While surgeon generals of the past have dealt with thorny public health issues such as smoking, AIDS and COVID-19, Surgeon General Vivek Murthy is taking on a crisis that is seldom considered a medical problem but has equally profound health implications: loneliness.
“Loneliness, unfortunately, has become this widespread crisis in our country,” Murthy told students at The University of Texas at Austin during a visit November 8. “More than half the people in our country are struggling with loneliness. It has real implications for our mental health and for our physical health.”
In a savvy promotional move, the surgeon general ensured a packed house in the Texas Union Theater and ample news coverage by teaming with UT alumnus and celebrity standard-bearer Matthew McConaughey, the accomplished actor who teaches film at UT and is a frequent presence on Longhorn sidelines. Murthy assumed the role of the interviewer, and McConaughey, his guest.
The event was part of a national tour Murthy is conducting on college campuses to address loneliness and isolation called We Are Made To Connect. Murthy served in the Obama administration as the 19th surgeon general of the United States since the position of “the nation’s top doctor” was created in 1869 and was asked by President Biden to return to the post as the 21st.
In welcoming the two and the student audience, President Jay Hartzell said, “Mental health challenges on college campuses have long been important, but the data suggest that the issues, risks and impacts have increased over the last several years.” He added that while UT’s leadership team has been working to increase services and support to the entire University community, “I’ve also come to appreciate that part of what is needed is setting the right culture on campus. This should be a place where we can and do talk about mental health, early and often.”
“It’s special for me to be here at UT in particular,” Murthy said, “because it was back in 2015, when I had just started my tenure as surgeon general in the Obama administration, that I came to UT. If you had asked me what I was going to focus on as surgeon general, I had a whole bunch of issues. This [loneliness and isolation] was not on the list. It was conversations here that actually helped me realize how powerful and common the issue of loneliness was. I remember students coming up to me one by one and saying, ‘You know, I love being at UT, but I feel like people don’t really know who I am. I feel really alone.’” Murthy said he then started to hear the same sentiment on college campuses across the country.
Asked about his bouts with loneliness, McConaughey held forth with his distinctive delivery: “I’ve had many times in my life when I had loneliness, lack of a sense of significance, felt no traction or viscosity with my past, was uncertain about the haziness in the future, which will make a person be very anxious in the present.”
When he was two weeks out of high school, he went to Australia as an exchange student for a year. He thought he was going to be living in Sydney and perhaps spot supermodel Elle McPherson on the beach, he mused. In reality he had been assigned to live with a family four hours outside Sydney in “a farmhouse in the middle of the desert,” and the family was “odd, to be fair.” He endured the experience by writing long letters to himself and then writing replies, and by realizing the deep connection he had to his parents.
“Since then, I’ve tried to learn that there is a difference between being alone and loneliness. I think it is very important for us mentally to be able to be alone with ourselves.” He recounted many trips he had taken by himself, stating in present tense that the “first 12 days are hell.” “I do not feel comfortable. I’ve got monkeys on my back, demons chasing me, guilt, regret. I don’t like to look in the mirror. I don’t like the dialogue that’s going on in my head. I cannot stand my own company. It gets bloody between me and me, but I’ve learned that when I’ve stuck with it, around day 12, all of a sudden some breaks come, and I’ve shaken hands with myself and said, ‘Buddy, McConaughey, I’m stuck with you. We’ve got to figure out how to get along.’”
Murthy noted that we can feel loneliness even around other people, and therefore it is the quality, not the quantity, of relationships that matters. “Loneliness is a subjective feeling that the connections you need in your life are greater than you actually have. What matters is the quality of those connections,” even if it is with one or two people. “Who you can be yourself with? Who you can show up for and just be who you are and not put on a mask and try to be somebody else? Will they show up for you in a crisis? Will you show up for them in a crisis? Those are the connections that remind us we are not alone.”
McConaughey said students can begin the long process of self-knowledge by defining their values and themselves by negation. “It’s hard to know who we are. It’s hard to know what we want to do, so let’s give ourselves a break first and go through the process of elimination of who we are not, what we don’t want to do, those people we don’t want to hang out with. That’s a lot easier than saying, ‘I know what I want to do! I know who I am!’ It’s a lot easier to eliminate the people, the places in our lives, even the thought patterns, first, and by sheer mathematics you end up with more of what will feed you: those people, places and things that do serve you and your own identity.”
McConaughey also encouraged students to resist societal pressure to settle on a path quickly and instead to explore. “You all have more pressure on you than any generation does. [Clap-clap] Claim it! What are you going to do? Who are you going to be, right now!’’” Then voicing a college student, he answered, “Right now? I’m 20 years old. I’m making my way. This is a time to dream and to try things out. What the world’s telling you is: quit dreaming! Get it on paper!”
McConaughey stressed to students to figure out what values they would put at the top of their lives. He said he became a better actor after he and his now-wife, Camila, started having children because there was then something more important than his career. “When that happened, I had the same amount of respect for my career but less reverence for it. I was able to be more involved with my career and less impressed with it, therefore I was better at it,” said the 2014 Oscar winner.
Murphy highlighted McConaughey’s point. “Society leads people to believe that career stuff — the courses you’re taking, the prep you’re doing, the résumé building, getting the fancy job and internship — all that is at the very top, ahead of everything else. But we just heard Matthew say that defining those priorities that are at the top — the people and the relationships — made him better at his career. I think there’s this false choice that we are sometimes pushing people to make between choosing people in your life or your career. That’s not the choice. We are better at everything we do when we are anchored in the people that we love and care about.”
“Success today is based on quantity,” McConaughey said. “It’s a fool’s errand if it doesn’t have quality, which is the relationships, with others and ourselves. Having a value-based, moral bottom line about yourself and what you’ll stand for and what you’ll stand against — that gives quality to the quantity.
“I’m a capitalist; I’m all for quantity!” said McConaughey, well known for his ads for Lincoln Motor Company. But he added he knows plenty of people who have “the most money, the most toys” and they’re “lonely son-of-a-guns.” “They’ve made it to the top, but they’re sitting there going, ‘Boy, did I run a fool’s errand. I don’t know what means anything in my life. I can have everything, but I don’t even know what I want, and I don’t have anybody to share it with.’ Measure quality when you’re chasing quantity. The question we all have to ask ourselves is: what’s our more? More what?”
Murthy said that as a doctor he has had the honor of caring for many patients in the final hours of their lives, holding their hands and listening to their stories. “I’ll tell you that what they all have shared to a T and what they all talk about is not how big their corner office was, how fancy their job was, how much money is in their bank account, how many followers they have on Instagram. This is actually not what people reflect on in the end. What they talk about is remarkably consistent: they talk about their relationships, about the people they love and people who love them, the people who broke their hearts. At the end of our lives, only the most meaningful threads of our existence remain, and what floats to the top is the relationships. We don’t have to wait until the end of our lives to recognize that.”
Murthy and McConaughey fielded a few questions submitted in advance by students, and Murthy then asked all those present to take up a challenge: doing one thing a day for the next five days to connect with someone else, be they an old friend or a stranger. As soft music played, he asked students to start right then by texting or emailing someone to tell them they were thinking about them, and when finished, to turn on their phone’s light and hold it up.