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America has a mental health crisis, and Vivek Murthy wants to talk about it.
When he was first named surgeon general in 2014, he traveled the country for a listening tour to learn how he could help. The “Nation’s Doctor” heard about addiction, obesity, cancer and heart disease – and, to his surprise, loneliness.
“It resonated with me personally, because I certainly struggled with loneliness throughout my own life,” says Murthy. “It’s so hard to tell from the outside world what’s happening inside. Many of us just try to put on a brave face.”
It’s still unusual for political leaders to talk about mental health, unless it’s a deflection from even more uncomfortable truths. But Murthy is different because . . . well, he was different.
As an Indian American growing up in Miami, he was an excellent student, but he worried about not having anyone to sit next to in the cafeteria. The food in his lunch bag was different from what the other kids had. His skin tone was different. His parents were different. “When you’re really shy and when your self-esteem is as low as it was for me as a child,” he says, “I knew those differences made me feel like I didn’t belong.”
That, of course, was before his degrees from Harvard and Yale and his appointment by President Barack Obama as the youngest-ever surgeon general. It was also before the pandemic, during which 10 of his family members have died of COVID-19. This country’s emotional health – arguably more damaged after the past two years of fear and loathing – is the reason he accepted President Joe Biden’s offer last year to serve a second term.
So Murthy goes to conferences and hospitals and schools and Twitter and anywhere else, wearing the military uniform of the Public Health Service, to explain that social connections are as vital to our health as food or water. He appeared with first lady Jill Biden to talk about youth mental health and with Vice President Kamala Harris to highlight burnout among health-care workers. Given the enormity of the crisis, it’s hard to gauge whether he’s making a dent. Murthy is that guy on the beach, throwing starfish back in the ocean one at a time.
“The pandemic has been tragic, but one silver lining of it is that I think it has compelled many people to look at the world and their lives differently,” he says – and ask how we can create a society that supports mental health and well-being. “That’s why I’m here.”
Without the determination of his paternal grandfather, Murthy might have been a poor farmer in India.
As a widower in a small village, his grandfather raised six children after his wife died of tuberculosis. There was no money, but he wanted his sons to become a doctor, engineer, an agriculture expert. “In those days in India, you did what your dad told you to do,” says Murthy. And so his father went to medical school, and then to England – where Murthy was born – to pay off his student loans, and finally to Florida.
“I always say that if life was governed by a probability, he would be a farmer, I would be a farmer, and we would still be there in the village,” says Murthy, 44, whose mother is also from India. “You realize you can’t take anything for granted, that when you are blessed with such an improbable opportunity, you want to make the most of it.”
Instead, Murthy’s father is a doctor, his sister is a doctor, he’s a doctor – and he married a doctor. In high school, he and his sister built a program around HIV education; at Harvard, he founded an organization to bring that information to this country and India. After medical school at Yale, he practiced in Boston and advocated for affordable health care. His soft-spoken exterior belies his fierce drive, although he doesn’t think of himself as an overachiever. He says, “My days of frustration usually stem from moments where I don’t feel like I’m doing enough to achieve my full potential.”
In 2013, Obama asked him to become the 19th surgeon general. Some critics thought the 36-year-old was too inexperienced; the National Rifle Association opposed his nomination because he called gun violence a public health threat. He was narrowly confirmed the following year.
He stepped into an office, part of the Department of Health and Human Services, with no tangible power and no budget to fund specific initiatives. It’s a bully pulpit that rarely makes headlines unless someone is outraged by one of the advisories. But occasionally, there’s real change: In 1964, the surgeon general issued a landmark report linking cigarettes to cancer and heart disease. C. Everett Koop became a household name in the 1980s for his colorful and sometimes-blunt warnings against smoking and for HIV/AIDS education.
David Satcher, who served as surgeon general for Bill Clinton and George W. Bush, persuaded Clinton to issue an overdue apology for the Tuskegee study that exploited Black men. Satcher says Murthy brings an unusual mix of science and reflection to the job. “It’s not a perfect relationship between the surgeon general and the American people,” he says. Still, he adds, “How many lives have been saved because of the surgeon general’s report on smoking and health?”
Murthy dived in, tackling addiction, obesity, Ebola and climate change. He overhauled the website to make it easier for the public to understand the reports produced by the office. He spent a lot of time giving speeches and doing media – including an appearance with Elmo on “Sesame Street” on childhood vaccinations.
Three years later, he watched a once-in-a century pandemic kill 10 of his extended family members in the United States and India. One was a favorite uncle – one of the few relatives Murthy had in this country growing up, and the person who first told him about the Public Health Service.
“It made COVID very personal,” he says. “But it also helped me feel a bit of the pain that millions of families around the country are experiencing. I think about the fact that more than 160,000 kids have lost a caregiver to COVID-19, and that the depths of pain that our country experienced are profound. When you’ve experienced personal loss with COVID, it prevents you from forgetting that easily. I do worry about that, because we’re in a time where we want to move past covid and leave it behind.”
In February, his 4-year-old daughter tested positive; Murthy, along with his wife, Alice, and 5-year-old son – all vaccinated – soon followed. Their symptoms were mild, but it was still stressful.
“You know what has made this experience easier?” Murthy said in a Mister Rogers-esque tweet. “The kindness of friends. It’s extraordinary how a few words or a few minutes of conversation can lift our spirits for days. COVID reminds me that our relationships can heal. We all have the power to heal because we can all be kind.”
During his first stint as surgeon general, Murthy was a newlywed but, again, lonely – although he didn’t realize it at the time.
“There were times in my life where my work was so intense and busy that I allowed my connections with people to wither and to diminish – that happened when I was surgeon general,” he says. “I told myself, ‘This is a once-in-a-lifetime opportunity. I have a real chance to make a contribution here to society. Let me do everything I can. Let me put every hour into this job.’ ”
But that meant he had less time for friends. Even when he was with family he was distracted, on his computer or phone: “It took a toll that I didn’t fully appreciate until much later, and it actually informed why I operate differently now.” The realization that he had neglected the people that mean the most to him – the ones who contribute the most to his mental health – was sobering. He resolved to do better and wrote a book, “Together: The Healing Power of Human Connection in a Sometimes Lonely World.”
The other big change? Two small children not yet willing to share him for the greater good. He tries to be home for dinner and bedtime stories, and then work after the kids are asleep. “I always tell my team, ‘You will get emails from me at weird hours, but don’t feel obligated to respond in those times.’ ” He tries to limit travel to one a week – and yet: “My son, almost every time I have to go on a trip, holds on to my shirt and looks into my eyes and says, ‘Why do you keep leaving me?’ Which is heartbreaking.”
These emotional truths all factored into his decision when Biden asked Murthy to serve again as his surgeon general. The two men – both highly empathetic, both willing to talk about their emotions publicly – had known each other for years, but really bonded in the spring of 2020 when Murthy advised the presidential candidate on how best to respond to the escalating coronavirus threat.
Murthy and former Food and Drug Administration head David Kessler would stay up until 2 or 3 in the morning to prepare to brief Biden together. Kessler says Murthy had the ability to synthesize complicated medical information and communicate it in a way that made it very accessible – but a sensitivity that informed the discussions: “It’s very much a part of his soul.”
“He has a way of just asking a question or two, a gentle way of changing the direction of a policy,” says Kessler. “He’s been involved quietly in every hard decision along the way.”
In a recent interview with Jimmy Kimmel, Biden said Murthy is advocating “significant mental health proposals relating to people who are . . . not knowing where they’re going, not knowing how to respond, not knowing how to act.”
Working to contain the pandemic took up most of his first year in office, although most of the public attention and attacks were directed at Anthony Fauci, Biden’s chief medical adviser. Now Murthy is leaning heavily into mental health initiatives, the unfinished business of his first term.
“I was hearing about it constantly, in small towns and big cities all across America, people were saying that it just feels like we’re more and more disconnected from one another,” he says. He’s especially worried about teen mental health, which worsened during the pandemic, according to a report his office released in December, and increases in anxiety and depression in the broader population, according to the Government Accountability Office.
He’s also up against misinformation and mistrust, which makes it harder to persuade millions of Americans to adopt proven public health measures such as vaccines – and affects their physical and mental health. “I see them as victims of a broader information environment that’s been polluted, in some cases willfully, in some cases inadvertently by technology.”
Last year, Murthy and his colleagues launched efforts to win over vaccine skeptics, but it’s impossible to know whether their approach made any real impact in such a polarized country.
How to change hearts and minds? Listen more, talk less. He’s trying to mobilize legislators, companies and community organizations to foster real connections, not the false intimacy of social media. “I’m under no illusion that that one trip is going to change that community’s life and their health forever,” he says. But he hopes that those visits inspire partnerships with trusted institutions such as faith groups, hospitals and charities to reach people in ways no government official ever could.
Murthy likes to use a word seldom heard around Washington: love.
“I feel fundamentally human beings are driven by one or two forces: love or fear,” he explains. “Love manifests as compassion and generosity and kindness, and fear as its own manifestations of insecurity and jealousy and rage. I think we are better off and the people around us are better off when we’re operating from a place of love.”
That’s why he talks about love. The question, of course, is whether anyone is listening.
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