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

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

Author: Vivek H. Murthy

Publication Information: Broadway, NY, HarperCollins, 2020, 326 pp., $20.49, hardcover

There could not be a timelier book than Together—The Healing Power of Human Connection in a Sometimes Lonely World. The author is the 19th United States Surgeon General Vivek H. Murthy, MD, who makes the case that we are experiencing an epidemic of loneliness. Ironically, this book was written in 2020 before we knew of the pandemic. Murthy provides a comprehensive, well annotated, and insightful study of the epidemic of loneliness that he passionately argues is eroding public health. Today, with social isolation and recommendations that we remain at home as much as possible, we are experiencing a surge in the loneliness epidemic Murthy brings to light.

It was during his time as a young internal medicine resident that Murthy first noticed loneliness that burdened so many of his patients. As family physicians we learn how the social domain of life contributes to illness, but are not given tools to recognize loneliness. We see loneliness daily in our offices often without recognizing it. In a 2013 poll of general practitioners in the UK, 75% said they saw between one and five patients per day whose visit was primarily driven by loneliness (p. 14). Consider the elderly patient with overly frequent visits your office who loves to chat with you and your staff; the angry adolescent experimenting with drugs because he has no peer crowd; or the workaholic administrator, who is focused on climbing the ladder, is not caring for his health, and is estranged from his family. And certainly we have all seen the patient in the hospital who has no visitors, no phone calls and no one to care for them.

Physicians are not immune to loneliness. Most people, perhaps physicians especially, do not want to admit that they are lonely. Murthy writes, “This shame is particularly acute in professional cultures like law and medicine, which promote self-reliance as a virtue” (p. xvii).

To make matters worse, there is the dehumanizing consequence of burnout, a chicken-and-egg relationship with loneliness.

During his time as surgeon general, Murthy traveled the United States and overseas, meeting scientists, doctors, and a wealth of other people to explore facts and stories about loneliness. By exploring social science, evolution, biochemistry, medical findings, and more, he promotes the idea that we are “wired” to connect with others. He then describes the population of the lonely, supported with alarming statistics of its prevalence. Loneliness is not limited to the aged or frail, although it may peak in the 50s and 80s. Adolescence and young adulthood into the 30s is also a time of risk for loneliness. Technology, in particular social media, is part of this mix that “distorts our sense of the value of actual contact with friends” (p. 107).

Dr Murthy goes to great length to describe the connection between relationships and health. Reported in the book is a meta-analysis of 148 studies with 300,000 participants from around the world by Dr Julia Holt-Lundstad.1 Her data show that people with weak social relationships are 50% more likely to die prematurely than those with strong social relationships. This reduction in years of life is equal to “the risk of smoking 15 cigarettes a day, and greater than the risk associated with obesity, excess alcohol consumption, and lack of exercise” (p. 13). And not to be forgotten, loneliness is closely associated with depression, overdose, and suicide, among other tragedies.

Based on his travels, Murthy suggests some ways to remedy this epidemic of loneliness. He describes many cultures’ and individuals’ efforts to address the connection we all need with one another. In Blue Zones, where people have highest life expectancy thought to be due to lifestyle, there is also an unusually high degree of social connection (p. 76). He discusses how we find our connections with family, friends, in work, and with the kindness of strangers. Suggested antidotes to loneliness include removing digital distractions, finding empathy, and being present with one another. He promotes programs that teach emotional fitness to our young and those who create community. Together identifies loneliness as a root cause of many of our social and medical illnesses, but it is also rich with hope.

In conclusion Murthy writes, “The universal drive to connect is still alive and well” (p. 284). The need for social connection is undervalued, especially today. Together is an eye-opening and inspiring examination of how being lonely impacts us all.