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Episode: Overcoming loneliness with Surgeon General Vivek Murthy

Author: TED
Duration: 00:31:30

Episode Shownotes

Surgeon General Vivek Murthy thinks about public health holistically. Whether he's addressing youth mental health crises, the loneliness epidemic or serving on the White House's COVID-19 pandemic response team, Vivek is dedicated to improving well-being. In a live conversation, Vivek and Adam discuss the individual and collective foundations of belonging

and wellness.Available transcripts for ReThinking can be found at go.ted.com/RWAGscripts

Summary

In this episode of "WorkLife with Adam Grant," Surgeon General Vivek Murthy addresses loneliness as a public health crisis, reflecting on his experiences during the COVID-19 pandemic. He emphasizes the need for quality relationships over quantity, highlighting how loneliness affects both mental and physical health. Murthy offers strategies for fostering meaningful connections, such as dedicated conversation time and active listening, and stresses the importance of social infrastructure to support community ties. Additionally, he calls for social media regulations to protect youth well-being, arguing that societal action is essential to combat loneliness and promote overall wellness.

Go to PodExtra AI's episode page (Overcoming loneliness with Surgeon General Vivek Murthy) to play and view complete AI-processed content: summary, mindmap, topics, takeaways, transcript, keywords and highlights.

Full Transcript

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00:02:14 Speaker_03
People are much more than their diagnosis and that if we don't understand how they are receiving their experience emotionally as well as physically, then we're missing half of the entire human experience here and we can't treat them as well.

00:02:28 Speaker_03
We can't build relationships.

00:02:32 Speaker_02
Hey everyone, it's Adam Grant. Welcome back to Rethinking, my podcast on the science of what makes us tick with the TED Audio Collective.

00:02:40 Speaker_02
I'm an organizational psychologist, and I'm taking you inside the minds of fascinating people to explore new thoughts and new ways of thinking. My guest today is Surgeon General Vivek Murthy. He's led the U.S.

00:02:54 Speaker_02
through major health crises, including the Ebola virus outbreak and the ongoing opioid epidemic. Vivek is the author of Together and hosts the podcast House Calls. He's also been outspoken in calling loneliness a public health epidemic.

00:03:10 Speaker_03
So I'm curious, just by a show of hands, how many people here know somebody in your life who is struggling with loneliness or isolation? Almost everyone. Every place I go, Adam, when I ask audiences this, this is the same response.

00:03:22 Speaker_03
Almost every hand goes up in the room.

00:03:24 Speaker_02
I invited Vivek to join me in a live conversation for the Authors at Warden series, and the audience found his reflections on loneliness and connection moving. We talked about how to take care of ourselves and each other.

00:03:44 Speaker_02
I just have to start by embarrassing you. I remember 2021, I got COVID and I was the first person in our household to get it. And I texted you and you proceeded to check in with me every day for at least two weeks.

00:03:59 Speaker_02
There have to be more important things to do in your job as Surgeon General. But my family was very grateful. And I think everyone who knows you has seen you show up in that incredibly generous way.

00:04:09 Speaker_02
And I think if we still had house calls, you would be the person we would all want to show up at our door. So I just want to start by thanking you for your kindness and your thoughtfulness.

00:04:17 Speaker_03
That is so nice of you. Thank you, Adam. One of the things I miss in this job is actually not being able to see patients as I used to over the years.

00:04:25 Speaker_03
And whenever a friend calls me or a family member with a medical question, they think I'm helping them, but I actually am really hungry to get back into clinical medicine again.

00:04:33 Speaker_03
It's always enjoyable for me and rewarding for me to be able to participate in people's care.

00:04:38 Speaker_02
Tell us, why are you here? How did you end up on this path?

00:04:41 Speaker_03
I don't know. I was going to New York and I got off at the wrong stop.

00:04:44 Speaker_02
No, not literally.

00:04:45 Speaker_03
I mean, how does one go from practicing medicine to being a surgeon general? I have no idea. I actually mean that somewhat seriously because there's not a defined path to becoming Surgeon General.

00:05:00 Speaker_03
Growing up, I never thought I would work in government. I never even considered the public sector as a place where I would spend time.

00:05:07 Speaker_03
And part of this was because I grew up with parents who were immigrants from India who were deeply suspicious of government to some extent.

00:05:14 Speaker_03
They always worried that it wasn't an easy place to sort of hold on to your values and to operate with integrity, given their experiences back in India. So one day when I was actually in ninth grade, I was taking a world history course in high school.

00:05:27 Speaker_03
And my teacher pulled me aside after school one day, and she said, Vivek, I know you really like this world history stuff. One day you should think about being secretary of state. And I was in ninth grade at the time, super excited.

00:05:38 Speaker_03
I came home and told my mom, I said, Mama, Ms. Bryce thinks that maybe I could be secretary of state one day. She immediately picked up the phone and called my dad and said, you need to come home and talk to him. He's thinking about going into politics.

00:05:49 Speaker_03
You know, went into medicine. I took some many detours along the way, some detours to start a few public health nonprofit organizations with my sister. a detour to go to business school as well, which was one of the best experiences of my life.

00:06:01 Speaker_03
And at the time that I was actually called about serving in government, I was practicing medicine and teaching medical students and residents.

00:06:08 Speaker_03
I was building a technology company with three friends, and I was actually building a grassroots advocacy organization to try to improve our healthcare system. July 10th, 2013, I got off a red eye flight and was going to pick up my laundry.

00:06:22 Speaker_03
and the dry cleaners. And I'm walking into my car, hands full of dry cleaning, and my phone rings. And it's a 202 number. And I wasn't going to pick it up, finally kept bringing it up. I said, let me just pick this up.

00:06:33 Speaker_03
And that happened to actually be this call from the White House asking me, would you be interested in being considered for the position of Surgeon General? And I thought just like, where is this coming from?

00:06:41 Speaker_03
This is like, you know, completely unexpected.

00:06:44 Speaker_02
We met about a decade ago, and I was struck by how unconventional your approach to the surgeon general role was. You were talking even then about mental health, about loneliness.

00:06:55 Speaker_02
And I think very early on, it was clear that you were a holistic thinker and you didn't see the body as fundamentally separate from the mind.

00:07:02 Speaker_02
But at what point did you decide this is actually part of my mantle as surgeon general to talk about what goes on in our heads?

00:07:08 Speaker_03
My mother and father brought me up that way to think holistically. They had a medical clinic in Miami, Florida when I was growing up.

00:07:13 Speaker_03
And I came to see like very early on, even before I really understood the science of what they were doing, that the relationships that they were building with their patients, the time they were spending with them, helping them feel seen and heard and understood was actually just as important a part of the healing process as was their listening to the patient's lungs and palpating their abdomen and prescribing medications to them.

00:07:35 Speaker_03
health and well-being are bigger than perhaps what we may read about in a scientific textbook.

00:07:40 Speaker_03
But in my own life, you know, I had also struggled at various times with my own mental health and well-being, especially as a kid, you know, I struggled with loneliness and in retrospect with symptoms of depression and anxiety.

00:07:50 Speaker_03
But I didn't know what they were, I didn't know what to call them, I felt a real sense of shame around it. So I was aware that that component of people's lives is important.

00:07:57 Speaker_03
I saw time and time again, Adam, that the smartest doctors in the hospital, smartest in terms of their ability to make a diagnosis and figure out what the right treatment was,

00:08:06 Speaker_03
Then when they didn't have sort of like the appreciation for somebody's mental and emotional well-being, they weren't able to connect with the patient and hence they couldn't deliver the full value of what they had in their heads to that patient because people need to trust you.

00:08:21 Speaker_03
before they're willing to put themselves in your hands. And you can only build trust by opening yourself up to the entire person, to listening to them, understanding who they are.

00:08:31 Speaker_03
And when I came into the role, though, even with all of that, Adam, I will say that the thing that finally made it clear to me that we have to take this broader approach in the role of surgeon general was this listening tour that I did in the very beginning of my first tenure.

00:08:44 Speaker_03
I had a very long. confirmation process. It was a 13 month long confirmation process. I had made what was perceived at the time to be a audacious and outlandish statement, which was that gun violence is a public health issue.

00:08:58 Speaker_03
And that seemed to draw the ire of many people who then ultimately it led to political challenges. And they asked me, do you want to change your point of view on that? I was like, no, it's like pretty obvious it's a public health issue.

00:09:08 Speaker_03
People are dying in large numbers for preventable causes. That's like almost by definition a public health issue.

00:09:14 Speaker_03
But during that time, like when I then finally was confirmed and started the job, the communications team member for the department came in and said, OK, tomorrow, let's get you on Good Morning America, on the Today Show and all the big shows and have you talk about your agenda for the country.

00:09:27 Speaker_03
I was like, you know, I don't want to talk. I just want to listen for a while. They thought I was nuts.

00:09:32 Speaker_03
But I was like, let's just spend the next two weeks traveling around the country and asking people a simple question, which is, what can we do to help? And it was in those conversations

00:09:40 Speaker_03
that I learned so much, that I heard not just about people's concern about obesity and diabetes and heart disease and cancer, but I also heard from moms and dads who were looking at their kids struggling with depression and anxiety and were unsure what to do.

00:09:56 Speaker_03
I heard from teachers who are seeing their kids taking their own lives at alarming rates that they had never seen before and were unsure what was going on. I heard from college students

00:10:08 Speaker_03
and graduate students who are on campuses surrounded by thousands of other students, yet they said they felt profoundly alone because nobody understood them.

00:10:17 Speaker_03
They didn't feel comfortable being themselves around other people, and so they felt isolated and alone.

00:10:21 Speaker_03
When I heard that time and time again in big cities, small towns all across America, that's what really made it super clear to me that we've got to do something to address the broader mental health issues that people are dealing with, while we also address some of the other challenges, like e-cigarettes and the other public health issues that we focused on.

00:10:39 Speaker_02
You've been thinking a lot about individual solutions, about community solutions, about policy solutions as well. Let's look at this at multiple levels.

00:10:46 Speaker_03
When we serve other people, we not only feel connected to them in the moment, but we actually remind ourselves that we have value to bring to the world. And that is something that we lose.

00:10:55 Speaker_03
When we struggle with chronic loneliness, we start to believe over time that we're lonely because we deserve it, because we're not likable, we're not lovable.

00:11:02 Speaker_03
And that can be a downward spiral for people, because the more you feel that, the harder it is to reach out to other people. And service can help break that cycle.

00:11:10 Speaker_02
My read of the research on pro-social behavior and helpfulness and its effects on well-being suggests that it's about as effective as taking anti-anxiety and anti-depressants. Now, this is not, by the way, a substitute in any way, shape, or form.

00:11:22 Speaker_02
Let's be clear about that, right? But I think that really helps us calibrate how powerful it is to know that we matter to other people.

00:11:28 Speaker_03
A lot of people think about loneliness and think, hey, it's just a bad feeling. What's the big deal?

00:11:32 Speaker_03
It turns out it's a much bigger deal than many of us thought, that people who struggle with loneliness and isolation are actually at greater risk for depression, anxiety, and suicide.

00:11:43 Speaker_03
But it also turns out, even more surprisingly, that there are greater risks for physical illness as well.

00:11:48 Speaker_03
So we're talking 29% increase in the risk of heart disease, 31% increase in the risk of stroke, 50% increase in the risk of dementia among older people, and an increased overall mortality with loneliness and isolation that are comparable to the mortality impact we see of smoking daily, even greater than the mortality impact we see with obesity.

00:12:08 Speaker_03
And there are biological reasons as to why this is, but this is why actually it's a profound public health challenge and not just a bad feeling. It's also extraordinarily common.

00:12:17 Speaker_03
When we released the Surgeon General's advisory on this topic last year, we noted that one in two adults in America are living with measurable levels of loneliness, but

00:12:27 Speaker_03
The numbers are actually much higher among young people, where they can range anywhere from 60 to 70%, in some cases even higher. There is actually a lot we can do about it.

00:12:35 Speaker_03
And we don't need to actually wait for an act of Congress to actually take action in our lives and build greater connection, which thank God is the case.

00:12:43 Speaker_03
The challenge I think that we have, especially after COVID, is that our social muscle weakened a lot.

00:12:49 Speaker_03
And, and I use that term very intentionally, social muscle, because like any other muscle, you know, it gets stronger when we use it more, it gets weaker when we don't use it.

00:12:57 Speaker_03
Many people have told me after the pandemic, you know, especially the worst of the pandemic in the first year or so, they said, you know, I don't know, I want to come back, but it feels a little weird to come back.

00:13:05 Speaker_03
I feel uncomfortable, like being these big groups. I'm not sure what to say to people. And I try to reassure them that that's okay. That's actually normal.

00:13:12 Speaker_03
That's all of us working out, you know, our social muscle once again, after a long time, clearing the cobwebs, and it will get easier each time we do it.

00:13:20 Speaker_03
I think in this setting, it becomes especially important to have spaces, times, and a bit of structure that allow people to get to know one another.

00:13:30 Speaker_03
It's if you just throw a bunch of people together in a room and a hope that through Brownian motion, like connections will be made, some people will connect.

00:13:38 Speaker_03
But many people actually won't, especially, you know, with this weekend social muscle we're dealing with.

00:13:43 Speaker_03
So that's actually why sometimes we need a little bit of structure to allow people to start the process of sharing their stories with one another. I'll give you a simple example that involves during our all staff meeting. Choosing two people, right?

00:13:55 Speaker_03
And so let's just say Adam and I were the two people that were chosen. And in that we would say, you have both have 10 minutes and we want one of you to interview the other just about your life.

00:14:05 Speaker_03
Anything is fair play as long as it's not about your current job. So in those conversations, people ask all kinds of things. They might ask, Hey, what did you dream of doing? Like when you were a kid, who'd you trust?

00:14:16 Speaker_03
Who'd you look up to when you were a kid? Where'd you think you would live? What are the things you do now when you're feeling stressed out or worried about something? Like who are the people you look to now? Who are your role models?

00:14:25 Speaker_03
What's your favorite music? Whatever it might be. We learn about the human being that's been on our team sometimes for a long time.

00:14:31 Speaker_03
But what is really striking to me is how we are so hardwired for connection that sometimes just a little bit of truly human interaction of learning somebody's story, hearing about their life, a little bit of honest sharing.

00:14:45 Speaker_03
can help forge really strong connections. I find that simply just taking 10 to 15 minutes a day to talk to somebody you care about, whether it's in person or on the phone or through video conference, makes a huge difference.

00:14:57 Speaker_03
It can just be a call to check on them. The second thing is to make sure when you're connecting with somebody in those 15 minutes, that you're actually giving them your full attention.

00:15:06 Speaker_03
How many times have we been in conversation, as I have been, when you're talking to somebody and then somehow your hand slips into your pocket,

00:15:13 Speaker_03
Somehow your phone comes out, somehow if you're me, you're on ESPN.com checking the scores, you're looking at your inbox, you're looking up the news, like something's going on.

00:15:21 Speaker_03
The third thing I do, and this is going to make me seem super old, but I actually call people on the phone. And I pick up the phone when they call. As human beings over thousands of years, we evolved to process all of that other input.

00:15:33 Speaker_03
Not just the content again, but the sound of their voice. the tones, the moments of silence, all of that. And so we get a lot out of simply picking up the phone.

00:15:43 Speaker_02
To your point about social skills being like muscles, I'm thinking about some of the evidence on prisoners who go to solitary confinement and also astronauts in remote environments on the space station and how the muscle metaphor may actually understate the effect.

00:15:57 Speaker_02
Because it's not just that you lose the strength, it's also you forget how to do it.

00:16:02 Speaker_03
Yes.

00:16:03 Speaker_02
And I'd love to talk a little bit about how do we warm up these connections that a lot of people are struggling with?

00:16:08 Speaker_03
There are a few elements of connection that make it really effective. One is when you're able to share honestly. and openly. The second is when you're able to listen deeply and meaningfully.

00:16:18 Speaker_03
And the third is when you're able to ask questions that actually prompt and it could create the space for somebody else to go deeper about something that matters to them. And those three things I think are really vital elements of conversation.

00:16:31 Speaker_03
The listening thing in particular, because listening is how we help people feel seen and understood and heard. It's how we tell people we respect them.

00:16:39 Speaker_03
And right now there are a lot of people who feel invisible, who don't feel like respected in the world.

00:16:43 Speaker_02
I've hated small talk my whole life. And I've always wanted to jump to meaningful discussion right away. And sometimes that's really jarring or off-putting to people.

00:16:52 Speaker_02
And then I read this research by Nick Epley and colleagues, which showed that most people actually want to go to deep talk and are not that excited to chat about the weather. People want to get to something of real consequence.

00:17:02 Speaker_02
How do you think about getting there? Because there is that sort of, it feels like you're jumping off a cliff a little bit and you don't know if the other person's going to have a parachute.

00:17:11 Speaker_03
You have to feel this out a little bit, but sometimes if you share first, more openly and authentically, the other person will take a cue from that and say, ah, okay, maybe it's okay for me to share as well.

00:17:22 Speaker_03
We have a broader challenge of needing to rebuild social infrastructure in our communities, but social infrastructure, these are the structures and programs and policies that actually help us foster healthy relationships, right? Like when you have.

00:17:36 Speaker_03
a community that's cut up by highways with no public transport system, it makes it harder for people to see each other.

00:17:41 Speaker_03
When you don't have safe spaces for people to gather, it makes it harder for people to have unplanned interactions, for parents to encounter one another at a park that may be in their neighborhood, for example.

00:17:51 Speaker_03
The sort of built infrastructure of our communities really matters, and we historically have not focused as much on that as a place to optimize connection. But the second thing that really matters from a policy perspective is our investment

00:18:05 Speaker_03
in the organizations that typically have brought us together, but we've seen a decline in participation in over the last 60 years.

00:18:13 Speaker_03
And those include service organizations, recreational leagues, even our faith institutions, which all of these used to be powerful, powerful sources of community for people. But participation in all of them has declined over time.

00:18:27 Speaker_03
And we need to rebuild many of those. And that can be something that we do with both public and private investment.

00:18:34 Speaker_03
We've been flying blind for many years on the issue of loneliness and isolation because we haven't prioritized that in terms of data collection. And that's something that we can change now.

00:18:42 Speaker_03
And the good news is there are validated scales that one can use. And so from a research perspective, there are tools there. You don't have to invent them on your own.

00:18:50 Speaker_03
And that actually helps tremendously to help us understand what, how bad is it and who is most at risk where we need to intervene. We just finished doing a college tour on the subject of loneliness and isolation.

00:19:01 Speaker_03
And one of the large universities at West did a survey of their students actually before we came. And they said, yeah, we think loneliness might be an issue here.

00:19:08 Speaker_03
We're not sure how much, maybe it's a third of the students are struggling with it, maybe a quarter. We're not sure. Their survey came back showing that 80% of their students. So that they were struggling with loneliness and isolation.

00:19:18 Speaker_03
They were stunned by those numbers. They've got to collect the data. We've got to build interventions and we've got to study those interventions to see what works.

00:19:25 Speaker_03
I think the social prescribing that we're seeing the UK and just to describe what that is, that's essentially the practice of if you go to see a doctor, the doctor will screen you if they, for loneliness and isolation.

00:19:34 Speaker_03
If they recognize you're somebody who's struggling with either one of those, then they will refer you. to somebody just like they would refer you to a heart specialist or kidney specialist.

00:19:43 Speaker_03
But this person is actually connected to community resources and organizations, and they can then facilitate a connection between the patient and an organization that can help them build community.

00:19:54 Speaker_03
It's not all in the healthcare system to do it, but the healthcare system can help identifying people at risk.

00:20:00 Speaker_02
Our dear colleague Seagal Barsaid found in her research on loneliness that in the workplace, if you wanted to avoid loneliness, she was curious about how many friends you needed. And she collected guesses and a lot of people said 20, 30, 6, 7.

00:20:13 Speaker_02
And as you know, she found it was only one. You just needed one friend at work. And I imagine the same is true on campus.

00:20:21 Speaker_03
Quality matters much more than quantity when it comes to addressing loneliness.

00:20:25 Speaker_03
You don't need 100 friends, but I think what has happened in the digital age is that we somehow ended up replacing our friends with followers, our confidants with contacts, and all of a sudden the quantity became really important, right?

00:20:38 Speaker_03
The real question is, at 3 a.m. when you get up and are in crisis, are you calling one of those contacts? Can you be yourself with them? Can you be vulnerable and truly who you are?

00:20:48 Speaker_03
That's a real question and you only need one or two people like that, like in your life.

00:20:57 Speaker_01
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00:20:59 Speaker_01
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00:21:27 Speaker_02
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00:21:40 Speaker_02
Connect to an audience of 36 million, unlock growth opportunities, and expand your reach with first-party audiences from Intuit SMB Media Labs. Learn more at medialabs.intuit.com. Let's go to a lightning round. Worst career advice you've ever gotten.

00:22:00 Speaker_03
Worst career advice I ever got was to not take risks because it would close off career opportunities for me. I was told this in medicine.

00:22:07 Speaker_03
I was told, Hey, if you go off and try to take a year off and try all these new things, and then you later want to go back and do a fellowship, go back on the same path that you were on in academia or otherwise, that people won't think you're serious.

00:22:17 Speaker_03
So don't get off the track because you won't be able to get back on. That was terrible advice.

00:22:22 Speaker_02
What was the biggest mistake you made in business school?

00:22:25 Speaker_03
I would actually say the biggest mistake I made was actually not spending more time just hanging out with my classmates.

00:22:33 Speaker_03
Business school is actually different from medical school in so many ways, but the just diversity of experiences that people came with, people from all over the world, it was phenomenal.

00:22:41 Speaker_03
And so I finally started doing that my second year, but I wish I had done it earlier. Do you have a favorite tip for fighting burnout? My favorite tip for fighting burnout is to find reasons to laugh. Laughter is so, so powerful.

00:22:53 Speaker_03
I had a series of funny shows that I would, and video clips that I actually keep in my toolbox when I need to feel joy or inspiration.

00:23:03 Speaker_02
Let the record show that the Surgeon General who issued an advisory last year about social media is recommending YouTube. as a cure for burnout.

00:23:10 Speaker_03
So there's a lot of old West Wing episodes. And then there are other shows or movies that I just have found deeply inspiring, especially sports movies. I'm a big speech junkie.

00:23:19 Speaker_03
MLK's final speech that he gave before he was assassinated always still gives me chills. RFK in particular, oh my gosh, so many beautiful, inspiring speeches of his that They don't just make me feel better, but they remind me what matters.

00:23:32 Speaker_03
It's our connection to each other, but also our commitment to one another, to society, that can often be the greatest source of fulfillment and joy.

00:23:39 Speaker_03
There's a story we've been telling ourselves for years now in society, which is that we want to be successful, because if we're successful, we'll be fulfilled. But what society keeps telling us is that to be successful, we've got to build our resume.

00:23:53 Speaker_03
We've got to build our contacts. We've got to essentially find some way to become rich, to become powerful, or to become famous. And gosh, if we do all three of those things, we've hit the jackpot. We've done it.

00:24:05 Speaker_03
But I think it has become increasingly clear through both empirical evidence and stories and data that there's nothing wrong with pursuing fame or fortune or power, but on their own, they actually aren't reliable paths to fulfillment.

00:24:23 Speaker_03
and to happiness and to wellbeing. Adam and I probably know plenty of people who are rich or powerful or famous and profoundly unhappy.

00:24:32 Speaker_03
It turns out there's another trio that's actually, I think science tells us much more clearly, is the path to fulfillment. And that is belonging, purpose, and service.

00:24:45 Speaker_03
The common thread between these three is they involve connecting with something bigger than ourselves. If you're a religious person, you look at scripture, you'll find this theme running through scripture as well in different faith traditions.

00:24:56 Speaker_03
You'll find philosophers writing about this over a thousand plus years. But there's a lot of life experience and data that tells us that when we have a sense of belonging, when we're connected to people, it can just be a few.

00:25:09 Speaker_03
When we have a sense of purpose, when we feel like there's something that gives us joy that we can delve into that will help contribute something to the world.

00:25:18 Speaker_03
And when we are involved in acts of service, however small or big they may be, these three turn out to be really enduring paths to fulfillment. And I say this because I've also seen this through my conversations with patients over the years.

00:25:31 Speaker_03
One of the great privileges in being a doctor has been over the years, I've been able to sit with people at some of the most meaningful moments of their life when they're reflecting deeply on the life they've lived and asking themselves, what really mattered and what I did over the last 20, 40, 60, or 80 years?

00:25:49 Speaker_03
And this story that they tell very, very consistently is that of connections to other people, to relationships. That's the story that they talk about. They tell the story of what they contributed to their community, to the lives of other people.

00:26:04 Speaker_03
None of those conversations I've had with patients in their dying days, none of those conversations have centered around them reflecting on how many followers they had on Instagram, or how much money was in their bank account, or which award they got at the last gathering of XYZ Association.

00:26:21 Speaker_03
They all talk about people. They all talk about the contributions they were able to make to people's lives. And so I just don't want any of us to feel like we have to wait till the end of our life to discover that.

00:26:33 Speaker_02
I have to ask one of the social media questions in here. It seems to be a tightrope walk between protecting, especially young adults, and on the other hand, enabling people to make their own choices. What kinds of protections do you think we need?

00:26:47 Speaker_03
As somebody who's spent many years building a tech company, I'm a believer in technology. I think it can improve our lives in profound ways. But I think what determines whether or not tech helps or hurts us is how it's designed and how it's used.

00:26:58 Speaker_03
And my big worry about social media in particular, and I say this as somebody who for many years has used social media, is that I think particularly for kids, for adolescents especially, that I do worry that many of them have actually been harmed by the use of social media.

00:27:15 Speaker_03
And this is actually why we put out a report on this last year, because the most common question I was getting from parents was about whether social media was safe for their kids. It's a very reasonable question if you're a parent, right?

00:27:25 Speaker_03
We asked about whether the food that we buy, the toys we buy, the cars that we buy is safe for our kids. Why wouldn't we ask about this product that they're using actually much more than any of those in terms of sheer amount of time.

00:27:35 Speaker_03
And the conclusion that we came to after looking at the research and talking to experts around the country and around the world really. was twofold. One is that there actually isn't enough evidence that tells us that it's safe.

00:27:45 Speaker_03
And in fact, there's growing evidence that points toward harms, right? We were seeing this powerful association between increased risk of depression and anxiety symptoms.

00:27:53 Speaker_03
Young people were telling us directly on surveys, nearly half of them that using social media made them feel worse about their body image.

00:27:59 Speaker_03
What you're seeing also just in terms of time taken away, that there was a massive substitution that was taking place in terms of time spent on social media was time that was not spent in person with other people.

00:28:10 Speaker_03
It was time that was not spent sleeping. Many kids were staying, about a third of adolescents were saying they were staying up till midnight or later on weeknights using their devices.

00:28:18 Speaker_03
These platforms are designed by some of the best product engineers in the world with some of the best behavioral science at their fingertips. And it's designed to maximize how much time we spend on them, right?

00:28:29 Speaker_03
That's what the revenue model is based on.

00:28:31 Speaker_03
And you're asking a child who's 13, 14 years old, at one of the most sensitive times of their brain's development, where we know that in that phase of brain development, they're especially sensitive to social suggestion and social comparison and have difficulty with impulse control.

00:28:49 Speaker_03
And you're asking that child to somehow manage something that frankly, most of us as adults struggle to do, right?

00:28:56 Speaker_03
That is a recipe for disaster and I think it has sadly become one of, not the only, but one of the major contributors to the youth mental health crisis that we're dealing with today.

00:29:06 Speaker_03
In my mind, the most expedient thing to do would be to do what we do with other products that kids use, which is to say we have to make these safe for kids and we have to demand the data that tells us that this is in fact safe for kids.

00:29:20 Speaker_03
But in a very peculiar turn of events, it turns out that researchers can't get full access to that data because the companies actually won't give it to them. We don't allow tolerate that with other many other products that kids use.

00:29:33 Speaker_03
So I think number one, we need data transparency. We number two, we need to actually put in place safety standards like what we did for cars in the 1980s. Like when I was growing up, there was a pretty high rate of car accident related deaths.

00:29:46 Speaker_03
And we didn't say at that time, you know what, it's just a price of modernity. This is just how it goes. We said, we have to make cars safer.

00:29:53 Speaker_03
So we put in place safety standards that got us seatbelts and airbags and crash testing and a host of other measures that ultimately brought down the rate of car accident related deaths.

00:30:03 Speaker_03
But right now, what we're doing is essentially with social media and kids is we're putting them in cars that have no safety features functionally. And we're asking them to drive on roads with no speed limits, no lanes and no traffic lights.

00:30:17 Speaker_03
And we're saying, hopefully you'll figure it out. And that is just in my mind, just a completely unacceptable and also unnecessary approach to take.

00:30:25 Speaker_03
But it will take some courage to actually to put these safety standards in place to require this kind of data transparency. This is a place where you actually do need a comprehensive solution.

00:30:35 Speaker_03
I'm generally pretty selective about where I think the federal government should put in place rules and policies because you can't be too overzealous about that. This is one of those places where you actually do need uniformity.

00:30:46 Speaker_03
And I think the fact that social media has been around for 20 years. And we have not, as a society, put in place any meaningful safety standards and enforce them. To me, it's just a dereliction of duty. And it's a failure from Congress.

00:31:01 Speaker_03
And it represents, I think, ultimately a failure to abide by one of our most important responsibilities as a society, which is to take care of our kids. Because we're not doing that. What are we doing?

00:31:11 Speaker_03
What else is worthwhile if we're not fundamentally taking care of our children? And that's what we've got to do.

00:31:17 Speaker_02
Okay, final question. There are some people who are curious about careers in public service, and even those who aren't are always fascinated by what it's really like to be in the White House and how real the West Wing is.

00:31:26 Speaker_02
I wanted to ask you if you could give us a story that would maybe illustrate what your life is like.

00:31:33 Speaker_03
I remember when I was sworn in for that first time. It was actually then Vice President Biden who actually swore me in for the role during the Obama administration.

00:31:41 Speaker_03
I remember thinking and saying to the friends and family who would gather that there are a few places in the world where the son of a poor farmer from India could be asked by the president to look out for the health of an entire nation.

00:31:56 Speaker_03
That's the power and the promise of America. It's something I will always be grateful for. And it's what I remember every time I stand on the top of those Navy steps.

00:32:05 Speaker_03
Whenever we go with our staff, whenever my team members are there, I'll also often make them stand there too on our way out.

00:32:12 Speaker_03
And just to take a deep breath, to look out at everything and to remember their family, to remember their journey that brought them to that moment. This is a 20 second exercise that I do, but I'll ask you to do it with me.

00:32:23 Speaker_03
So just, I want you to hold up your right hand. I want you to place it over your heart and I want you to close your eyes.

00:32:31 Speaker_03
And for the next few moments, I want you to think about the people in your life who have been there for you during good times and bad times. People who have supported you, who have been there when you weren't even sure if you believed in yourself.

00:32:48 Speaker_03
People who reminded you that you mattered, that they still cared for you. I want you to feel their warmth and their love flowing through you, filling your heart and filling you with peace. Now open your eyes.

00:33:05 Speaker_03
What we all felt in those brief moments was the power of human connection. We felt the power of love. And that is something that we can cultivate each and every day in our life.

00:33:21 Speaker_03
I know that the world around us is telling us that we need to live a work-centered life.

00:33:27 Speaker_03
But living a people-centered life, where we prioritize our relationships, that actually not only makes us more fulfilled, it often helps us do our work better as well. And so that's my hope for you leaving today.

00:33:41 Speaker_03
is that there's something in this conversation, something in your own reflections, that you have the capacity to give and receive the love that is at the heart of building those relationships.

00:33:51 Speaker_03
So let's build them, let's enjoy them, and let's ultimately benefit from the fulfillment that comes from them.

00:33:57 Speaker_02
Vivek, grateful that you were willing to come and join us today, and I just want to say thank you. Thanks for inviting me. Rethinking is hosted by me, Adam Grant. The show is part of the TED Audio Collective.

00:34:12 Speaker_02
And this episode was produced and mixed by Cosmic Standard. Our producers are Hannah Kingsley-Mah and Asia Simpson. Our editor is Alejandra Salazar. Our fact checker is Paul Durbin. Original music by Hansdale Sue and Allison Leighton Brown.

00:34:25 Speaker_02
Our team includes Eliza Smith, Jacob Winnick, Samaya Adams, Roxanne Highlash, Bam Bam Chang, Julia Dickerson, and Whitney Pennington Rogers. I always thought of the Surgeon General as the person who tells us not to smoke. Get that in there.

00:34:41 Speaker_02
Goes without saying.