't always know what that is. And I think this is where I see the work that I'm focused on now and that others who are of similar mind are doing is so important because what we need to be able to put forward to people is that alternative and show them there actually is a different way to live. There are different set of choices that we can make. And there are other people out there who want what you want too. I think the challenge we face is both structural and cultural. I do think that we find ourselves inundated with technology, particularly social media, that is primarily trying to maximize our engagement. And the best way to maximize engagement is to keep content on there or drive us to content using the algorithm that's mired in fear and anxiety because evolutionarily we tend to pay attention to things that we think are sources of danger, but that might be great for the bottom line of an engagement focused ad-based revenue sort of operation, but it is not good for the mental health and wellbeing of people. And it feeds into culture because it shifts young people into thinking that this is how you dialogue.

TED ROOSEVELT V:

Yeah. I had an experience with my daughter probably about eight months ago, but I was having a very lovely, intimate conversation with her and she said, "I need to go up and go to the bathroom, but I don't want to." And I was like, "Go to the bathroom. Come on back. I'm going to be right here. No worries." And she said, "I know when I get up and leave, you're going to take your phone out and I'm going to lose you." And it —

DR. VIVEK MURTHY:

Oh my gosh.

TED ROOSEVELT V:

... broke my heart because she was 100% right. And I realized that it wasn't — it was the feature of the phone for me was that in fact, I was in a moment of intimacy and vulnerability with my daughter and it made me uncomfortable enough that I knew I could break that by looking at my phone. And in fact, it's the inverse of what makes healthy relationships and makes good parenting and everything. And it really took me a while to digest that moment and understand how I was interjecting my phone and social media and checking an email from work or whatever it was that I thought I needed to do in that moment because the reality was what I was doing was trying to break the social connection, but it actually had profound implications in my ability to connect with my daughter. And I'm sure I do it across my life with the people I interact with.

DR. VIVEK MURTHY:

Wow, that gave me the chills just hearing that. It made me think about my own kids and how I've done that at times as well. Look, I think about our phones in many ways as state disruptors, right, so what they do is when we're getting into a deepening state of connection with someone, we suddenly break and look at our phone, that can disrupt our state. And often it takes a while to get into that deeper form of communication where we feel really connected with someone, we're really focused on the conversation, we're starting to bring up real deeper reflections and thoughts and stories, and all that can get thrown off track. We tend to say, "Oh no, I'm still remember — I'm listening with the person saying I can repeat their words," but we're actually losing a lot of the feeling and the nuance. It's not just about the words that someone says. It's about the feel. It's what's unsaid. It's about the silence and what that sounds like and feels like." I think our phones in particular have soaked up all the silence and this is one of the places where I think nature comes in.

Nature is one of the most powerful sources of health and wellbeing that we have around us, but we spend less and less time in nature. We know, for example, that people who are around green spaces, spending time in green spaces, that they tend to have better self-reported anxiety and stress symptoms. But we have, just like with social connection, no one's gone out there and said nature is bad, just like no one has gone out there and said, "Well, relationships are bad, human connection is bad," but more out of neglect, we have allowed those to be edged out of our life. And this is our time to reclaim those powerful sources of wellbeing.

TED ROOSEVELT V:

So first of all, you're preaching to the choir on nature. To me, it's sort of the spiritual religious space that I go to and where I feel the most connected, both with myself, with my community, with the world around me, and everybody approaches spirituality a little differently, but we've seen a decline in organized religion in this country. And I wonder how you think about the correlation of that decline and some of this loneliness epidemic.

DR. VIVEK MURTHY:

Well, I think the decline in religious communities has certainly contributed to the loneliness crisis we have. It's not the only reason, by the way, and participation in many organizations has declined in the last half century, recreationally, service organizations, as well as religious organizations. And so let's just talk about that for a minute because you use the word spiritual. And it's a word we don't use often enough because it's not just about religion. When I think about health, for example, I think about that there are four dimensions of health that we have to nurture if we truly want to be well. First is our physical health, the second is our mental health, the third is our social health — that has to do with our connection, our relationships — fourth is our spiritual health. And spiritual health has to do fundamentally with meaning. Where do we find deep meaning in our lives?

And one of the reasons that I've been focused on this triad of fulfillment, relationships, purpose, and service, is because those are powerful sources of meaning in our lives. Our faith traditions can also be powerful sources of meaning, but you can have a deep sense of meaning. You can be really nourishing in your spiritual health and wellbeing, even if you're not religious. It doesn't mean you have to have a specific faith tradition. But I do think that spiritual health fundamentally is about what nourishes our spirit and we need meaning in our lives. You can surround somebody with all the resources and wealth in the world, but if they don't have meaning, they don't have someone to share that with. Life becomes very empty.

TED ROOSEVELT V:

If I were to go to medical school today, is this a message? Is this a lesson that I would hear?

DR. VIVEK MURTHY:

I don't think you would hear all of that, of what I just told you. I think certainly you'd hear a lot about physical health, as we always have. You'd hear a lot more about mental health than you did 20 years ago. In some places, you'd start to hear a little bit more about social health. The medical community, I think, has responded very strongly to our public health worth on loneliness. And I clearly seize this as an important issue, but has that trickle down to actually teaching students? I think we're still in the early stages of that, particularly when it comes to our spiritual health and wellbeing, to our social health, our connections, where you truly need human beings. You can't replace a friendship with an AI chatbot. You can try to. You can get the chatbot to say all of the "right things" so that someone feels better in the moment. But what we need in friendships are often not someone who tells us everything that we want to hear in a tone that we can dial up or dial down. We need somebody who cares deeply about us and we know that they care about us as a human being. We need somebody who will push us at times, who won't always agree with us. Sometimes they'll disagree with us, but do it in a way that'll help us expand our way of thinking and help us grow. We need somebody who can hold our hand, literally, in a crisis, who can show up at our door at 4:00 AM when our child is sick to lend a hand. And that is not something that an AI chatbot does. So when people ask me, "Is there going to be a role for doctors in the future? Are patients really going to need us?" I would say absolutely yes, because the core elements of empathy and compassion, the life experience that we all have as human beings that allows us to connect with each other in such a deep and authentic way, these are qualities that are deeply, deeply human, and that's what we have to hold onto.

TED ROOSEVELT V:

We had Karl Rove on the podcast, very different guests, but we spent a lot of time talking about the political fractures in our country right now. And he gave us a fair bit of comfort talking about the historical context that, yes, it feels bad in this moment in time, but the fact of the matter is that we've had other moments that have been equally disruptive, equally divisive. And I wonder if you see any historical context for this loneliness epidemic that we're experiencing right now, or if this is unchartered territory.

DR. VIVEK MURTHY:

The circumstances we're living in today are quite different, right? We didn't have AI and technology as a forces. And I think change is also happening far more rapidly today than it was back then, which is also incredibly disruptive for people, whether it's changing the kind of job I do or changing my identity and my sense of my place in the world. So those are unique, but I think that the solution is actually, there's a common thread here, which is that if we want to address this, we do need to build a stronger sense of connection and community. We're not going to overcome political polarization with the right message. We're not going to overcome it with a single politician who chooses to have a message that's uplifting, even though I think that would actually be quite helpful. It has to be more fundamental. We have to stitch together the social ties and we have to do that not only through stronger investments in community organizations and not only in rebuilding the social infrastructure of our communities, but we've also got to do that from a cultural perspective.This is a time where we have to ask ourselves a deeper question, what really matters for our fulfillment? And are we willing to shape and build a culture that supports those core elements? If we want to anchor in relationships, if we want people to be enmeshed and an ethic of service, if we want people to find purpose in lifting each other up, then we've got to model that for our kids. We've got to teach that to our kids in school. We need to have organizations that strengthen and support that– other civic organizations. We need workplaces that help strengthen that ethic of connection and service. We need leaders who embody that. And we need people who are willing to say that these are the qualities I want in my leaders. So these are the changes we can make, but it's got to be both structural and cultural.

TED ROOSEVELT V:

Vivek, you previously launched the first ever podcast from a US surgeon general called House Calls, and now you're launching a new show called Staying Human. Tell me about Staying Human and why were you drawn to doing another podcast?

DR. VIVEK MURTHY:

Well, I still care deeply, Ted, about the issues that I worked on in office. And as a dad watching my kids grow up and really challenging world, a world that I don't know that I would have done as well in as if I were growing up today, I want to do everything I can to make sure that people have the support and the tools and the community that they need in order to find real fulfillment. In a world that's full of really challenging rapidly moving forces, including AI and other technology, how do we hold on to the parts of ourselves that make us truly human — our compassion, our empathy, our courage, and our love — and how do we see these not as things that are optional, not as sources of weakness, but as real sources of strength? That is the conversation I want us to have. The point of the podcast, of Staying Human, is to explore these topics through different lenses, to bring people in, to have conversations from all walks of life, whether that's from the arts, from science and medicine, from policy, to bring people together walks of life to explore what is a common human need, which is a need for fulfillment and to understand how we can build the drivers of fulfillment into our day-to-day life, how we can shape our culture and institutions to support that end as well.

TED ROOSEVELT V:

Last question. What does it mean to be a good citizen?

DR. VIVEK MURTHY:

I think to be a good citizen means to see yourself as part of a broader community and to be committed to improving the lives of people in that community. I think fundamentally, yes, we all need to care for ourselves. We want to take care of ourselves and our families, and we should do that. But the difference between 330 million plus people who are all on their own versus a nation of people who are together, the difference between those two is whether or not we see in each other a common sense of obligation, a common sense of affiliation. The most important affiliation we have is that we are human beings trying to navigate a messy world, trying to take care of our families and find a way forward. And we need to just recognize that we are all part of that struggle, that we can also make progress, especially when we reach out and help each other.

So I would love to see a model of citizenship that's forged in that core belief that being a good citizen is about being committed to the people around you, to improving their lives. And that's what good citizenship is about. Sometimes it's about quietly lending somebody flower or milk who's run out of it. Sometimes it's about being a catalyst to help people step up and help each other. But the more of us who can operate in that way, the more we can feel, less alone, more like we're part of something that's bigger than ourselves. So this is what happens when we operate as citizens, part of a collective with a commitment to each other. We start to stand up for each other in the public square and in private moments, and that is what makes society, I think, ultimately, a healthy and strong place to be.

TED ROOSEVELT V:

I love it. Thank you really genuinely, very, very much. That was awesome.

DR. VIVEK MURTHY:

Thanks so much. I'm so glad that we did this together. I know it took a while to schedule, so thank you for your patience as we got this on the calendar.

TED ROOSEVELT V:

Vivek, I will always hold the spot for you on my calendar. This was a truly important conversation and one that I hope really makes listeners think end act. Thank you for your time. Listeners, why not open up Dr. Vivek Murphy's Staying Human Substack now and stay tuned for his podcast — it's coming soon. Please share this episode with a friend, or better yet, tell them about it in person. Good Citizen is produced by the Theodore Roosevelt Presidential Library in collaboration with the Future of StoryTelling and Charts & Leisure. You can learn more about TR's upcoming presidential library at trlibrary.com.