Tag Archives: #connection

Our New Surgeon General, Vivek Murthy Brings Us Together

Loneliness is like a cold hand resting on your heart. It can tighten your chest, and make you desperate with longing for company and support. I have certainly felt it on many an occasion: while new to a place, recovering from a loss, a death, a fractured friendship. You may have too. It can only be shaken off by the warm hand of a friend, a loved one, or sometimes, even a stranger.

Vivek Murthy’s book Together, The Healing Power of Human Connection in a Sometimes Lonely World was written before the COVID-19 pandemic and was published in April 2020. Many of its observations, however, have a heightened bearing in the pandemic. In an interview published in the LA Review of Books, Murthy defined it eloquently: “Loneliness exists in that gap between the social connection we need, and the social connection we feel is available to us.” In the book, he calls loneliness “the great masquerader” as it can appear in different forms such as “anger, alienation, sadness, and a host of distressing emotional states.”

Vivek Murthy comes across in this book as a gentle soul, deeply understanding of the feelings of loneliness from his own life experiences. This understanding, coupled with his medical training, scientific bent, intellectual curiosity, keen powers of observation, and obvious commitment to public health makes this a very readable, thought-provoking book.

His tone, sincerity, and story-telling skills reminded me of another physician and author, Abraham Verghese, whose book The Tennis Partner is a beautiful account of friendship, addiction, and loneliness.

Murthy starts by laying out the different types of loneliness identified by research: 

  • Intimate, or emotional, loneliness – the longing for a close confidante or intimate partner;
  • Relational, or social, loneliness – the yearning for quality friendships and social companionship and support;
  • Collective loneliness – the hunger for a network or community of people who share your sense of purpose and interests.

All three dimensions are needed for us to thrive; one may have fulfillment in one or two areas but still feel lonely.

Murthy makes the case for how loneliness has evolved, the scientific, neurological underpinnings. Throughout history and evolution over millions of years, humans have depended on community for survival. Together, humans were stronger and better able to withstand dangers, such as attacks by other groups. When one strayed or was separated from the group, one’s very life could be at risk. Hence, the importance of community is practically hardwired into us.

The science underlying loneliness, along with the implications to one’s health, is well researched by Murthy and presented with the requisite references. Dr. John Cacioppo, one of the founders of the field of social neuroscience, first likened loneliness to hunger and thirst, as an important warning signal with biochemical and genetic roots, calling it “a biological and social imperative rooted in thousands of years of human evolution.” The work of Dr. Julianne Holt-Lundstad, a health and social psychologist, showed that weak social connections can be a significant danger to our health.

There are fascinating accounts of research into brain activity during the times we are engaged with others. One of the most striking findings for me was to learn that the same part of the brain that responds to physical pain also responds to emotional pain. Connecting the dots, Murthy makes the connection clear: that people in emotional pain and despair often reach for a numbing drug or drink, as they might for physical pain. This is particularly insightful for the opioid epidemic, from which society is currently reeling.

Murthy’s relates several examples of how people’s lives have been affected by loneliness: children, young, middle-aged, and older adults, both men and women. His account of his own childhood, being bullied for looking and sounding different, will strike a chord with many who have struggled with fitting in and felt they didn’t belong. In a section of friendships among middle school girls, I paused to remember my own daughter’s deep sadness when a close friendship broke off. So many children go through this in middle school, a critical period in their social and emotional development. Support and love are essential to help them tide over such times, until they feel more secure in themselves.

Some of Murthy’s accounts of children subjected to toxic stress (from neglect and or abuse) were heartbreaking. He said studies that have shown, mercifully, that all it takes is one caring adult to prevent and reverse the effects. He gives the example of  Big Brothers and Big Sisters of America,  a non-profit which matches children with supportive adults in one-to-one mentoring relationships.

While the physiological underpinnings of loneliness are the same for all, circumstances may vary, and the effective countermeasure depends on individual inclinations, preferences, and reservations people may have. It’s no big secret or surprise that men are typically less inclined to openly share what is troubling them than are women. Their styles of communicating, and hence their preferred ways of seeking and finding comfort and support, are very different. For example, “Men’s sheds”, local non-profit organizations where men gather around a common activity, build trust, companionship, and community, is an initiative that was started in one locality in Australia and has spread to different parts of the world.

In the second section of the book, he speaks of the different ways we can connect with one another to preempt or assuage loneliness, and with that, be on the path to a healthier life and a healthier society. The circles of connection he describes track with the different types of loneliness; the friendship circles consist of:

  • an inner circle of close friends and confidants,
  • a middle circle of occasional companions, and
  • an outer circle of colleagues and acquaintances.

In a beautiful section on the importance of solitary reflection, Murthy encourages us to tune in to ourselves with an analogy to the heart pumping blood: while the heart pumps blood in systole, it is in diastole that the blood is supplied with oxygen. Hence, “pausing is what sustains the heart.” Art, music, reading, and being in nature are all experiences that can be enjoyed in solitude but make us feel connected with others. One shining example for me is that of Andrea Bocelli on Easter Sunday, singing “Amazing Grace” from the Duomo Cathedral in Italy at the height of the pandemic, bringing the whole world together as we all sat apart in fear and worry. I wrote of this and other ways we have been able to come together during the pandemic.

Murthy describes the three-way relationship between service, loneliness, and addiction. He quotes Rabindranath Tagore, India’s Nobel laureate poet, and from the scriptures of Hinduism, Christianity, Judaism, and Islam, all of which have service written into them. I was reminded of a prominent scientist in the bay area, the late Nagesh Mhatre, who would exhort people “If you are feeling down, find someone who is suffering more and help them. You will both feel better.” The very act of helping someone makes one feel more needed, less lonely, adds a feeling of self-worth.

There are several inspiring examples of individuals, a college freshman named Serena Bian, for one, who surmounted her feelings of loneliness and depression. Even with these inspiring anecdotes and observations, the second section doesn’t hold together as well as the first. There are newer problem statements: connecting kids in the digital age, seeking support from one’s community during parental crises. Parents struggle with childcare. When anything goes awry, a carefully constructed day can fall apart in minutes. While this book was written in pre-pandemic days, parents’ struggles have only become greater. Being responsible for months for children’s schooling from home has stretched many a family to breaking point. Those who must work outside the home have sometimes been forced to make a choice between work and caring for their children. Most of the time, the burden falls on women. The economics are sobering. There have been articles stating that in the workplace, the pandemic will set back women by decades.

While the last two chapters are filled with inspiring anecdotes, I am left wondering how all this can be formalized, how scalable the approaches are without a coordinated nationwide initiative. It requires effort, work, to build community, and it might take more energy than many have when they are burdened by their circumstances or depression.

In America, we live in a deeply individualistic society. Murthy seems optimistic of the ways in which we can build community even with everything that keeps us apart. I find myself less hopeful: since this book was published, we have had the most sobering, divisive period in American history since the struggle to end segregation. Building community seems harder now than ever. On the positive side, we have a new administration, of which Murthy is an important part, and perhaps there will be change for the better.

Towards the end of the book, Murthy’s states surprisingly that “as hard as we may work… the future will depend on our children. It’s up to all of us to teach them how to build a more connected and compassionate world.” Indeed it is, we must strive to be good parents. But are we to just kick the can down the road to our children? I was reminded of Greta Thunberg’s outrage at the 2019 UN climate summit when she exclaimed to the adults who had left things to her generation: “This is all wrong. I shouldn’t be up here. I should be back at school on the other side of the ocean. You come to us young people for hope. How dare you?”

This book presents an important concept that leads to a policy focus on child development. How about assuring social-emotional development at the national level, instead of relying on countless non-profit organizations to pick up where schools and society have dropped the ball? 

In Amanda Gorman’s powerful words, delivered at the inauguration of President Joe Biden.

“…our inaction and inertia will be the inheritance of the next generation.

Our blunders become their burdens.

But one thing is certain:

If we merge mercy with might, and might with right, then love becomes our

legacy and change, our children’s birthright.”

Vivek Murthy has used his pulpit to shine a light on a key contributor to our health and well-being. This book explicitly callout loneliness as a critical contributor to much of what ails us, our physical health as well as the health of our society. If the purpose of the book is to increase awareness and understanding, it has succeeded. If it is to show a clear path forward, it falls short. A diagnosis is the first step. A remedy must follow. In the UK, in 2018, an initiative to combat loneliness was started at the ministerial level. It is not clear what progress has been made. Perhaps the US needs to follow suit.

Dr. Murthy is in a position to chart out the role the government might play, now that he is starting his second stint as Surgeon General, this time in the Biden administration. With his deeply realized perspective on loneliness and health, perhaps we can expect to see more work on this front.

All the best, Dr. Murthy, and Godspeed.

Upcoming Silicon Valley Reads book events are shown here.


Raji Pillai lives in the SF Bay Area and writes at www.rajiwrites.com where this article was originally published. 

Count the Ticking TikToks

The summer has been eventful for ByteDance, the owner of the rapidly growing social network TikTok. First, the government of India banned the application from distribution in the country due to concerns that the Chinese government is accessing user data. Then, a number of US companies warned employees to remove TikTok from their work phones. Most recently, US President Donald J. Trump threatened to ban TikTok in the US.

Into this maelstrom has stepped Microsoft CEO Satya Nadella with an offer to purchase the US business of TikTok. Nadella has earned a reputation as a savvy operator. He has restored Microsoft’s growth with smart bets on various types of business software, and a strong push to move the users of various applications, including the company’s lucrative Office products on to the online Office 365 version. Nadella has also remade the image of the swaggering giant as a kinder, gentler, more thoughtful company.

Image of Satya Nadella by Brian Smale

Microsoft’s purchase of TikTok would be Nadella’s riskiest bet to date. If Beijing, in fact, views TikTok as a crucial asset for influencing US political and social discourse, it could attempt to put backdoors into the software and service. Microsoft would need to work hard to extricate them, and they could result in TikTok’s being shut down anyway.

Also, with TikTok, Microsoft would enter the politically fraught world of social-content moderation. Microsoft has assiduously avoided political controversy, but TikTok would inevitably force Nadella to enter that arena in one way or another. For example, critics have loudly complained that TikTok censored videos of recent Hong Kong protests, citing that as evidence of Chinese government control. One can imagine similar discontent, due to slights — real or perceived — arising among any number of causes, particularly at either extreme of the US political spectrum.

TikTok’s present valuation $5 billion has critics warning that Microsoft is about to overpay. That is one of many things that could halt the deal altogether — valuation, government intervention, and fresh revelations of spying on users being just a few.

Yet the logic of the acquisition is clear. TikTok is under threat of closure by the US federal government. It’s hard to imagine that Microsoft will pay its full valuation price. For ByteDance, this may offer a graceful exit from a business that it realizes will only create more problems. So, Nadella may be making a smart bet — one with less to lose and more to gain than others realize.

Microsoft would increase its market presence by simultaneously acquiring both a social medium and an application popular with the younger crowd. It has long pined for more of the under-25 group, and TikTok may fulfill that aspiration most clearly and cleanly. Also, TikTok, a kinder, gentler social network than Facebook and Twitter, aligns culturally with Microsoft’s carefully groomed image.

The platform is designed to encourage discovery and consumption, but not to fan the flames of extremism. That does entail algorithmically controlling content more carefully and spreading new content more slowly than Facebook and Twitter care to. To date, however, moderation has been a lesser problem on TikTok than on other platforms and, due to its design and mechanism, is likely to remain so.

With TikTok would come a large and growing pool of user-generated video data for training Microsoft’s artificial intelligence (AI) engines. In theory, if Microsoft can continue to grow TikTok’s user base, its advertising benefits to Microsoft may be enormous. Microsoft’s cash flow would benefit from the added diversity of the advertising revenue and potentially of another rapidly growing source: social advertising. To put this into perspective, Amazon’s fastest-growing revenue stream, of late, has been advertising sales on its powerful eCommerce platform.

The purchase’s major benefit to Microsoft and the US public may be the ability of US consumers to continue to use an innovative platform for free expression and creativity after rescuing it from the quicksand of politics. Yes, we must remain vigilant in limiting government spying (which, let’s be honest, both sides engage in) and restrictive business practices (in which China is clearly the worst offender). But ultimately the potential of such technology as TikTok is to soar above partisanship and divisiveness to let people connect and create.

Certainly, social networks have created their fair share of problems for society, and TikTok is not a perfect vessel. People will find ways to abuse its potential. For now, however, Microsoft’s purchase of TikTok would, in a rare win-win, benefit Microsoft, TikTok’s users, and society.

And just as the US learned from India’s ban, India now needs to learn from it. China’s National Intelligence Law of 2017 requires all of its companies and citizens to ‘support, assist and cooperate with the state intelligence work’. If China decided to launch more aggressive moves against India, it could have its companies intercept private communications, shut down key services, or even sabotage infrastructure. This is why the US State Department launched the Clean Network program: to purge Chinese companies from US infrastructure. This applies to telecoms carriers, cloud services, undersea cables, apps, and app stores.

Removing Chinese-developed infrastructure will take time. But India can surely take a page out of the US State Department’s book and require companies such as Xiaomi, Haier, Oppo, Vivo, Oneplus, Huawei, and Motorola to sell their Indian products to local players. Companies such as Reliance, Mahindra, and Tata have the capability and funding and could win in the same way as Microsoft.


Vivek Wadhwa is a distinguished fellow, Labour and Worklife Program, Harvard Law School, US, and co-author of the forthcoming book, From Incremental to Exponential: How Large Companies Can See the Future and Rethink Innovation.

This piece was first published here.

License for embedded image can be found here.

What Is Your Friend?

Covid-19’s social distancing protocols have resurrected and increased social connections. It looks like we all have an uptick in the frequency of video calls, large chat groups, and increased social media activity. I know many of us are now in touch with college groups, school groups, family groups, cousin groups, children’s school groups, neighborhood groups and so much more. There really was no reason for any of these interactions to have not taken place earlier – the infrastructure, technology, and people were always there. Only one thing seems to have changed – the incessant demands of the clock on our time. 

For some, caring for younger people or older people in their care, Covid-19 has been doubling difficult. But for several others, Covid-19 has presented us with a curious dilemma: Finding ways to spend time.  Covid-19 has affected people in several ways, and in recent chats and calls, one trend seems to be emerging: What is your friend?

A few months ago, one of our aunts was visiting and the family had gathered around for a day of fun, and laughter which she invariably ensured was there around her. 

“What is your day like Athai (Aunt)? How do you pass time?” I asked.

This is one of the questions that I pose to those of the older generation often. I know boredom and loneliness can be a big problem for some people. However, there are a few in the older generation who somehow manage to retain their vibrant joie-de-vivre as they age, so that they are not just occupied but keep themselves happily occupied and stimulated. 

“I am occupied enough, “ she began. After she told us in loving detail of time spent with her family, particularly grandsons, she said with a smile, “I practice what I want to teach later in the day to my students, and I find the time flies past. Music is really a friend.“

It was true. I remember visiting this Aunt and heard her humming and practicing a particularly tricky song that she wanted to teach her students later that day. She was trying it as she cooked & cleaned and it made for a comforting background while we went about our day. 

Many I know find it heavy-going after retiring from their busy lives. Some find solace in the demands of religion, others find themselves watching a lot of television. A few, though, find ways in which to keep themselves intellectually stimulated and happy. These people seem to be the kind of people who are not only in touch with their Eternal Selves, but also nourished and sustained it. They are the ones who quite unwittingly spread joy and happiness around them by virtue of being happy with their own state of being.

Mary Oliver’s, Upstream is a book of many marvelous essays. The essay, Of Power and Time, talks about the three selves in many of us:

The Child Self is in us always, it never really leaves us. 

The second self is the Social Self. This is the do-er, the list maker, the planner, the executor. 

Then, there is the Eternal Self: the creative self, the dreamer, the wanderer. 

The Child Self is in us always, it never really leaves us. I completely identify with that. I am decades away from my childhood, but I can dip into it like I only just grew up.  Everything felt keener and sharper as children, and that is part of the reason why The Child Self never really leaves us, I suppose. (Probably the reason why I forget the name of the person I met yesterday, but remember the names of my friends from when I was 5 years old)

The second self is the Social Self. This is the do-er, the list maker, the planner, the executor. The one, in short, that most of us find ourselves trapped in for the most part of our lives. This is “the smiler and the doorkeeper” as Mary Oliver so elegantly puts it. This self I am familiar with: metaphorically the whirlpool, the swift horses of time, the minute keeper.

“This is the portion that winds the clock, that steers through the dailiness of life, that keeps in mind appointments that must be made. Whether it gathers as it goes some branch of wisdom or delight, or nothing at all, is a matter with which it is hardly concerned. What this self hears night and day, what it loves beyond all other songs, is the endless springing forward of the clock, those measures strict and vivacious, and full of certainty.”

The social, attentive self’s surety is what makes the world go around as she says.

Then, there is the third self: The Creative Self, the dreamer, the wanderer.

“Certainly there is within each of us a self that is neither a child, nor a servant of the hours. It is a third self, occasional in some of us, tyrant in others. This self is out of love with the ordinary, it is out of love with time. It has a hunger for eternity.”

The essay goes on to explain the regular, ordinary self in contrast to the creative self. The Creative Self – the one that is out of love with the ordinary, out of love with the demands of time or the regular routines of life, is concerned with something else, the extraordinary. This is the self, she says, that makes the world move forward.

“The extraordinary is what Art is about. No one yet has made a list of places where the extraordinary may happen and where it may not. Among crowds, in drawing rooms, among easements and comforts and pleasures it is seldom seen, It likes the out-of-doors. It likes the concentrating mind. It likes its solitude.”

Finding something that makes us want to do something without tangible rewards is the most gratifying thing in the world. Not all of us can lead the life of an artist, but we each can devote small amounts of time consistently to find an artistic pursuit that sustains us. It may be in the creative process in things as varied as tinkering with wood or analyzing the ebb and flow of economic market conditions. 

The essay ended on this note:

“The most regretful people on Earth are those who felt their own creative power restive and uprising, and gave to it neither time nor power.” – Mary Oliver

The Aunt who said “Music is a friend!” gave to her creative spirit time and power. Covid-19 has given us the unique opportunity to pause and evaluate what we do with our time. Some have exceeded themselves on the culinary front, some others with photography, some have taken up gardening. I find it refreshing to see the Creative Self reviving in so many of us who have given in to the power of the time-bound social self for so long.

What is your friend?

Saumya Balasubramanian writes regularly at nourishncherish.wordpress.com. Some of her articles have been published in the San Francisco Chronicle, The Hindu, and India Currents. She lives with her family in the Bay Area where she lilts along savoring the ability to find humor in everyday life and finding joy in the little things.