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>> so on to the main event from 2013 to 2017 to he has been busy from joe biden on :-colon 18 what citizens could do. >> i'm so sorry this is meant to be interpreted but it is breaking up because you're speaking so quickly. please start over. >> as the 19th surgeon general of the united states

and is the author of tonight's book and uncovered 19 doctor murphy and with michelle obama. and with those interpreted services and with the signing. >> thank you so much. this is a joy way to be here someone that i admire so greatly especially to talk about this book one of the most important books i have

read in a long time and totally under chant on - - change my understanding partially meaningful so i'm thrilled to be here today. >> thank you for indulging me this way. [laughter] >> you are the surgeon general of the united states of america. you written a memoir or tell all or leadership book but instead you wrote a book about loneliness arguing it is a serious problem here and around the world. why did you decide to write this book and what makes it a serious problem? >> and then to share this book with the world with your friend whom i deeply admire if anybody writes a tell all and

use those to share anyways. but i will see that i did have some ideas may be there would be a new view of public health with infrastructure and my time in office learning about governmen government. so sometimes you can have the best laid plans and that's what happened to me. in 2017 i wrote this article for harvard business review with loneliness in the workplace i was not sure how business readers would be that what i found in the days and weeks following the publication i was getting so many messages from around the world from those that said we think this is a real problem

in our country all over the united states and india japan and south korea and latin america. but other different types of messages from individuals that say i've been struggling with loneliness for a long time i didn't realize it was so common and i don't need to be ashamed. that was striking. long story short it became clear to the advice of good friends and confidants not only worth writing about that the more i talked about it the more it was important to me as a child and as a doctor that led me to focus on this topic in the early stages of the book when i traveled as surgeon general i met people

in small towns and big cities and they heard stories that were not surprising about struggles with addiction and substance abuse disorders and parents watching their children overdose and parents worried about depression and anxiety rising among kids and other children from the generation but what i started to see what is a deeper threat of loneliness. it wasn't someone saying my name is jack i am struggling with loneliness but i feel we have to deal with all of these problems and i do it all on my own and nobody would notice or say i feel invisible. time after time hearing that

is started to register for me there is something bigger going on it reminded me of my experiences and hospital to see how many patients would come in so if we have an important diagnosis or a decision about treatment i would ask them who can i call because these are tough issues to deal with by yourself and so often i get the answer there is nobody to call. even at the last stages of life in the final days and hours i was privileged to sit with people and be with them in their final moments, it was me and my colleagues in the hospital and nobody else. i was reminded of those experiences traveling the country and then i realized

loneliness is more common in consequential was a determining impact on our health and i had realized. >> it seems that you see loneliness in many different populations you typically think of the elderly by people all ages and backgrounds. >> absolutely. people traveled abroad talking to people in other countries most people have a notion the elderly struggle with loneliness and we believe that because as we get older we are more limited and cannot go out because of illness or disability or the expanse of losing family and friends and not able to connect as well. all of that is true but i found out loneliness was

affecting people across with the spike of young people and folks who think of themselves as the millennial generation also it seems to be a great equalizer whether rich or poor and urban areas or rural areas with fishing villages in alaska or members of congress in washington dc tell me in hushed tones they were struggling with loneliness and feared many colleagues were. rich and poor everybody seems to have an experience to share that's what made me realize something different is going on. so the issues that both can agree on but i found

interestingly enough that it and talking about the subject of loneliness and social connection i would say there is no topic including the opioid epidemic that i touched on that seem to strike a chord as deeply. >> interesting in terms of the effects that i was struck in your book how the physical health effects because it is equivalent to a certain number of cigarettes but it was shocking. >> this was surprising to me as well. i learned through the accommodations that loneliness is more than a bad feeling and it turns out there is major

consequences impacting how they work in the workplace and to have serious contribution to the polarization of politics and the difficulty that there is a strong association between loneliness and dementia and depression and anxiety those that struggle with loneliness so now given everything we are learning about the importance of sleep for overall health to realize sleep is important that perhaps is the most striking what you reference is a study done from brigham

young university that shows and with that longevity. and that is similar and then to be greater and then to see this as someone who served as surgeon general in an office with obesity and physical activity seeming to focus on social connection we never fully appreciate how powerful. >> that is extraordinary and sobering. >> very quickly when you say loneliness what do you mean?

you distinguish between loneliness and solitude is there something more to it than that? >> it's a great question loneliness is a subjective term if we feel about the quality of connection and then to say loneliness is a gap between the social connection we feel we need and the ones that we have some a couple of things is that and then i say that not just as a theoretical point from personal experience

that so i never talk to my family about loneliness with my mother and father and sister from my youngest memories away always felt secure. but that sense of belonging walking into school and that stinking pit in my stomach i was scared about those moments on the playground in a worried about being the last one and most of all into the cafeteria. and i just get away until 3:00 p.m. when the bell rang to go back to that environment where it was secure.

so i know from first-hand experience that a shame that comes with loneliness and then to admit what is happening because everyone else around us is hiding but i bring this up there is an important reason to understand it is an actual signal suggest to experience hunger and thirst when we lack social connection that has led us to with a similar signal. and then to seek out meaningful connection by calling a parent or a dear friend that it could subside benefit persist for a long period of time and then into

those health consequences we are talking about a very interesting thing happened that we love these patterns and what we sense is happening that we feel that we are in a state of threat and danger and we are lonely when we were hunter gatherers and if we were together and trusted relationships and then to take turns to watch out for predators one became separated from the tribe the chance of survival drops and then to perceive separation and loneliness and the experience

with threat level so that makes sense in that evolutionary context. and then to be chronically lonely. with those developments were around you. and ngc to make it harder and then you combine that with the fact chronic loneliness shifts away at self-esteem and then that makes it even in a paradoxical sense. and then you can go further and further into your shell is one of the reasons and then to be so persistent how to approach that correctly. >> that is just heartbreaking that loneliness leads to

deeper loneliness and deeper loneliness. so stepping back for a minute what are the historical trends to the rise of loneliness. with the role of social media and possibly to alleviate loneliness. and then that broader societal trend. >> and then you hear that topic and say i will tell you talking about the subject over the last few years and with that office of loneliness. with that power of connection

not only our body and mines but the society in which we live that made me realize at our fingertips the ability to build that world and that can support children and the ways that we hope. and i will talk more about that but it's important to recognize to discover that deeper resource but where does this come from? it doesn't just happen when the internet started but for generations we hadn't written about it for the longest times in which are several factors

more than ever and the other challenge is the cultural challenge one of the most insidious and difficult so even though to go out on a street corner what is the number one priority in life? their kids or spouse even though i would say that and so judged by where we put our time and attention and energy for many of us and the case for me to focus on those people or on other priorities.

because we don't value human relationships but success is defined in a particular way not just to build positive relationships and nurture over time with power and reputation so then to be called successful and then to have people all around me and then say i really made it. and the power and principle of my school and really made it

but the thing is when you talk to people who have achieved and that the pursuit of that goal contrasted after they achieved it that moment of exhilaration that they wish they had to that culture that leads us to prioritize and define success from human relationships is one that leads us to focus on things that separate us to be prioritized. >> technology is the single most common question and parents in particular is asserting my child are making much of are lonely and these are important questions to ask

is that technology itself is how do we use it and to use that to strengthen to live far away from a relative but that's can be with that social experience. and by connecting with people off-line. and coming to miami florida and then i'm coming to miami or any of my friends free to hang out? that's a great way to stay connected with friends. there are many people like you around.

and if you don't have a community online platforms can be powerful to connect with others so all of that can be helpful that what i worry predominantly we are using technology in a way that further disconnects with the use of technology that time that we stand on social media and devices takes away from the time we would spend was somebody in person so there is that distraction with only 24 hours a day. and with that in person interaction so how many of us have lunch or dinner at a restaurant and found each of us are checking our phones in

between are checking for alerts? and with those experiences of talking to friends on the phone and then just to through the social media feed and i need to do that i just fall into it but science tells us very clearly we cannot multitask if we do we are actually task switching very rapidly this is why i think it's important for us to ask that quantity with the quality of time so all this to say that it can be used to strengthen that connection

however using tech isn't serving us as well particularly thinking about young people and what they encounter was social media that accelerated culture to be propagated on social media and comparing feeling that we come up short. this is a recipe for chipping away further at self-worth. >> opening up to the audience question. and then in a beautiful progress the story of so many people engaging in solutions

in america and around the world and individuals and cities and states to hear the solutions and in the middle of a pandemic in this struck me weird and not just to feel better but also to feel normal together we just feel not very normal so what is that solution and pre- pandemic right now? >> this is one of the most inspiring parts and to have that incredible meeting and with those around the world who have struggled with loneliness but not only knows extraordinary ways to connect with people and that risk with

initiative and to creativity that we are not consigned to be lonely and that doesn't have to be our destiny to find ways to build connection as well. and with those principles that came up that i think of as the bedrock for living one has to do with time if we are spending some time each day at least 15 minutes a day connecting with someone we love that can be an extraordinary foundation and time spent on videoconference or to hear their voice to say

im thinking about you and how you are doing it may not seem like a long time but what i have learned and with our connection that we don't need to quit our jobs and spend all of our time we don't need to necessarily turn our lives upside down at the moment and then to feel much more deeply connected the second thing that i learned the quality of time really matters in the way they improve the quality of time is limiting distraction. one of the greatest gifts we can give someone else is a gift of the full attention and overhauled we are so trying to solve the task is easy to

forget can have a profound healing effect on other people. and for those that have been fully present listening actively to what you are saying to have this amazing feeling of being seen to feel like it's an incredibly intimate experience so by eliminating distraction and her full attention to be open and sharing and in that moment we can deepen the quality of the interaction and five minutes of high quality interaction and the third thing and this is a bit of a surprise is the service it turns out and with that

biology and evolution how it has is paradoxical effect and chipping away at self-esteem because it shifts the attention to someone else and with that positive interaction and reaffirms that value in a very tangible way and also with her own sense of self to reaffirm who we really are. there is an important note about the importance of solitude. and you may be alone but it is pleasant state and one where we lessen noise and then

connect with ourselves not could be five minutes with the wind against your face for those minutes you spend remembering but at the beginning of the day meditation or prayer. and then to be anchor ourselves and with that conversation to enjoy those conversations with those core principles that i admire it's not always easy to do especially given the state of the world and how you are struggling with covid-19 to

physically distance from each other. it's more important to build on these principles. may be physically distant but not socially distant. now we have the opportunity to choose as we distance from each other or the choice of the opposite direction and then to reaffirm the importance of connection and recommit and to prioritize those relationships and actually act on it by reaching out to people and a chance to serve in those having a hard time homeschooling the kids into the small opportunities

shifting the perspective now we can only defend the connection to set ourselves up to be connected and more fulfilled and less alone than we were pre- pandemic. >> what a beautiful sentiment. and with that social recession it seems like what you are urging and then asking people about socially and then in that relationship and friendships that social economy doesn't go into recession and economic economy. >> we can think of this as an opportunity for social revival doesn't mean more parties in large group gatherings maybe that's one way that whether an

introvert or extrovert we all need social connections in our lives and that social revival is where we prioritize people in our life one simple credo coming out of the book is people first and i realize in my own life and at the heart of building a people centered life. and then to first find out and finding out we are pregnant with her first child and the kind of world it will embody. with the violence and communities of the polarization and the struggles we have with climate change to healthcare and on and on.

and also concerned how separated people seem to be to each other and wonder what kind of world they are getting on - - are bringing our child into an think how we could create a better world for our children. and then to tip the scales toward love. so we saw there is a deep struggle the world is watching between these two powerful forces. and with that generosity and compassion and kindness. and as anxiety and anger and with those in the politics.

and those of the motivation and though whole reason that we worked on this book over the last two years is because and to tip the world and to create the world to heal by compassion by the very forces and then to that change only happen and then how to live out of love and i fear. >> now we will go to audience

questions. >> does data show have a wider variety of friends old or younger black or white is that better than just friends like you? >> that one thing that we are seeing in increasingly if you have diversity that can open your mind up to people who may think differently from you in other respects so in traditional society for those who thought like you people weren't traveling between countries like they are now and diverse communities in the

united states in particular but in 2020 it's much harder to avoid diversity with other racial and ethnic and religious background so to recognize this diversity to go in one of two directions embrace with a desire to understand and reflect that are closer to people that think like us and the problem is because we will always be interacting with people from the way the world works but not with that ability and to defend them and we run the risk to be alienated from those around us and that's

what we are seeing in society that have pulled themselves away from those who are not like them and to feel angry their way of life is changed and we develop those narratives i think one of the ways we have to address this to that approach to look at others can lead to demonization and that intent and the scores and not just say let's all talk about her views on controversial issues and i see this not ingest but a common solution especially as people say from different sides of the aisle and then come to an agreement but

that's not how human beings work is not by talking about issues first but building relationships when we get to know other people as human beings to understand common ground that's how we build relationships and then we have deals with challenging controversial issues so think about the enter the uncle over for thanksgiving dinner you have different views with you may not at all agree perhaps more willing to listen to them then you are a random stranger on the internet. that's because the relationship is had a capacity to listen and that ability to listen is at the heart to work

through a big problems and solve big challenges like healthcare together. >> we have two questions given the dire health consequences deeply physicians should be screening patients for loneliness or lack of social connection? you talk about how the stories remind you have a time in a hospital of patients final days to understand what loneliness can have what are the major takeaways and what do you do to recommend professionals do for this? to screen and deal with loneliness? >> it is an important question

for the position i found myself but it is exceedingly important doctors and nurses recognize loneliness and the consequences and the ability to screen for it with the care to engage. so i medical school we receive very little training on that but is it the responsibility of a doctor to identify loneliness? that's not a responsibility on nurses and doctors alone it would be better to recognize that around us it can look like anger and frustration and irritability it is a great

masquerade or. but once we identify that how we connect people to the resources in their community so certainly it is growing in england and other countries and those that are partnering with community organizations and connect them to community resources and lastly there is tremendous value to surface the conversation between a healthcare practitioner in many times i didn't know how to talk about loneliness i hadn't thought enough and i did not think about that to help the people struggling when you are trained clinician

and then to be powerful and transformative spent there is a question as a writer many are skeptical of mental health it can be difficult to convey loneliness or beneficial things as a science writer trying to figure out what it means to you for the mental health stigma. and to get people to take it seriously as part of the reason i wrote this book this is an important issue we had to take seriously and i had to apply the public health and vantage point not just to make

you feel bad but part of the way to get people to take this seriously and with that downside loneliness but just the society around them to tell them it's a very different situation for someone who's never experienced loneliness and then to talk about those experiences and how important it is when you make that emotional connection with the data and science that shows it's consequential and then to recognize this is important. and to share our experiences can be extraordinarily powerful and empowering to other people into the larger

movement around recovery that is part of what has power that movement of people coming forward to make the case addiction is not a character flaw but with urgency and compassion and the same is true here to think about those patients that i saw the final moments of their life and those conversations that we had and i was privileged to participate in to hold their hand on the bedside. think what they talked about. not the promotions they have received or the amount in their trust fund or bank account or how many followers on social media or media

profiles that relationships people they loved and they wish they spent more time with those that broke your heart those are deeply terrifying moments to give us a clue as to what's truly important we don't have to wait until the end of life to realize what really matters it is actually right there to be embraced. and those relationships that we have and to focus on the human part of connection and to build that community to

prioritize that connection with that social revival not just in the united states. >> amen to that. to my questions. the first is combining two questions about children and early life. as a middle school teacher my students seem lonely and distance-learning and then second time struck by the potential connection for the adverse childhood experience is that teaching how to connect to others with childhood and experience and trauma? >> that's beautiful question. it is really important to have

conversations with our kids and more broadly to converse with the motion and then devoted himself with that particular program that is really designed to build emotional literacy and that recognizing what they are feeling and it starts very powerfully to see other teachers and adults talk about emotions and talk about feeling sad it's okay we all feel sad and gives a child permission to think about sadness and experience sadness

and the same with their own experiences and to also feel that way it's important we make it clear that being lonely doesn't mean you're broken or deficient somebody at some point experiences loneliness and then to be invisible that doesn't mean it's not there so it's important for kids so when it comes to trauma especially, one of the things i was struck by that looked to children who experienced trauma and there is a wonderful study over several decades that those who experienced trauma to get

strong social connections in their life are far fewer than those who did not have those relationships and talking to people for years and years and one of the common themes that comes up in conversation is as powerful as a diverse childhood experience as deep as the wounds may go and increasing the risk from addiction to lung disease it turns out one of the most powerful medicines is in fact social connection so those so i say this with love very intentionally because it's important we talk about love we don't talk enough about it is not just a feeling better

force writing prescriptions for many medications over the years but there's nothing that i have prescribed that is more powerful than the healing potential. that's why we go about our day to reconfigure and rebuild our lives look at the loneliness the point to recognize you don't need a medical or nursing degree to heal and help people feel more connected we need a willingness to show up with a full heart and compassion and a desire to give and receive and ultimately to address loneliness that's how we build a more connected world. >> dad is beautiful. the final question in light of what the uk has done does this

have a public policy solution or stimulus plan so to talk about those various faith communities do we need a national public policy for an approach to loneliness? >> that's an interesting question and is not the responsibility of anyone but this is a shared problem to step up to individual professions as well as the public sector but the government can do is to invest real resources and understand those drivers and the second thing government can do is to help prioritize issues so it faces a crisis as we did as

surgeon general with the opioid epidemic you can help convened to bring people together that this is a top priority. >> and they can examine those policies on social connection we now understand which we cannot appreciate 30 or 40 years ago and not just healthcare policy with transportation education policy has an impact on health and with that physical and mental health of our children. similarly met with housing and transportation and with those military servants and the

social connection and with those increasingly in the social connection and to push schools on exclusivity of testing for math and english and science but pay little attention to prioritizing social and emotional learning as an impac impact, so all of these ways the government to how they prioritize loneliness and how we drive solutions. >> this is a very special

experience because i'm doing this with a dear friend and also one of the first events we are doing to bring it to the world and to pay tribute to my family and my wife and mother and father and to my grandmother extraordinarily powerful supports but also the teachers on the final pages of the conclusion i wrote about my parents and my sister and the patient my mother and father cared for after their struggle with cancer and when they passed away they woke us

up at 2:00 a.m. and we drove to a trailer park in miami where we would visit his widow because my parents were worried that she was grieving alone. not because i was in their job description as doctors were to be the manager or being reimbursed from the insurance company but as a member of the community to have that relationship and then going when a hard time. and then the traditional side and then to embrace i remember the tears flowing and staring at the scene to think how different they were my mother

growing up in india with a vastly different life experience but in that moment i realize they were so deeply connected, they were family not the kind you are born into but who you choose for yourself. . . . .

i am so proud to have been watching along with you. thank you so much for that beautiful, profound, timely discussion. thank you everybody in the audience for being with us tonight. your patronage and attendance and most importantly your book

sales are what enable us to bring this kind of programming. politics and prose, we pride ourselves in love hosting these kind of even. we appreciate you all purchasing the book tonight and coming out. we encourage you to keep supporting the authors and supporting independent bookstores. you can follow politics and prose at the top of the screen and be notified on the same platform. we've got a great program event the rest of the month and going into may as well. what are you reading this time is there anything you are

turning to a. i'm going to do it, i need a little time to. i'm reading a lot of other boo books. that's the literature i think.

thanks everybody.

>> university of new york professor ruth wilson gilmore offers her thoughts on ending mass incarceration in the u.s.. here is a portion of the talk. >> in los angeles county decades ago, the nco you brought conditions of confinement case against the county with the horrendous condition in the jails. over the years the aclu was in charge of taking care of what the county did to remedy the conditions. about the teen years ago, the

aclu invited a few abolitionists to talk to them about something they never imagined which was perhaps the way that they remedy the problem with the la county jail wasn't to have jail at all rather than to build a better jail. 16 years later, abolitionists who joined forces in the reform managed to persuade the los angeles county board of supervisors which have the biggest government in the united states not to build new jails but to put the billions of

dollars that could have gone into that into housing and healthcare and other life-affirming projects. so abolition is present and how we connect with growth from and multiply organizations that have the capacity to list the movement. i learned many years ago our main work is to lift the movement, not to leave it up to lift it by showing how people are central to the formation of abolition and mutual aid organizations which are now flourishing.

it's connected with the movement in the direction of abolition because abolition to which prison became the solution to problems rather than abolishing the building. the director of the institute for public knowledge i'd like to welcome you to tonight's virtual events celebrating the newest book this is all i got.