Dr. Vivek Murthy

giving us this time. Of course, David, I'm glad that we're having this conversation. I am sorry that I can't do this in person with you, but as you probably heard, I did come down with COVID. I managed to dodge it for two years. Uh. I don't know what happened, but I guess my luck ran out. But is COVID still a major problem in the United States? People like me are still getting it. Well, David, first time, I'm

sorry that you have COVID. I from personal experience, I know that, uh, you know, can can It's a serious thing, and even though you're vaccinated and everything, sometimes you can have these break through infections and have mild symptoms. So I we should the best in your recovery. But you know, as a country, here's where we are. You know, we have certainly come a long way in the last couple

of years. I still remember very clearly in March, when more and more people were getting sick, when hospitals were starting to fill up. We're seeing terrible scenes from New York City in the months that followed UH, and we didn't know a lot about the virus, and we didn't really have treatments and much less vaccines. Fast forward now to you know, a couple of years forward, and we actually have these vaccines that are incredibly effective at keeping

people out of the hospital and saving their lives. Even if you do get an infection after a vaccine, again, the likelihood of you having a really bad outcome like being in the hospital are dying from this virus are much much lower. And you combine that with the treatments that we now have available, treatments like packs livid UH, and you find that most debts in from COVID nineteen should be preventable at this point. So that is a

long way to come from where we were. With that said, we are still losing several hundred people three to four hundred people a day to COVID nineteen, and they tend to be predominantly individuals who are not up to date on their vaccines or who haven't received treatment. So we still have more work to do, and especially with the winter coming, we've seen the last couple of years there's been an increase in cases during the winter. So that's why we want people to be up to date with

their vaccines. We've got an updated vaccine right now, in fact, that his tailored for the new omicron variant b A five. We want people to get that and to make sure they have maximal protection when winter comes. Well, let me ask you, and the early part of the COVID vaccine COVID problem, people were dying in enormous numbers in the United States. I think maybe now maybe more than a million people have died in the United States, maybe five

million around the world. Was that in part because they weren't vaccinated and the vaccination has made those who get it, like me um not as weak as we would have been without the vaccination. Yeah, so that's a really good question. So early on, before we had a vaccine, you know, people didn't have real protection against this virus. They didn't

have prior infection with COVID nineteen. This is a new coronavirus that had emerged on the scene, but now thankfully UH those vaccines do give protection against the worst hot coms of COVID. And this is actually an important point underscore, which is what is the goal of a vaccine. Sometimes people think if I get vaccine and then I get sick, that means a vaccine didn't work. But it turns out the most important goal of the vaccine is to save your life, and by that measure, it's actually doing a

remarkable job to keep the protection that people have. Though it's important for them to stay updated with their vaccines, and we've seen that over time that the COVID vaccine, like many other vaccines, that its effectiveness can wane over time, which is why I just like you've got a tetanus booster or you've got an annual flu shot, it's important to be up to date with your COVID vaccines as well.

So the bottom line is these are life saving tools that we now have, the vaccines and the treatments, and by you know, depending on what calculation you look at, we have saved hundreds of thousands of lives in the United States own because of the vaccination being available and the vaccination campaign that was mounted to get people protected. Now, did you ever get COVID? I did get COVID. Yes, In fact, in earlier this year, in early two, my wife and my two kids and I all got COVID

and we actually know how it happened. It turns out my daughter, who was four years old and was in pre kindergarten at the time, she ended up catching the virus from somebody in her classroom. It's really challenging, you know, if you're a family, especially a family with small children, uh, to prevent yourself from getting infected, it's worth trying, and we certainly did, you know as well. But end of the day, you know, you're taking care of your child.

You've got a hold and comfort them when they're ill, and that puts to a red risk, you know, if you've got small kids, and many parents have experiences. So thankfully we were all uh, you know, vaccinated except my daughter at the time. There was not a vaccine yet for kids her age, but the rest of us were vaccine and thankfully we had a mild course of illness.

But me you know even more respect, um, for this virus is somebody it should be taken seriously, because again, even with the protection we had, you know, we were knocked out for several days there. Now, did you tell your four year old daughter that she had infected the Surgeon General of the United States and that she recognized the consequences of that. Oh, to my daughter, I'm just her dad who she sometimes pays attention to when her mom's not around. So I'm not sure she's so aware

of what I do. But you know, it was also to your point, David, it was just a very humanizing moment, you know, like I had been working on COVID for you know, the better part of you know, a year at that point, um, but you know, to to be able to go through uh this you know, experience as well, just giving giving even more understanding and empathy for folks out there who are not just getting sick, but who are trying to manage their family responsibilities while they're ill.

Whether it's getting their kids, you know, you know, you know, it to school, whether it's making sure that they're managing work, whether it's taking care of elderly relatives. The ripple effects of getting sick are significant and uh, and that was certainly something that I have kept with me ever since I was ill. Let me ask you about what it means to be the Surgeon General of the United States. You're not a surgeon and you're not a general, So why are you called the surgeon general? What is the

surgeon General's job? And one of the jobs of the surgeon General, and the reason in fact why I wear this uniform, is to oversee the US Public Health Service Commission Corps. This is one of the eight uniformed services in the United States government. It consists of six thousand officers who are dedicated to improving public health each and

every day in their day jobs. But we also deploy them during times of emergency, so we send them with their hurricanes and tornadoes that hit towns, we will send officers there to help provide basic care, and routinely during COVID nineteen, we've deployed thousands of officers to help with everything from vaccinations to supporting health care systems. So that

is one of the jobs of the Surgeon General. The other job, though, is to inform the public about critical public health issues that are rise and this could be informing them about how to prevent, uh, if you yourself from getting sick, how to manage an illness when it arises. Certainly with COVID that has been an important part of my work, but increasingly my focus has been on the broader issues of mental health and well being, which have taken a hard hit during the COVID pandemic, but which

we're real struggle for a country. Even before then, you were the surgeon General under President Obama, and you served under President Obama and did a very good job. I'll talk about that in the moment. And then uh, President Obama left the office after eight years, and President Biden came in four years later, and then he asked you to be surgeon general again. Did you tell him you've already done that job once and why did you want to do it again? And were you surprised that that

that they wanted you to do the same job again. Well, got it's an interesting question. I certainly had not planned to come back and serve as Surgeon General again. I you know, I had always told myself when I had the privilege of serving the first time, that this is a once in a lifetime and experience. I didn't know it would be a twice in a lifetime experience. But you know, the pandemic really scrambled everyone's lives, including mine.

While it wasn't in a difficult decision when he asked me to serve, and it was certainly a big decision, had big implications for my family, certainly, and I was aware of that having served the time before. But I'll tell you, David, it was one of those moments where and the throes of a crisis that was up ending our country in the world. You know, I felt that it was my responsibility and our collective responsibilities to all do as much as we could to address this crisis.

I was being given an opportunity to uh serve and hopefully to help, you know, at a larger scale, and I wanted to to make sure I did that. What was in the head my head at that time, David, was really the voice of my my parents and really the example that they had set for me when I was growing up, which they set again more through what they did rather than what they said. But they had

always sort of taught me through their actions. And whenever your community is in need, it is our responsibilities to step up and do as much as we can. It might only be a little that we can do in that moment, but all of us have to step up and serve in some way. So let's talk about your parents and your background. Where did you grow up. I grew up in Miami, Florida, will move there when I

was three years old. I went to public schools, you know, all throughout through high school, and my parents they ran a medical practice there that my uh dad mom had set up when I was in elementary school and uh and that sort of was a pivotal, uh sort of experience for me because I spent a lot of time there as a kid, and it shaped my excitement and interest for pursuing medicine later in life. And we're both your parents medical doctors. So my father is a doctor.

He's a family medicine doctor. My mother actually did her degree in English literature. But we like to say that she's an inherent healer herself because it comes naturally to her. And as somebody who ran my dad's clinic for many years there, the patients and the clinic all came to know her and to trust her. So did you always want to be a doctor when you were in elementary

school in high school, did you know that was your calling? Well, I was really in fired by my parents early on to become a doctor, and that's you know, for much of grade school, that was pretty clear that that's what I wanted to do. But towards the end of high school things changed a little bit. I started to get really interested in English literature. I got really interested in history and in economics as well, and I went to college thinking that I might want to pursue something in

one of those three fields. So I took classes and you know, in economics and in history and was you know, really trying to get a sense of whether that would be my path. But what happened actually in between was interesting that shifted things for me, which is that my freshman year, my father called me and he said, you know, there's this philanthropist who is looking for a cause that he wants to support, but he doesn't know what the causes.

So he said, if you have any ideas that you want to work on, there may be an opportunity for you to build something with his support. And I thought about it, and I had actually been working on some HIV projects when I was in high school and had been visiting India, where my family is originally from, and realized actually after high school that the crisis was really exploding. So my sister and I ended up developing an idea to build a education program around HIV in India that

would be a peer education program. This is it's commonplace now. Is more unusual then, but the idea of bringing UH you know, peers together and training them to actually go out and and inform college and high school students around the community was novel then in India, but it's something that we decided to be wanted to try to build, and that was the project we ultimately we're able to

get funding for UH. We built that, ran it for eight years, built chapters around India and the United States as well, and that changed my perception and my my feeling about what I wanted to do in the world. And it brought me back to health and to wanting to not only become a doctor, but to to build programs and communities that would hopefully have a large, scalable impact on public health. I assume you were a reasonably good student in high school. I think you were valegatory

and of your classes at right. Yes, guilty is charged, and so did you want to go to Harvard? Was at your first choice? Which is where you went to the school? Cool reason actually came to learn a little bit about Harvard is I had my best friend in high school, Miriam. Miriam went to this, Uh, she was interested in going to this summer school program at Harvard. We all end up going to this Harvard summer school program between junior and senior year and it was a

really wonderful experience. But that's what actually made me think, hey, maybe this would be a great place to come to college if I'm lucky enough to have the opportunity. So, uh, that's why I applied to Harvard. I was fortunate to be given an opportunity to attend uh, and I had a great experience there. And then after Harvard, you went to medical school at Yale? I did? I did? Yeah? And how did you happen to pick Yale was a place to go? You got tired of Cambridge? Well, this

is this is also an interesting experience. It was you know, I actually wanted to go to Harvard Medical School because I was doing research there when I was in college and I had you know, I just decided for myself that that was the right place for me to be. Um, even though I didn't have exposured other institutions, and UM, it turned out I did not get into Harvard Medical School. Uh, and I was I still remember that coming home on this day and opening the letter and seeing that it

was a rejection, and I was so crushed. And I called my father and he said, UM. He said to me, He's like, I know you're really upset about this, but something good will come of this because you'll be able to go somewhere else and get a different kind of exposure. This is going to help you grow. And I was fortunate to, you know, be given a chance to attend Yale.

It became one of the most powerful educational experiences of my life, not just because of what I learned in the classroom, but because of these incredible relationships that I built at this community that I was part of, and then I continue to still feel like I'm a part of, even many years after the fact. So have you ever seen the admissions officer from Harvard Medical School and told

him that he missed on the two times Surgeon General? Oh? God, No, no, I haven't, but I know that there's Look, there's a degree of randomness number one to admissions processes. And I always uh tell young people now who are going to school that you should never like assume that whether or not you get into school or not as a measure of your worth and your value because again, having now served on admissions committees, I know that there's a degree

of randomness. They are good people who don't get in and there uh you know, and and that's just the way it is. And many people, when you're a class at Harvard went into something also important called private equity. You were never tempted by that. Well, you know, I

was interested in in a lot of things, David. You know, after I finished my residency program, I actually ended up taking uh some time and building a company and technology company that I ran for with some colleagues for about seven years to help use technology to actually advance uh clinical research and clinical trials in particular. So I've always had an interest you know, in uh in building businesses and in building taking innovations that could actually help people

and bring them to scale. Uh. So you know, who knows what the future holds, but uh uh and maybe one day I'll come get some advice from you, David. What advice would you have for a young person who says I want to inspire to a career like yours. Find a problem that you care about and try to

help address it in whatever small way you can. You've been the Surgeon General twice, but what would you like to see as the legacy that you leave behind for future surgeon generals or further people generally what you've done with your life. Gosh, that's a great question, David. Um. I'll tell you what my greatest concern is. Where I hope to make the greatest contribution UM is actually more around the core set of values that we build and

design society around in our lives around UH. And this is a very personal thing for me because I think about my two children, David, and about the world they're growing up in, and I, like many other parents, UM,

worry at times. I look at the vitriol and the polarization and so much of the hatred in our world, and I ask myself, is my child going to grow up in a world where people are kind, where they're embracing, where they don't condemn my child because they made one mistake, UM, but they give them a chance and given the benefit of the doubt. We need to build a society David, that is firmly grounded in kindness and compassion and in of and we need to build our workplace culture is

to reflect that. We need to build our education systems to support that. And we need to also support parents because they are really struggling right now. Is they seek to give, you know, support on a foundation for well being to their kids. So my hope going forward, if there's anything I could contribute to, it would be to emphasizing and underscoring those values as we seek to redesign

our lives in society. We have a once in a generation opportunity David, in this pandemic, when people are taking stock of their lives and re and ask themselfs a question what kind of world do I really want to live in? We have a chance to go back and to say, hey, what can we tweak in our lives? How do we want to recenter our lives around a core set of values? Is our chance to build a better life and a better world, uh than we had

pre pandemic for us, but also for today. What do you consider the biggest health challenge facing the United States and the people in the United States? You know, It's a great question. I mean, there are so many challenges we're dealing with. Obviously, we're still dealing with the ndemic, and we need to be make sure that we're prepared for the next one that may come down the line. We have a whole bevy of chronic illnesses that people

are struggling with, from obesity to heart disease. But the one that's actually most on my mind, uh and which I'm most deeply concerned about, that I see as foundational to our health, is actually the mental health crisis that we have in our country. It turns out that when you struggle with your mental health, uh as certainly I have at points in my life, and I've taken care of many patients over the years who struggle with their mental health. But when you struggle with your mental health,

it doesn't just impact how you feel. It impacts your physical health as well. It impacts how you show up at work. I can impact productivity, absentee is um in the workplace, and also impacts how our children perform in school and how they learn, and so however you cut it, I think of our mental health is the fuel that allows us to show up for our family and friends for you know, our community, and when our mental health is negatively impacted, it compromises, uh, you know, all those fronts,

and that's what we're dealing with right now. You know, if you look at the numbers, uh, David, they're they're really staggering, especially among youth, you know, right. You know, if you look at the population overall, about five of people in twenty had suicidal ideations, they contemplated taking their

own life. You look at kids in particular, and you see that there was a fifty seven percent increase in the suicide rate in the ten years preceding the pandemic, and things have gotten more challenging for many kids now.

When I worked in the White House for President Carter, his wife roseland Carter headed a mental health task force, and it was seen at the time as somewhat unusual for a first lady to be interested in that subject, and in part she had always been interested in it, and she recognized her was a stigma attached to mental health. Now we're forty five years later. But do you think there's still a stigma attached to mental health as opposed

to physical health problems? Well? I do, David. I think It's gotten better, certainly than it was years ago, but I still see that stigma all the time. I see it one in the conversations I have with people, especially it's a stronger stigma in my generation and older generations. Younger generations are less affected by it, but there too, I still see a reluctance to talk about uh, you know, needing help and about being a bullied or being the

victim of abuse, which contributes to mental health struggles. But the other piece I think it's important is it's not just in our words and actions that I see that stigma. I see it actually structurally as well. You look at how we reimburse for mental health care in in our country, and despite passing in two thousand and eight a mental health parity law, that law has been unevenly enforced and

it needs to be stronger. So it's harder for people to actually get mental health care in our system than it is for them to get you know, care for their physical health issues. So we we still have a long way to go to close that gap. Are there mental health problems with people at work? In other words, um, if you're working remotely, are you going to be more lone and is that going to cause a bigger problem?

And do you think it's better for the mental health of people to actually be coming back to the offices and so forth. Oh, this is such a good question. And I do think that our workplaces have a really

powerful effect on our mental health and well being. It's one of the reasons I just issued a Surgeon General's Framework on Workplace Mental Health and well Being because right now, you know, almost eighty percent of people are saying there's some aspect of the workplace that is contributing negatively to their mental health and well being. But in around people actually want to find a workplace that supports mental health.

So this is our chance to really figure out how to make workplaces engines for mental health and well being. And I've laid out a strategy for how to do that. But when it comes to working from home, this is an important consideration. There's some benefits to people from working from home. Uh, they can actually be there more for their family. They can many people can actually be home for for dinner time or drop their kids off from school. They're not spending as much time commuting, they can have

more time with family and friends. That's an important positive on the downside, when you know it might it's harder, I think, to connect with your coworkers when you're not

having some in person time. So there's a balance to be struck here, and what I suggest that workplaces you often is to have conversations with your employees about how to strike that balance, about how to have some time where they may be able to gather in person, to to collaborate, to come to no one each other more deeply, to build stronger working relationships that in person time is invaluable.

But this is not black and white, you know, Finding that right balance is important because we know when people are satisfying, fulfilled outside of work, it has a huge impact positive impact on their mental health, and that positively impacts their productivity and their creativity in the workplace. So it's a win win. I'm part of the baby boomer generation, and this generation is now increasingly dealing with problems relating

to Alzheimer's dimension and so forth. Not particularly my age, but maybe some people my age even younger, but obviously in their late seventies, eighties, and nineties, More and more we're reading about Alzheimer's. Is this uh an epidemic that you can't really deal anything about or is it something we could deal with in some way. It's the real

challenge for a lot of families, mine included. You know, I have a ninety year old grandmother at home who's struggling with dementia, and providing care for her has been a real challenge. And from my family, we love her dearly, we want to be there for her, but where it's painful for us to see the told dementia has taken on her. Uh So this is rightfully uh you know, a concern for for families across the country. We're investing a lot in studying dementia to not just Alzheimer's but

other forms of demensia, to understand what's driving it. But very interestingly, there's also uh some research that's taking place, lifestyle research, if you will, on the impact of diet, of social connection, of physical activity, and sleep on dementia as well. Dean Ornish, professor at the University of California, San Francisco, has been actually one of the key folks you know, who has been leading some of that research on the impact of lifestyle and dementia. Uh. And you know,

this is a promising area. But I certainly think this is we should expect, it should be this is gonna be concerned for families across America in the future, and just keeping a mind it's not just about the people who are impacted by dementia, it's about their families as well. It impacts when you look at like what pulls people away from work, what makes it harder for them to

be there for their community. It's often caregiving responsibilities, and the caregiver burnout crisis in America is real and dementia is a big part of that. For a young person who says I want to be the next Surgeon General of the United States or someday grew up to resurge in general, what advice would you have for a young person who says I want to aspire to a career

like yours. What would you say, go to medical school, um do what find a problem that you care about, and try to help address it in whatever small way you can, and don't be limited by the amount of training you have or the experience that you have. You know, in a lot of times, what I found early in life is when I began my first nonprofit organization, I was I was seventeen years old. At the time, I didn't know a lot about a whole lot of things,

and I made a lot of mis stakes. Uh Is my sister and I tried to build this entity, but we learned a lot along the way, and what we lacked in experience and an education, we made up for an enthusiasm and in a willingness to learn. And so I would just encourage young people to look for find a problem you really care about, and start trying to address in whatever small way you can. Maybe it's on your own, maybe it's in the community organization, but start

trying to help right away. Don't wait until you're done with your education. Thanks for listening to hear more of my interviews. You can subscribe and download my podcast on Spotify, Apple, or wherever you listen.