Optimal
mental this altitude I can run flat out for a half mile before my hands start shaking another downside of walking ISM living tissue over metal endoskeleton.
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Hello boys and girls, this is Tim Ferriss and welcome to another episode of the Tim Ferriss show where it is my job to deconstruct world-class performers of all different types, whether from business science chess. It doesn't really matter. What we're looking for are habits routines thought patterns Frameworks Etc that you can hopefully Ponder and test and apply in your own lives and my guest today and I'm going to Massacre this name, but I'll do my best is dr. Vivek Murthy.
The that's mu R. Th why on Twitter at Vivek Murthy, that's Vivek underscore Murthy on Facebook Instagram at dr. Vivek Murthy and Vivek Murthy.com. Dr. Murthy served as the 19th Surgeon General of the United States between 2014 2017 as the vice admiral the US Public Health Service commissioned corpse. He committed a uniform service of 6600 Public Health officers. Globally during his tenure. Dr. Murthy launched the
The turn the tide campaign catalyzing a movement among health professionals to address the nation's opioid crisis. He also issued the first surgeon general's report on alcohol drugs and health calling for expanded access for prevention and treatment and for recognizing addiction as a chronic illness not a character flaw in 2017. Dr. Murthy focused his attention on chronic stress and loneliness as prevalent problems that have profound implications for health productivity and happiness. He has co-founded a number of organizations Visions in HIV/AIDS
Station program in India swastika a Community Health Partnership in rural India training women as health providers and Educators software company trial networks and the Grassroots physicians organization doctors for America since leaving government service. Dr. Murthy has continued to focus on loneliness and social connection his brand new book is titled together subtitle the healing power of human connection and a sometimes lonely world. Dr. Murphy received. His bachelor's degree from Harvard and his MD and MBA degrees from Yale. He completed his
Internal Medicine Residency at Brigham and Women's Hospital in Boston and later joined Harvard Medical school's faculty and Internal Medicine his research focused on vaccine development and later on the participation of women and minorities in clinical trials.
Dr. Murthy welcome to the
show. Thanks so much Tim. It's great to be on with you. I have really
enjoyed getting to know you over the last handful of years and I thought we should start with how to pronounce your name properly. And I know we had a warm-up we had a warm-up pre-recording but perhaps you could describe how you have trained people to
say your name in the past. I'm happy to well. They were many years where I just gave up and didn't correct people, but when
I was in business school. I started teaching people to say my name the following way. It's printed spelled vi v EK and the vi is pronounced like the vi and Victor and the vek is pronounced vake so around zero rhymes with the lake. So that's what I used to tell people. But instead of calling me Vivek. They just call me Victor Lake for the next two
years so so much for that. Well, we have a lot that we can explore and a
We will explore and I thought we could start with loneliness and that is certainly a perennial topic. This is something that I have struggled with personally over decades certainly struggled with as a kid. This is something that also many people are acutely struggling with because of SARS covid to covid-19 at the moment and to place things in
we're recording this on March 24th, 2020. Both of us are at home and we'll have time to talk about certainly covid-19 and so on and we'll dive into that, but I'd like to focus on
Loneliness first and let's start at the beginning is this a topic of interest to you? Because it is something personal that you have experience with or is it from observing the impact of loneliness on Health on a wider
scale? Well, Tim, you know my interest in this initially stemmed from my own personal experience and I'll tell you a little bit about that but I'll just say that I think what a lot of people are lonely they do they don't.
As how common it is and they can think that it's just them and somehow their loneliness is evidence that they are just not likeable or evidence of a character flaw or maladjustment. But the reality is that there are a lot of people I came to see Andrea would later years who struggle with loneliness where and we're all around each other just in silence and often feeling a bit ashamed of how we feel for me the feelings of loneliness began in elementary school.
You know, I always a pretty shy kid growing up and you know, I wanted to hang out with other kids. It wasn't that I wanted to be alone and by myself, but I just had a hard time kind of getting conversations started in breaking in two other cliques and into the in-group and that persisted for a long time and I still remember going to elementary school and feeling this pit in my stomach when my parents would drop me off and I wasn't scared about tests or teachers. I was just
Worried about going to the cafeteria and not knowing who to sit with and I was worried about being on the playground as the last person picked for a team despite. The fact that I was actually quite athletic and had good athletic skill. I was worried about feeling lonely and I would wait every day until three o'clock when the bell rang in elementary school. And then I was this feeling of relief I can finally go back home where I knew I was loved and where relationships were just so easy, you know my parents and my sister were just the best thinking
in you to be just extraordinary loving family members to me, but that was my first experience of loneliness. And you know, it's funny that how these experiences is stick with you for years and years and years even later in life when I was able to build beautiful friendships and feel quite secure in my relationships. I still felt sensitive to those experiences of being lonely or sensitive of being in circumstances where I might be by myself, so it's taken a while to process and work through some of those feelings.
And what does that look like for you as an adult? Is that something that you're able to compartmentalize or put on the side? For instance for a period of time were you reminded of this? I'm just making this up. This isn't something you've said but for instance looking closely at the opioid crisis and a lot of let's call it comorbidity with depression or other types of conditions that might be associated with perceived loneliness.
How did this come to play out in your adult
life? Yeah, so he played out in two ways in my adult life, you know, the first was in a really direct way. So as I got older, you know, I was able to build friendships in high school. I enjoyed those friendships. I felt like I started to Blossom socially in terms of becoming a person on the outside who I felt like I was on the inside, but they were still patches, you know in my life where I felt lonely. It was a state that was easy.
To fall back into and it was a state that was self-reinforcing in a way when I felt lonely. I would actually get down on myself. I withdraw even further from other people which would deepen the loneliness but there is a second thing that was happening when I was an adult which is that I was going through my medical training and starting to encounter patients in the clinic and in the hospital and I trained in Internal Medicine and I assumed that the people I would be seeing in caring for would have issues like diabetes or heart disease.
These or infections like pneumonia or complications of their cancer treatment and I'd certainly saw many patients with with those conditions. But what I did not expect to see were so many patients who were alone and this is how it first showed up. I began seeing patients who would be admitted to the hospital and wouldn't have anybody with them and I would often ask, you know in the just routine course of taking an initial history and physical I would ask about their social
Chuckles, you know do they live alone at home? I do they have been somebody that they can rely on in terms of friends or families in the area and I was Finding often that people were saying no, there's nobody there. So that was one thing but then when urgent situations would come up when we would get a test result. For example, that was really concerning that showed maybe somebody had a new diagnosis of cancer and I would want to talk it through with them. I would often ask them easier somebody you want us to call so that we can you share this information together. So you have some support so
we can make some tough decisions together and very often people would say I wish there was but there's nobody there were even times Tim at the end of life. We're on many occasions. It was just me and my colleagues my fellow doctors and nurses who were the only witnesses to people's passing away and those really struck me deeply because in those most important moments in life, you know, birth death and the critical moments, you know in between when
Um, either have success at work or have major break UPS Etc you hope that there will be people there for you though. You'll be surrounded by the people you love but for so many of these people there was nobody at the end and that that was a very heavy feeling that lingered with me for for a long time. And so I came to see in my adult life that Not only was loneliness something that continue to affect me in waves including during the time. I was Surgeon General, but it was also something that I was encountering quite commonly.
Among the patients I cared for keep in mind him. I had no training in how to deal with loneliness. There was no class on loneliness in medical school. We was not really part of our curricula to think about how to ask people deeply about their social connections. So I felt out of my league in a sense that I was encountering problems that I frankly had no idea how to solve but they seemed important because they kept coming up and they seem to fill people with sadness.
I would love to ask you.
About several facets of what you what you just shared. The first is being the only person or along with your colleagues. The only people with someone who is going to die or who is in palliative care as opposed to those are synonymous or who has just been given a very grave diagnosis. I've found you over the last handful of years to be very calm very
a soothing and I'd be curious to know what you did in those circumstances to help these people psychologically what types of things would you say? What would you do? Are there any particular examples that that spring to mind that we're difficult? I'd love to just if you're open to it talk about a really any any specific example that the jumps to mind because that strikes me as a
If a potentially difficult circumstance navigate and I don't know how how long these people are in the hospital but it's possible that they'd been alone or felt alone for a long time and really the strongest Heather they had at the time of the diagnosis or before passing would be with you or one of your colleagues. So I just be very interested to hear you speak to that.
Yeah, you know those moments Tim are still so
to deeply etched in my memory because they were they were they impacted me a great deal as well. But you know in those moments, you know as a doctor you're trained to use your head and your heart but I found in those moments in particular that I had to get completely out of my head and just try to fully inhabit my heart and be they're not as a doctor but as a human being and I do think that all of us regardless of what stage of life or at we have we've got three basic needs. We all want to know.
That we matter we want to be seen for who we are and we want to know that we're loved and in those moments what I tried my best to do is to help people feel that they were seeing just simply by sitting there and focusing on them and listening to them by putting my pager aside by not standing at the doorway, but actually pulling up a chair and sitting with them by holding their hand often. The physical contact is such an important part of our human connection, and I tried to just listen to whatever it was.
That they wanted to talk about and there were times where I struggled I felt like, you know, maybe I should say something insightful or thoughtful or or empathic. But when I really look back on those conversations, I think the most important part was just showing up and being there and being fully present. So that's what I try to do. And you know, I had this ritual that I would do also like when they passed which is, you know, when a patient passes away you're always called.
The doctor to pronounce them and so you have to document that the heart has stopped that there's no corneal reflex, and there are series of steps that you have to take like that and so I would do that but I would also then take a minute just stand by their bedside in Silence with them and to just imagine sort of like the energy, you know of the universe just washing over them, you know with love and with kindness and that was my special moment with them.
And even though they passed I would like to I would hope that it was meaningful for their Spirit. It was certainly meaningful for me. But those are some of the things that I would try to do at the end of life. I don't know if they matter to made a huge difference in people's lives, but I hope that it may have eased the pain of their passing just a little bit. Thank
you for sharing that how do you think about your own mortality or relate to mortality and I won't get I don't mean to take this in a metaphysical or esoteric Direction, but
As someone who has witnessed a fair amount of death and no doubt thought about the finite time that you have on this planet at least for now. How do you relate to mortality or think about it?
It's really good question. You know, I think I think about my mortality often not in a morbid way, but in a way that I hope will remind me to appreciate the present moment. You know what I was in
Residency training. I remember one week being on the oncology service where half of the patients I was taking care of or young people in their 20s who had end stage gastric cancer.
And I was in my 20s at the time and it was really a stark experience for me because I could have been lying in that bed instead of them like these were accidents of fate. And so there's something about training in medicine those years and then caring for patients afterward that made me continually recommit to trying to be as present as I could recognizing that tomorrow is not guarantee. We don't know how long we have with the people we love but but we can make
Choices today to dramatically improve the quality of our life and the depth of our happiness and so it when I think about my mortality, I think I try to think about being fully present. Now I try to think like, you know after that my residency training I made a significant change for example and how I spend my leisure time, so I made it a point to try to come home to see my family in Miami every two to three months prior to that. I used to go about twice a year.
And there's no right number of visits to make to one's family. But for me, I realized that I wanted to be there as often as I could for the people who had given everything so that I could live the life that I have and to me that was the well worth it. And I look back on my life. And you know, we all look back in our life and we wonder if you made the right decisions and I the same I'm not always sure I made the right decisions on things. But in that one area, I feel like yes, that was the right thing to do to come see them more often. So yeah, you know, is it Dad?
Little different now. Also I think about mortality and it's bittersweet because I think about the things I may miss if I'm not here in terms of my children's major milestones in life. There are moments of great joy and happiness. I want them to find true love in life. I want to be there when that happens, I think about those moments and with a tinge of sadness, I would be sad to not be there but that makes me all the more want to live my life in a way where the time I'm spending right now is time well spent
Spent I'll focus on relationships and focus on giving and receiving love
there's a fantastic essay. If people listening have not read it by Tim Urban called the tail end that I certainly recommend everybody read that had the same impact on me in in the sense that I ended up dramatically increasing the amount of time per year that that I spent with parents in particular and also my brother
If you don't mind, I'd love to zoom out just to provide some context and maybe Define what this what the Surgeon General does and I would love to hear you describe the role of the Surgeon General and then how and why you ended up the Surgeon
General? Well, this is a good thing to talk about because I think very few people.
I'll actually know what the Surgeon General does even though many people know the position exists and that frankly includes people in government who don't necessarily know what the Surgeon General does even though. They may have a working relationship with the office of the Surgeon General. So I'll tell you when I actually became certain General it was a fascinating process and which I'm happy to talk about but at very few if any points in all of the conversations I had with people in the administration did somebody sit down and say okay. This is what you're
Job will entail so one of the first things I did when I became surgeon general's I went to The General Counsel at the Department of Health and Human Services. And I said, you know, I have a sense of what I want to do a Surgeon General of what the job entails but what I really want to know is what is the law actually say about what my job is because everyone seems to have a different idea here. And so what the law says is it says that the job of the Surgeon General is to be the commanding officer overseeing the United States Public Health Service commissioned Corps. So this is one of
of the Uniformed Services and the United States government alongside the Army the Navy the Air Force and the other Uniformed Services and the officers in the commissioned Corps are doctors and nurses and public health engineers and physical therapists and other health practitioners, but overseeing that service and serving is the vice admiral of that service is the statutory responsibility, but there's another responsibility that is evolved over time, which is at the Surgeon General is
To provide the public with the best possible information on health. So people can make good decisions for themselves and their families and that's taken on many forms some surgeons General have published reports and surgeon Del reports have become these iconic Publications that spark major changes in policy and in practice all around the world, others have taken to being out in the public often to the issue PSAs and to talk to people directly about steps. They can take to be healthier.
ER but all of this comes down to the fact that the job itself is actually quite flexible. And that was one of the things that I certainly appreciated about it is that unlike most other political appointees. Your Allegiance is not to the president Your Allegiance and in your highest responsibility is to the public and to science and I like that. So if there's a disagreement between what the President says and what science says you're supposed to side with science even if that puts
You at risk of being fired. So I liked that I like being able to create your own agenda and being you know, it sort of attuned to what the people want and being out there in communities across the country that really spoke to me. It was exciting to me and one of the reasons I ultimately felt the job was a good fit. When
would a listener if ever encounter one of these 6,000 plus Public Health officers.
Who were under your command? So to speak as vice admiral? I'm just wondering what in what context we can imagine these people working have and I asked in part because I'm hearing currently, of course. This is late March of the National Guard potentially building field hospitals and so on so would they end up in at a field hospital or are they working exclusively in?
Permit and don't have contact with civilians. Could you describe?
What types of work that the that Uniform service of 6,000 plus do
yes, so they do a variety of jobs throughout the federal government. So some are stationed at this Centers for Disease Control and prevention the CDC summer at the Food and Drug Administration some are at NIH the National Institutes of Health. So they are throughout the Department of Health and Human Services, but they also work at other agencies in government. They provide a lot of the Healthcare in the Bureau of prisoners, too.
How people who are incarcerated they also work in the National Park Service to help guide the department of interior on matters related to health when you may have encountered so these are people just to keep in mind who helped build and preserve and execute the infrastructure for public health throughout the country where you may have encountered them are actually during times of Crisis. So we deploy our officers to disaster areas when there's a major hurricane or tornado that comes through or major.
Flood after 9/11 we sent many officers to New York to help provide basic Medical Care and to help stand up the medical and public health infrastructure. When the Ebola crisis hit in in the Obama Administration, we sent hundreds of officers to Liberia to help open what was called the Monrovia medical unit and provide Direct Care to people there and the reason we did that was because prior to setting up the Monrovia medical unit countries around the world were not sending their volunteers.
To Liberia, even though the Ebola outbreak was ramping up a tad at a really scary Pace, but they weren't doing that because they were worried their volunteers would get sick and no one would be there to take care of them. But when we set up that unit when these commissioned Corps officers started caring for people then countries open the floodgates knowing that if they're member volunteers got sick someone would be there to care for them. So these are some of the many circumstances in which you see commissioned Corps officers and but you know, they are often invisible. We talk about them as one of the best kept secrets in the
US Government personally, I don't think they should be a secret. I think they should actually be much more out there and visible and that's something is leadership. We've got to do a better job on but they are a critical part of our health infrastructure in the
country. If we take a closer look at the Ebola crisis for a second. What was the term? You used the Monrovia on blanking taskforce Monrovia
in the Monrovia medical unit. There
we go medical unit. What was it like making that happen was that difficult?
To create this tip of the spear slash Vanguard to to go to Liberia was was that challenging to navigate sort of in inside the machine of the United States government or was that relatively straightforward or somewhere in between? What was that experience like for
you? Well, it was a very complicated experience and it was an experience of an Endeavor that was begun shortly before I entered office and that continued long after I got there, but it was not easy.
Easy for us to pull together because it required a fair amount of of legal work to make sure that we had the authorities to go abroad and to set up a medical unit like that. That was one piece of it. The second is we had to think deeply about how to make sure that these officers who had not been deployed to West Africa before had the training the support they needed to be effective and to achieve and accomplish the mission, but we also, you know had to deal with real human factors.
Factors that affect any Soldier uniformed officer who goes overseas during the theater of war whether that war is with visible soldiers or invisible agents like the Ebola virus, which is that there's trauma that comes with it as well. And it took us a while to get our of full I think handle around the extent of the trauma that was involved that officers experience when they went abroad, you know, knowing that their life was on the line and try to care for
or people who had Ebola so these are complicated missions. They're all so complicated because in government while government has powerful mechanisms for implementing change their complicated mechanisms their big ships that turn slowly and having to move quickly without breaking something having to collaborate with multiple arms, you know of the Uniformed Services and especially the Army in West Africa and with you know, the legislative branch and the executive Branch's was just took a lot of conversations a lot of
In a lot of putting out fires, so they always a messy, you know behind the scenes, you know, the sausage-making often is but it was worth doing because it was a key part of turning the tide on the Ebola crisis.
If you don't mind, I'd love to chat a little bit about the the pink elephant in the room, which is just for sake of Simplicity. I'll call covid-19. I understand there's a virus and then there's the disease and so on and so forth. But how are you currently?
Currently thinking about covid-19. What are people missing or misunderstanding or really? What would you like to?
Share in terms of your thinking related to covid-19
- there's so much that covid-19 is teaching us not just about science and health, but about our infrastructure and about Society more broadly. The one of the key things to recognize about covid-19 is as we're having this conversation. We've learned a lot about the virus but there's still a lot. We don't know, you know the several weeks ago when the during the early days of this outbreak there was an assumption that young people don't have much to worry about
And that this is an illness that primarily affects the elderly and those with other complicated medical conditions, but the data that we're starting to get now shows that perhaps that distinction was too Stark and that in fact younger people are more affected and get more seriously ill than we had previously thought. So this is a humbling virus. It's teaching us new things about it, and we've got to keep that in mind and and make sure that we approach it with caution and that we are on the side of being too.
Cautious and too aggressive in addressing it. I think the second thing that's important to realize about you know about covid-19 is that this virus is not the flu. This is a very different virus. It's much more contagious. It's much more deadly and we don't have any tools in terms of medications or vaccines to address it at the current moment and hopefully that will change over time. But right now we don't have those tools and we also don't have natural immunity in the
And because this hasn't been circulating for years, you know, I think the other part to remember here is that every now and then there is a moment in the world history where we are faced with a challenge that's far bigger than any one of us or than any one country can solve on its own and covid-19 has presented us with one of those challenges. And the question is, how are we going to respond? You know as a world, how are we going to collaborate to not only develop Therapeutics, but also
to help each other overcome shortages of masks and other protective equipment. Are we going to share data so that we can learn together about how to prevent catastrophe as the virus spreads across the world. It's a real test, you know of the relationships that we have between countries, but it's also and I think perhaps more poignantly at a test of the relationships we have in our communities, you know, we're coming to realize that with a virus itis it spreads really easily where there is no treatment yet.
one of our most effective mechanisms of preventing spread is to physically distance people as painful as that is as lonely as that can be it is one of the more effective strategies and so as we speak we're currently implementing that you know here in the United States and is not an easy thing to do but one of the things that it's already started to illuminate and remind many of us of is that we really do need each other but as much as we live in a
world that and in a country I should say that's built on an ethic of individual responsibility and that's built on a narrative of the single entrepreneur who builds the company or the single scientists who solves, you know, a major disease and finds a cure. The reality is that we are far more interdependent and interconnected than perhaps those narratives might suggest and I think that this experience of covid-19 is a powerful reminder of that and finally Tim I think
Covid covid-19 is pushing us to confront some messy difficult, but important questions and questions around what we believe people need to support them and what role government has in providing those supports. So in a scenario like this, for example, when somebody may get sick and they've got to stay home for a couple of weeks because they have covid-19 infection. What if they don't have paid sick leave then how did they take care of their child and make
sure that he or she is food on the table if they're an Uber or Lyft driver and they're depending on that income in order to help put their child through college or take care of an elderly relative. What do they do when nobody's out on the road taking rides because they're worried about safety. The truth is we don't have as robust a net to catch people and support people when they fall is we perhaps may have thought we had in the United States. And so this I think is a deeper moment for us, too.
Grapple with that and to ask well if we truly are interdependent, how can we best support each other as individuals and as a government, what do we need to do to ensure that people have the best shot at Living a healthy and fulfilled life.
It certainly is bring up a lot of inconvenient and important questions some of which you mentioned and one hand. It's been very uplifting as a silver lining to see how much certain communities have rallied.
Or coalesced grown stronger as a result of this where the importance of community and seeing each other's faces and so on has increased and I was struck earlier today. I had a team call with my employees and there is a very fast rotation where each person spoke about one thing. They were proud of and one thing they were happy about before getting into the business matters.
And we came up most often was seeing communities come together. That was that was the happy about point that came up the most and I do want to talk about that. I'm going to ask you about remembering your anchors and I have a whole host of other questions that I'd like to ask, but I'd also like to dig into covid-19 just a little bit more if you're open to it sure and again as a snapshot in time as we speak your
our City's Javits Center is being turned into a disaster hospital for covid-19 patients and or maybe overflow from other conditions. I don't know. I imagine it would probably be dedicated for covid-19. There's there's a lot of movement right now. There are some people who would argue that the United States has really been caught on its heels in a lot of respects and as not taken aggressive enough actions from the playbooks of South Korea.
Etc China other places if you were the benevolent dictator of the United States and your team came to you and asked what should be done at this point in time. Is there anything that comes to mind that that you would you would tell your team?
Well, yes, I would tell them about the three important principles that you have to make sure you adhere to and Disaster Response.
The number one you have to lead with science in your decision-making and lead with Scientists in your communication. The number two, you got to be transparent with the public even when it's painful. Not only because that's how you build and maintain trust which is one of the most important assets you have in fighting a crisis like this, but also because that transparency creates the accountability that you need as government and the third thing I would tell them is that our job
And we've been more than that our sacred responsibility in a crisis like this when people are putting their lives on the line is to make sure that we pull out all the stops to get resources to people on the front lines. And those are the doctors and nurses and healthcare workers and hospitals. Those are the public health workers and communities across the country who are trying to trace contacts and coming in contact with people who are ill those are the individuals who are impacted economically as we pull back.
On social interaction and is businesses shut down. Those are the three principles that have the guide us and in particular when I think about the circumstances in our hospitals, you know, it's so deeply painful to me because we we are encountering a pandemic that we haven't seen the likes of in over a century and we are not prepared for and we have certainly done some preparation for a major disaster.
Jurors, but this is not a typical disaster. This is far greater in scale and scope. And so we right now as we speak have doctors and nurses who are reusing masks and hospitals who are going to see patients and some cases doing surgeries without masks which is bad for the doctor and patient. But because there is no other option, we have hospitals that are running out of gallons and gloves. We have doctors who are trying to figure out how to take one ventilator and somehow rigged it.
So that it can care for two patients at the same time because they're running out of ventilators. These are the realities that were facing in our hospitals today in 2020 in the richest country in the world. And this is so boring, you know, it's and it's painful to recognize this but that's the situation that we're in with that means to me is that we we have to do everything within our power Avail ourselves of every Authority and mobilize every resource that we have access to
to ensure that we close the gap between what those Healthcare settings have and what they need because here's the truth. It's not just a moral responsibility. We have to protect those on the front lines, but on a very practical level as doctors and nurses start to get sick in larger and larger numbers because they don't have the protection they need when they're caring for sick patients that pulse will pulls people out of the workforce exactly when we need them in our hospitals and in further deepens the crisis
This is
how I would frame the challenge to my team. These responses are never easy, you know, I was in the administration in the federal government during the Ebola response and during the zika response and those are not easy either. We hadn't quite dealt with those kind of crises before and so, you know, they're always stumbles like in these instances. The question is not do you stumble the think the more important question is, how do you get up? How do you get up quickly? And how do you learn from your mistakes and Ensure?
Sure that you are serving even better as a result of what you've learned.
Thank you and feel free not to answer or we can punt but I'd be very curious adhering to those three principles of crisis response since you're the benevolent dictator you can you can on some level and cysts and enforce those three principles.
At this point in time what types of interventions or actions whether Statewide or Nationwide would you be considering implementing knowing what you
know, well, so a couple I mean there's a I'll just mention a couple of things that come to mind.
We have all the time in the world fortunately. This isn't morning TV smooth a luxury of space take all these more than
30 seconds to make profound statements about the world. Okay. That's great.
so a couple things I do number one, I would make sure that as the federal government that we were providing clear directives to States and localities about when to pull the trigger on various measures that they may take to protect their population including closing schools shutting down businesses issuing shelter in place or stay at home orders, one of the great challenges that states and
Cool government struggle with is how to make these decisions based on what criteria and what you see right now is a very uneven response, you know across the country and so people are confused. They're asking well, why is California issuing a stay-at-home order but other states aren't even though they may have a similar number of cases. It's because there's confusion in Bard. And so that's one thing I would do is to make sure that as a federal government. We were putting our nickel down so to speak and providing clear criteria to States and local governments about
And to implement some of these restrictions the second thing that I would do is I would take the responsibility as a federal government to make sure that we were filling the gaps in terms of materials and space that hospitals needed that doesn't mean that we have to provide everything directly ourselves, but it does mean that we need to be responsible for solving the problem. So if for example New York State and California state and Washington State are short on masks
it would be inefficient for them to spend all of this time looking for gloves calling vendors and fictive Lee competing against each other for a limited Supply. This is a place where it makes sense actually for the federal government to step in on to use its power to procure what's needed. And so that's a second place where I would exercise Authority the third place where I we do it the third area that I would focus on would be to ramp up domestic production.
The materials that we need particularly around personal protective equipment for healthcare workers is includes masks and gowns and gloves. Now. We have authorities that the federal government can use to compel Private Industry to produce these products. If they're in the National interest in this case, they are now I think we should only use those kind of authorities as the last resort because they are disruptive but part of what real leadership is about.
Is about bringing people together to do voluntarily what we need as a country to have done. And in this case, I think if we had a clear and compelling call to Private Industry with clear directives on what is needed and then the specs for what needed to produced. I think we would start to see more and more businesses who voluntarily switch over their production and start to produce masks and gloves and gowns
This isn't actually theoretical like even as we speak. I've spent the last five or six days in touch with multiple companies that have sought me out and are seeking other public health experts out saying, you know, I have a shirt factory or I have an apparent another type of apparel Factory. I want to help give me the specs. I will start producing today. This is the spirit, you know of America that we're seeing with people standing up in every corner of this country raising their hand and saying, how can I
I help and part of what we need to do as government is to give them the opportunities to help to make it easier for them to step up and to make a difference. So there's a you know, these are just a few of the things I think that are essential to do right now, but I think one of the last things in the really really important role of government in these kind of crises is to be in a sense the both the data keeper as well as the Storyteller and let me explain what I mean by that.
In moments like this. There are key questions that people want to know the answer to they want to know how many people have the illness how many people have survived how many people have been tested how many of those tests are positive are there shortages of tests anywhere and house quickly. Can we meet those shortages these are data questions and in the absence of having a clear place where people can go it makes a response much harder and we don't have full clarity on some of these critical data questions right now, but that
That absolutely needs to be something that the federal government steps in to help solve in partnership with States. But the Storyteller side of the coin is also very important. Storytelling is is is essential it's not just entertainment. It's how we process events. It's how we anchor ourselves, you know, in an experience. It's how we find meaning and make sense of really confusing times and the role of a leader and a crisis whether it's an
Leader or an organization like this case that the federal government that's taking the lead is to be able to tell a clear honest transparent but compelling story about the journey we've been on and where we're going you need to be able to tell people what we've seen and experienced what their real costs of it are but you also have to provide a hopeful path forward and help people see how we can emerge from this what the path to doing that actually is and how we can actually get there together. None of these things. I've described are easy.
But they are necessary. They're essential during crises. And these are some of the areas that I would focus on, you know, if I had the privilege of serving
thank you. It's been it's been fascinating to observe. At least on the on the state level Cuomo's daily briefings, which I think seem to be certainly a step in the right direction, but that would be needed if I'm hearing you correctly more so on a national on a national level God. I hope we can get
Back
together. I'm I'm optimistic and pessimistic depending on the on the hour in which you happen to catch me. But it's do you think it is possible in a country like the United States and we won't spend too much more time on the nitty-gritty of this but to implement some of the aspects of the playbooks from countries like say a South Korea or China that
I'm to have played roles in somewhat Edition sinisterly completely containing but lowering the are not of the Stars cuff to in these places for instance, you know, there's contact tracing and so on which seems like it would run into privacy issues in the United States if we're using private cell phone data and geolocation and so on you have sand.
Korea's actual penalties in other words enforcement of shelter at home, which I believe escalated over time to the point where they got to something like in the thousands between five and eight thousand dollars per infraction and I mentioned that just because a friend of mine told me that looking at Satellite data of San Francisco after the shelter-in-place command the foot traffic was roughly 60 percent of normal. So that doesn't strike me as a very leaky condom that you're using to
itís safe sex metaphorically speaking, right? So that that doesn't that doesn't really give me a super high degree of confidence in a compliant population without enforcement. Do you think we are simply to culturally different and to politically divided to implement some of these more some of these stricter measures or would you if you could Implement some of these things in the United
States? Yeah. It is a such a good question and
You know, you did some of the extraordinary Public Health measures that have been taken in South Korea and China to really stem the tide of covid-19 would be hard to take here for sure. But I think what we have in the United States in part as a result of our our cherished preservation of freedom and individual liberties is as the government. We have a greater burden of responsibility to ensure that we are
Explaining things in making our case to the public of what needs to be done. And so that is an important but not always an efficient way to achieve Behavior change. You mentioned that foot traffic intermit Cisco is 60% of what it was after the shelter in place order was issued and that's not that's not good. That's like, you know, that means that we're going to still see continued spread if there indeed is a lot of virus in the city which we have reason to believe there is
and so I think the burden of responsibility on the government and on leaders to really communicate in a clear and compelling way what has to be done. I think is much greater in society here with that said I do think that there are moments when the national interest is threatened where we have to ask ourselves what trade-offs are necessary in terms of individual liberties, you know to protect the national interest and we make these decisions.
The time for example, we don't say that individual liberty means that you can drive whatever speed you want on the highway, you know, we don't see the say that we've also said that individual Freedom doesn't mean that you can drive without a seatbelt. We've made mandatory seat belt laws that thing and see it's all across the country so as much as we may pride ourselves on being a country that preserves individual liberty, we have made thoughtful calculated decisions in many occasions on what
Trade-offs are worth it for our own benefit and also for the public benefit and I think when it comes to epidemic responses, what we're going to have to do in the aftermath of covid-19 is I think have a much deeper discussion about what kind of trade-offs we need to make to make sure that something like this does not react the kind of havoc on our country that a very well may and seems poised to do and if that means that we may need to consider contact tracing and our location tracing.
Part of what you know needs to be discussed and we should have that discussion. I'm not saying that everyone should give their data over to the government but these are the conversations that we need and debates that we need to have. We also have to ask ourselves what kind of power we want to give to different levels of government. Like what should a local government be able to impose in terms of restrictions on your movement. What about a state government? What about a federal government? So these are these are like these are tough and complicated questions, but I think part of the challenge.
We have with difficult issues in the modern-day setting in the United States is that when things are difficult because of the polarized environment in which we live we tend to move on and just focus on other issues. So we don't deal with climate change because it has become a politically polarized issue. We don't deal with many aspects of healthcare because they've become politically polarized and I think that if we really want to overcome that
And a polarization we actually have to do the opposite of what we hear recommended a lot. You know, I hear a live in Washington DC and I hear many pundits say well we really got to do is get people with different views in the same room have them really talk to each other and understand what their points of view are and then maybe they can find a point of agreement or convince each other that really never works the way people overcome these barriers the way they sort of bring
Ridge the polarization that they're experiencing right now is actually by building relationship first that has nothing to do with the actual issue at hand whether its climate change or gun violence or Reproductive Rights, but when we build relationship with each other or better able to talk to each other and listen to each other that's why many of us who may have an aunt or an uncle or a grandmother or grandfather who has views that we find to be disagreeable and Despicable we can still
Have them over for Thanksgiving dinner. We still want to have them over we can still respond if they're in an accident because we deeply care about them because there's a foundation which is the relationship on which rebuilding our conversations. The problem right now in America is increasingly. We don't have those bonds between each other. We don't have those relationships to build conversation and discussion on so what ends up happening is we're having discussions about polarized topics with strangers.
Who are easy to caricature and those discussions don't often go very well and it's reflected frankly with what's happening in Congress were members of Congress increasingly don't have relationships with each other and it makes not a surprise that it's harder for them to come together and broker real solutions for the larger public. I've
been thinking quite a lot about this polarization in what at least temporarily can suspend or make a relevant that polarization.
That 911 would be perhaps one example these acute losses of life these very graphic events that seem to unite people at least temporarily to take certain steps Pearl Harbor probably another fantastic example, right? So Japanese attempt to destroy Pacific Fleet under estimating sort of dynamic qualities and
variables that could change when the United States United and suddenly changed all of its production and so on to then later turn around and sort of exact Vengeance a thousand fold and I think I am on some level Darkly optimistic that I mean, it sounds terrible but I you know sort of anticipating that there could be something that graphic.
And I and awful particularly given the nature of every cell phone having a video and video camera and still camera embedded that would perhaps suspend the polarity the political polarity long enough to take really decisive action. Do you think there's anything that comes to mind as it relates to covid-19 that could act as such a catalyzing event.
What what would it take if anything comes to mind to temporarily give us a political ceasefire so we could take really decisive unified action.
Well, I do think Tim that covid-19 could be a catalyst for greater unity and for stepping back from the polarization and part of what gives me hope is that I'm already starting to see that happen here and there in communities across the country as people.
Reach out to each other and help each other. There's people checking on neighbors who are struggling now without any way to help them because they're alone and I've seen even on the local level, even though this doesn't get a lot of press, you know, I've seen local officials and to step up and put traditional partisan issues aside to work together because they recognize that there's something much much greater at stake and much more urgent which is the lives of the people.
That they're there to serve and I'd so I do think it can happen. I what I worry about is is this is does it always have to take a crisis particularly one that involves a loss of life and great suffering for us to realize that we truly need each other and that we need to come together and put our Collective well-being over individual interest. I hope it won't always take that but I do think that given the magnitude of
What covid-19 has already done and what it stands to do to the United States and to the world that this could be a wake-up call. This could be an opportunity for people to come together. The real question though Tim is will they stay together? And if you look back at 9/11 and at many of the tragedies we've experienced as a country. We do come together and what we see in those moments is I think the actual authentic intrinsic human Spirit, which is a spirit of together.
Spirit of interdependence the spirit of compassion and generosity and joy, but that gets quickly eroded as we settle back into our day-to-day lives and there are many reasons why we settled that and there are forces. I think in the messaging we see in media and from work and then the larger culture which keep pulling us back I think away from a focus on relationships, you know to what I find interesting is if you and I went to
a street corner in any major city in the United States and we pulled a hundred people aside and we asked them all what their top priority in life was I can almost guarantee you that all of them would have a person as their top priority maybe their spouse maybe their child may be their mother or father.
But if we look at how we live our lives if you look at where we put our time energy and focus if you look at what Society tells us constitutes success. It's actually very different like the message that Society sends us and in particular that young people get through the various forms of media is that success is driven by your ability to acquire wealth power or reputation / Fame and if that is what
This connected to then we'll build our lives around that that's where we'll spend our time. That's what we'll be thinking about when we go to sleep at night. That's what will invest our energy in.
But in reality, I think would gives us the deepest joy and fulfillment in our life is actually our relationships. And when I think back on the people that I had the privilege of caring for in the hospital at the end of their life, I think a lot about what they talked about in those final days and what they talked about were not their promotions that they received or how big their bonuses were any talk about how many
Followers they had on Instagram or how many friends they had in the world what they talked about really where the quality of their relationships they talked about the people they loved about the relationships. They wish they had spent more time with they talked about the joy that the people in their life brought them and I think that is a very powerful signal to us of what really matters that's not something that I just I'm seeing that something that people
In all walks of life who spend time with people in the father final days. This is what they focus on the focus on people. And so I think that if we want to ultimately address the deeper issues were facing is deciding whether it's the polarization were dealing with whether it's the challenges we face on the health front with chronic illness particularly with mental illness and with addiction. I think we have to ask ourselves what role does social connection and loneliness play
In the outcomes that we're worried about and what I have found over the last few years in thinking about this issue and talking to people who are I've studied this for a lifetime in hearing and listening to the stories of people all across the world who have struggled with loneliness, but we've also built lives a rich social connection.
Is that it is our relationships that are the foundation on which we build everything else good health fulfillment and a good life. How would you
suggest as we've been discussing? We've sort of Zoom from the macro into the micro which is where I would like to stay for a bit rather than looking at the federal level. Let's let's talk about a company if you're talking to a CEO or a c-suite or at liter.
of a large group of people within a company what are things that they can do to help improve the sense of connectedness or worth as a counterweight to loneliness, which I think that is going to be a challenge for life is a challenge for a lot of people and will increasingly be a challenge for a lot of people certainly over the next few weeks and
therein lies an opportunity to sharpen the saw as it relates to developing countervailing or counter balancing forces opposing isolation or loneliness. So what types of tools or advice would you suggest with Business Leaders people who run companies whether it's five people or 500 or 5000. Hmm.
I'm really glad you asked him because I think
The workplace is an incredibly powerful place for us to cultivate human connection. And I think when we don't have work places where people feel like they have strong relationships that has a measurable impact on productivity on retention and an overall satisfaction at work. There are some fascinating and researchers who have been working in this area including Seagal Barse at at at Wharton who have found that loneliness in
The workplace is just as common as it is in the general population somewhere that around 20-25 percent of people in the workplace seem to struggle with loneliness and the consequences are substantial. So whether you care about the bottom line or you care about the happiness of your employees loneliness and social connection matter and I think there are a couple of things that we can do in companies that that would really help I think one is to create opportunities for people to really see and understand each other for who
Are beyond the roles that they play in the workplace, you know, all of us have a fundamental desire to want to be seen for who we are not just as you know Tim who's great at pricing strategy or the vehicles good at COD. I don't know what I'm good at not sure but you know, we want to be known for more than a skill set. We want to be known as human beings who got a story. I'll tell you one example is something we did when I was a Surgeon General is we created this exercise called the inside scoop.
Exercise and we did this when after a year of working really hard to try to create a family environment in the office. We realized that people still were not as connected as they could be despite all of the weekend picnics and the happy hours and all of
that quick question before we get to the practice the inside scoop. How did you ascertain that you had that problem? Does that make sense? Like how did you diagnose that or observe that before we get to the inside scoop. I want to get
I want to also know how you diagnosed it because I would imagine there are plenty of Business Leaders who think everything is just hunky-dory going along swimmingly. Whereas in fact it is it is perhaps not so if you could speak to that.
Yeah, so, you know, what we didn't do is we didn't have a very specific survey tool that we use to assess in a quantitative way whether people felt connected or not those kind of tools actually exist, but we need you.
Them but we were going on was actually a more much more simple observation from my perspective. I was observing the office and feeling that people were not stepping out of their Lanes enough to help each other. Now, that's a voluntary thing. It's not their job description to help someone else with their job, but it wasn't happening to the extent that I thought it should be happening and I started to wonder why and to me when I think about the work place a lot of my my my thinking comes back to the model of the family. So in a
Family people help each other. Why do they help each other because they feel a sense of commitment and connection to each other because they know each other deeply so even if somebody messes up is the deeper well of knowledge about who that person is that makes you more likely to forgive them and to give them the benefit of the doubt in a workplace. I think you can ideally create a similar kind of environment. So the fact that the people were not stepping out of their Lane enough to help each other made me think that their connection to each other was not as strong as what we wanted it to be
and so this inside scoop exercise that we instituted was actually very simple. It was five minutes in our weekly all staff meeting where we picked one individual and we asked them to show us pictures for those five minutes pictures of anything. They wanted except it couldn't be connected to the work that they were doing right now to their current job. So some people showed examples of careers. They had before others showed pictures of their families people pick what they wanted was really powerful.
About this despite our simple a wise. Is it gave people a chance to share who they were without any pressure and the sense that like we weren't telling them to like fits fill some criteria to generate some sort of response have a list of questions that they could pose to the group. There was none of that. It was just very simple show us something that you'd want us to know about your life. I'll tell you the one gentleman in particular who is my aide to camp and was in the Marine Corps prior to joining the Public Health Service.
We all thought that he might show pictures of his time in the Marine Corps. You was his strong allegiance to the Marine Corps. He talked about his experiences there a lot. He was also very stoic. You still had her same crew cut and haircut that he had in the in the Marine Corps. He had maintained, you know over all those years. He was what people in the office called a guy's guy and when the day came though for his exercise. He didn't show pictures of his time in the service when he showed her pictures of his mother.
And pictures of his father and he said that he could see the musical Talent of his father living on in his children as they tinkered with the piano. He said with his mother that when he was in him in those moments of grave danger in the Marine Corps when he was deployed on missions where he wasn't even sure if he would come back alive that in those moments when he felt the fear rising in his stomach. There was his mother that he would think of because she was his picture of strength. She had raised him in here his
Largely on her own. She had fed them and clothed them and got them an education and help them build a successful life and that to him was real strength when he shared that story Tim. It was so deeply moving that five minutes of sharing built relationships that we have not built over the past year and within a few weeks. We started to see people stepping out of their lanes and helping each other. We started to see people who had previously been quiet.
In meetings start to raise their hand and participate because they felt that they were seen and that they were appreciated for who they were that was a very powerful moment for our so workplaces that can create opportunities like this semi structured opportunities for people to share more about who they are that is very powerful. There's one other thing to him that I want to mention also which is that there's great power in people helping each other in the workplace and one of this story
That I came across when doing research on loneliness was their stories and their in the research of of a gentleman at the University of Michigan Wayne Baker at the business school there who's done a lot of work on relational energy on understanding what our interactions with other people due to the energy we feel and how that energy translates into productivity in the workplace.
And one of the things that he has found is that high quality connections, which can be lasting friendships or momentary interactions both can be extraordinarily powerful and raising our energy level and one of the things that really boosts that relational energy is the experience of helping someone else but also the experience of receiving help from someone else. So what he did, is he along with Adam Grant and a few
Earth put together a structured sort of tool through a company now that they've built called give a toss which allows organizations to have an organized setting where people can be a part of a community where they submit a need that they have and other people can submit answers or offers of help to meet that need and you can do this online. You can actually do it in person and regular sort of gatherings.
In groups and companies, but the point is that the experience of being able to identify people's needs and then have people step up to meet those needs in a structured way can be extraordinarily powerful and can significantly boost relational energy. But the final linked image is hard to put into you know, a specific protocol has to do with culture in the workplace and creating a culture of kindness and compassion is extraordinarily important if you want to
Build human Connection in the workplace and have people build strong connections with each other and that is not something you can just put on your mission statement or your value statement stamp it on the wall and just hope it happens. That's a place where leadership by example really matters, you know people is despite all the cynicism that we have in the world people still do look to their leaders for examples and when the leaders in organizations treat each other with kindness when they look
Look, you know to people throughout the organization give them time and actually listened to their concerns honestly and empathically that makes a difference people take note of that. And so I think these are some areas, you know, that can be extraordinarily powerful in the workplace in terms of how we build connection creating opportunities for people to see each other for who they are creating opportunities for people to give and receive help and helping to build that culture of kindness and compassion through example and through practice these I think are the key ingredients
The building a connected workplace. I
love the inside scoop exercise and and I have a a question about the specifics in one respect because I want to try this and I will try this with my employees. I am lucky in the sense. Well, at least in one sense that I have a very small team how many staff members did you have in these
all-hands meetings. So these meetings were meetings of our immediate office so they were about 20 people.
How did you pick?
The people who would go or how were they chosen the goal is
to go through everyone in the office, but we started with the people who is we saw it were the least seen in the office either because they were the quietest or because they may be work from home often and people didn't see them very often. So that's how we started hmm
makes a lot of sense and the company you mentioned I believe co-founded.
By Adam Grant if I heard you correctly is that give it to us like gravitas or what? Okay, could you spell that? I can take a stab at it, but it isn't. Yeah, if you wouldn't mind just so pure and we'll put this in the show notes as well. So people can find it. But just so that people know the spelling.
Yes. Oh, it's GI VI Tas.
Alright, we will put that in the show notes for everybody at Tim double OG forward slash podcast along with everything else.
If people wanted to pull their employees or ask questions of their work force, are there any questions that you would suggest? I know that that's not how you approach this you were missing it more on the observation that you described but are there any questions or tools that you would suggest for people who want to check the pulse of their of their of their team?
So a couple of things I would suggest if you are looking for an actual
Survey the Gallup organization actually does poles around social Connection in the workplace and you can look to their questions as as one set of serve as a survey tool that you could use the other survey tool that you could use is the UCLA loneliness scale which is a different versions of it as a 20 question version of it. There's also a three-question version on both the validated tools, but that may give you a sense of how much loneliness there is in your organization if you are looking for
One or two simple questions. One of the interesting ones that has actually been found to be quite useful as an indicator and the Gallup polls has been the question. Do you have a best friend at work? And it turns out that people who do not have a best friend at work people who answer that question no have significantly lower engagement in the workplace. And that engagement is tied to productivity at the end of the day and also impacts how people feel about the company and their colleagues.
Writing it down and I promised earlier lest I get chastised by my listeners that I would ask you about anchors and remember your anchors. Could you please speak to what remember your anchors means and also describe your anchors and why they're your
anchors. That's an interesting. You asking me that can I ask you where that question came from Tim?
Yeah. The question came from homework. I was
Reading a Forbes piece. And the that is where the mention of anchors came up, but you can't believe everything you read on the internet. So perhaps I have been reading an interview of Victor Lake and miss and miss attributing but I'll read what I have in front of me and we can use that as a jumping off point. So
feel free. Actually. I know what you're talking about on that was art. That was actually Vivek Murthy not Victor like so we're
on Solid Ground.
Here perfect. So perfect
Tim. Remember your anchors is is a piece of advice that I developed to remind myself actually of often when I was in residency. And you know when I was in residency training, it was a really intense experience for me. I was both dealing with life and death every day. I was seeing people who were Gravely ill who were my age and who very well could have been me.
I was also though trying to figure out a lot of stuff in my own life. I wasn't sure what I wanted to do. I was kind of going through yet another identity crisis or trying to figure out do I want to be a doctor under percent of the time to want to be something else? So I was trying to figure out a lot of stuff and I was dealing with a tumultuous sort of intellectual and emotional experience and in that very unsettling ungrounded time in my life. I found that what I really needed was some
Force that would ground me in my life and I began to think of those as my anchors the forces that we keep me tethered that would make sure that I didn't float off, you know in these moments of hopelessness and worry and anxiety and those anchors ultimately were people in my life. They were my mother and my father my sister they were a few close friends like my friend. I'll kill who was my roommate in college these became
Anchors and what I want what I try to force myself to remember in the years that followed well after I finish residency is that I need to be keep tracking it keeping track of whether or not you know, I'm remembering those anchors and reaching out to them and staying connected to them because it times in my life where I have felt anxious and worried the times where I felt just lost frankly of which there have been many.
Any including very recently those moments are often when I've lost touch with the people like in my life the people who are really the ones who know me almost Better Than I Know Myself the people who can remind me of who I am even in those moments when I forget and I want to say that last part again because that to me is a true definition of a friend and this came from somebody that I spent some time with in college.
Overseas trip to India to do HIV work in one of these like late night. So to philosophical discussions. I just happened to ask them was like hey. Hey, man, what do you think real friendship is about and he said to me just pause for a moment. He said a real friend is somebody who reminds you of who you are even when you forget and that is stuck with me and those people are our anchors there the mirrors that we need during moments in our life where our vision is foggy, and we can't really see our way out of the Fog.
And we don't know who we are. We don't know where we want to go. We're just lost and so anchors to me. Those are people those are relationships. That's what we've got. Hold on to regardless of what stage of life where at
it is easy for me at least to forget who I am. It's easy to lose lose the plot there that's supposed to probably shared characteristics and that typify the episodes in which that's most likely to happen.
You mentioned a recent experience of feeling lost. What was that? What happened or what? What what caused that feeling to come up for you?
Well, it was when I ended my my stint in government when I was no longer Surgeon General and I was back to being a civilian and I was trying to figure out what to do with my life. That was the time of real difficulty for me. I
I was I was lost. I was lonely. I was probably depressed I was
Unsure if I had any value to contribute to the world and if I did I was unsure how to actually Unsure how to actually deliver that value. It was a really hard time and you know part of it was that and I even told myself this during my time in office. I was like, I'm here as a custodian of an office and I'm the custodian of the office of the Surgeon General but the Surgeon General is not my identity.
That's not who I fundamentally an intrinsically am as a human being to an office that I'm occupying but despite all of those sort of warnings and admonitions. If you will like they were still sort of a shift in identity that had happened to me when I was in office where I think almost just by perhaps by necessity, you know, we you know, I don't want to say we I should say I like took on the the trappings of that role.
And and came to identify very strongly with then. I wanted to be a good shepherd for the office. I wanted to set the office up to be stronger for the person who inherited it after me. I wanted to do those things but it became kind of part of who I was and when when I was no longer Surgeon General which happened I mean we're being open here. It happened in a very dramatic way, which I'm happy to delve into if you'd like, but when it happened it was it was it was difficult to sort of
All of that and there was a part of me which felt like because I no longer occupy that office that somehow people wouldn't want to engage with me or maybe they wouldn't think that I had any value to add the word to the world or maybe the same very things that I had said back then if I said them again would somehow be less valuable because they were not coming from somebody who held that position. They were all of these thoughts often irrational thoughts that were going through my head and it was really really hard to him it was
One of the loneliest times I've had since my childhood. I
want to ask you how you found your way through that or out of that the things that most contributed and certainly I mean, there's might be a component of regression to the mean but I would love to ask you about pieces of the puzzle that you found particularly helpful for getting through that period but just so my listeners Minds don't
Wild with all sorts of imaginative scenarios. Could you could you speak briefly to why the transition was so traumatic you don't have to share of course any detail, you're uncomfortable sharing but I do think a little more context would be helpful and frankly. I'm also curious myself because you and I haven't haven't spoken about this.
Hmm. Now we have at em, yeah, so I'll tell you so the is office the Surgeon General is an unusual appointment.
It in government in that it even though it's an appointment made by the president. The term does not end when the president leaves office. So the vast majority of political appointments will end on January 20th when the new president takes office and you submit your resignation letter and then you move on and you give the new president the opportunity to appoint their people. That's how it works. But there are a few positions where that doesn't happen. There are called term appointments. So you're given a four-year term and that may run into the next Administration.
But you you just serve that term but you still serve at the pleasure of the president. So if the present new president comes in and they say, you know, I've got my own person that I want to appoint and I would like you to step down then, you know, then you make room for the new person. So in certain General is not the only position that's like this. The FBI director is another there are several. I can in the federal government that have term appointments in my case. What had happened is that my term technically ran until
December of 2018 there's a new Administration that started in January of 2017 and you know for various reasons, you know, I knew that it was a possibility. I might be asked to leave and you know, if that it came to that, you know, I wanted to you know to make room for the president's pick, but the way it sort of happened was was a bit surprising to me because there was it was one of those things there was really no discussion sort of about it.
Often there is but it was sort of in the early days, you know, probably four months and three four months into the administration where things were still a bit chaotic people were finding their footing and figuring out the building. So one day I had a meeting at believe it was three o'clock on a Friday in April and I was supposed to be meeting with with the one of the assistant secretaries and I walked into the room and the assistant secretary was sitting on the side not
it in his chair and I was surprised but there was somebody else sitting in his chair and he said to me he said well, you know as if three o'clock, you know, we are going to terminate you unless you resign right now.
And I was puzzled because the same person who is in that chair and actually I had meetings with him before and he had said hey, we're really excited to work with you on your opioid initiative because the opioid epidemic is a big problem. It's a bipartisan issue and we know you've been doing a lot on the issue. You've been leading a lot in the country on and we think this is going to be an area of collaboration. So I was thinking of myself as well. Yes, you know would be great to work together on that because it's still a huge issue for the country. So I was gearing up to
Working on on the opiate crisis. So I literally did not expect that message nor did I expect it from this person? And so I looked at the clock at that moment and I was 307 and I said wow it if I would mean terminate as a three o'clock, then that means that I'm already terminated. So I guess I guess there's no point to having a discussion, but he seemed insisted on trying to get to get me to resign and so it was this sort of awkward back and forth where I said, well, you know, I
Respect the president's decision. The president would like to you know, like me to move on to bring his own person and I said but it feels like it would be an authentic for me to resign and try to claim that, you know wanted to spend more time with my family or something like that. That's just it didn't feel authentic. It didn't feel like it was real and I said, you know with respect if you wanted to pursue a termination and if you want to appoint your own person and just do that, it's within your rights like like this.
One's Gonna question that it's fine and that's how I left and so it was abrupt. I never had a chance to say goodbye to my team and I didn't have a chance to you know process. You know, what all this meant. It all happened very suddenly and
I remember going home and I you know had a few minutes to pack my belongings into a box and I got into a cab and started going home. And you know what my first worry was that popped into my head on the way home was what are we going to do for health insurance for our baby boy.
It sounds like a difficult difficult ride. It was
it was
Yeah, it was and I was aware in that moment him that.
What I was worried about then terms of health insurance for our boy and for the family was a worry that a lot of people have around the country every day. We're teetering on the edge of not having the health care they need but in that moment, you know, I was just I was just a dad who was worried about his child and they were a lot of practical things to figure out and the days that followed one thing I didn't really do in those early days as I busy.
Software trying to figure out a lot of the logistics. Is it really I think fully give myself this space to process everything that was happening the sort of a re anchor myself not just in my identity, but in the people in my life who had for so many years help me to remember what my real identity was that my real identity wasn't being a doctor wasn't being surgeongeneral. It wasn't any of
of the titles that may have held at other points in my life. My real identity was
The human being I was as a friend and as a brother and his a son to the people that I love and it was the values that I cherished in my better moments the values of compassion and kindness the values that are intrinsic to all of us, I think in our best moments like that was really who I was that was my identity, but I didn't give myself enough think space and time and frankly. I didn't I think I blame myself also for what had happened in some way even though on rare.
Level, I knew that it wasn't my fault per se I blame myself somehow maybe if I had done things differently. I maybe still would have had the opportunity to serve and to finish so many of the campaign's that we had been building around the opiate epidemic around loneliness around emotional well-being and you know, I was doing all of this Tim in the absence of community. It wasn't because my friends had shunned me.
It was more the other way around, you know during my time in office. I had I had convinced myself that it was so important to pour myself into the job because I never knew how long I might have and I wanted to do as much as I could and make as much of a contribution as I could that I convinced myself that I should just leave it all on the floor and sacrifice everything for that which men not keeping up with friends not talking as often with my
And also I'm somewhat ashamed to say meant that a lot of times when I was with people I loved I was distracted. Just trying to keep up with with messages and get deliverables out the door and I look back on all of that and I started to realize what a toll that decision that approach to my work had taken start to realize how lonely I had become and how little Community I actually had and so I had to live with that for a while. I had to figure that out.
Out and it was not easy. It was painful at times. I felt ashamed, you know of having done this, you know, I knew I could just call up those friends and reconnect again, these are these are friends for life, but I felt embarrassed that I had disappeared, you know for a few years and it took some time for me to summon the courage to reach out and to actually pull myself out of you know, my my shell in my sort of downward spiral to just say hey, let's
Is pick up the phone and call a friend? Let's make it a point to go visit. You know, somebody who's been really into your friend to me for years, but I haven't seen and doing that bit by bit Tim that helped another packed. I made actually during that Journey with two friends in particular when we met at a fellowship Retreat. We're walking around this Lake together and these are two guys I love to death and their their bike brothers and
we never see each other the very often because we live in different cities and we're just saying how awesome would it be if we could just get together more often. I was like it's never going to happen unless we do something different. So we made a pact then we said, you know, what we're going to do. We're going to once a month. We're going to video conference with each other. We're going to make that commitment right here right now to each other and when we video conference, yeah will you know will have fun will shoot the breeze here and there but we want to make it a point to talk about the hard stuff with each other the stuff that doesn't normally
Come up between friends the want to talk about our health want to talk about our relationships when I talk about our finances the kind of stuff that everyone worries about but that not many people often feel comfortable talking to friends about but we want to be real with each other and I felt this hunger for that kind of realness. I was like, I'm tired of trying to think about who I should be. I'm trying to tired of thinking about like what my identity is what my brand is what brand I should build like. I had all these people after were telling me. Okay, you gotta get on social.
And really build your presence, you got to establish a brand so that you can get Consulting gigs and get on boards and do all this kind of stuff and I just felt so unhappy with that kind of approach. It just didn't feel like in feel authentic. It didn't feel real didn't feel like who I was and what I created was that realness. And so when I saw these guys I was like, let's just make a commitment to not just spending the time but to be real with each other and we've done that now for about a year and a half. I'll tell you it's been one of the most powerful forces
In my life and helping me re-anchor remember who I am what my real identity is and commit to working on the things that truly feel like they're in alignment with my values the stuff that I would be proud to tell my children about when they grow up that's the power of what honest authentic relationships can do and I'm just so grateful for it.
I really appreciate you being so vulnerable and transparent with all that you just shared. I think it's it's really easy.
has someone I shouldn't generalize speaking personally as someone who struggled with depression in during which
The response to feeling lonely and isolated is often to isolate further which deepens the feeling of loneliness. As you said very early on in this conversation. It is a it is a prominent feature of
I think the or common experience the very least of the majority of humans who walk the face of this planet. It's it's not a reflection of being uniquely flawed to have these emotions and to experience these episodes and it's I just applaud you for sharing because it's so incredibly powerful when someone like yourself who even
you don't necessarily identify as such who has achieved very high levels of success in multiple areas former Surgeon General are willing to share that in fact you also have
Gone through these experiences I think in a way and Nobles and normalizes that experience for other people. So I really appreciate you sharing all of that and it it actually leads to a question for me and maybe a comment and then a question. So I was doing homework as I always do for this conversation. And before I get to my comment on my question, I'll give a pre comment comment, which is
You you should if you don't already. I feel like you could impact millions of people very effectively and authentically with a podcast. So to be continued as far as conversation, you may already have a podcast and I'm just putting putting my foot in my mouth, but quite a number of people have been on this podcast.
Cast Jocko will Inc. Caliph Osman Peter Atiya and others who have started podcasts and I so far have a hundred percent success rate at predicting which guests can do well in this format. So wait to be continued and we can we can we can chat more about that if you ever wanted to thank him. I'll of course. Yeah, of course and the comment is related to a Washington Post piece. This is from 2017.
Quote here, please. Feel free to fact-check, of course, but this is attributed to you. I was at a well-known University about nine months ago when I was in office and I asked an audience of 400 faculty and students the following question. How many of you look at emotions as a source of weakness versus a source of power and nearly every hand went up. This is the Paradigm. We have to flip in this country. Could you comment on that please or share anything that comes up as I mention that and also speak to how you if you
Have been able to view your own emotions as a source of power.
He had Tim, you know that was surprising moment for me. And when I saw all of those hands and that room of 400 people going up saying the associated emotions with weakness, and I think one thing I've noticed in my own life is that I have been in that camp often as well if I think about growing up in the messages that I absorb from
The stories that were around me whether those were on TV or told by people or in movies it was that especially if you're a guy that strength is associated with suppressing emotion and its associated with stoicism and with not needing other people not being dependent. That's what strength is and what I realize is that that didn't work for me. Like I didn't enjoy being the guy who's out there in need anyone else for anything because I actually did need people for stuff.
But I just felt embarrassed to say that because I was told that somehow that wasn't manly or wasn't strong similarly. I like terms of emotions. Like I have always been an expressive person. I've always thrived on emotions. It's been you know, I've engaged in intellectual Pursuits, but I know I'm primary primarily driven by emotion and I feel like that has been my source of power not a source of weakness. And so, you know in thinking about this I have an in talking to
There is about it. I've just realized that our emotions are not a source of weakness. They are. In fact if used well our greatest source of strength, like when you look at an elite athlete, for example, you will get someone like Serena Williams or Lebron James people. I don't know personally, but I'm using them as examples. My guess would be that they recognize that the difference between good and great is not just how much time you
you spend in the weight room or on the treadmill. It's about your ability to translate your negative emotions into positive emotions into a source of power. And that's what we do in our better moments. Like you look at parents, for example who go through extraordinary lengths even putting themselves In Harm's Way for their children. It's because that's driven by the emotion of love and emotion. That's far more powerful than anything else than any that we have out there are emotions.
Our greatest source of strength and so I think part of what we have to do as a country, especially for our boys but especially but for boys and girls is we have to redefine strength as vulnerability as human connection as belonging as a motion if we recognize that strength can be drawn from those moments of emotional vulnerability than we can draw upon. I think one of the greatest resources
That we actually have you know, it struck me many times when I reflect on my own life and thinking about others that it seems like there are two primary forces that drive us in our life and they drive the decisions that we make and those forces are love and fear and fear shows up in a bunch of different ways. It shows up as insecurity or jealousy or rage or anxiety.
And love also shows up in different ways is compassion as kindness as generosity.
as warmth
and when we lead with love, then we can transform other people's lives. We can transform the organizations that we are leading.
When we lead with fear, then that's corrosive at infects the environment in which we work in the people around us. And when we think about the decisions that we make as I have in recent years started to do I ask myself that question. Am I making this decision because of Love or fear I'm making this decision because I'm scared of something or because I'm being inspired by Compassion or by generosity or by kindness and I find almost
Always if not, always when I make decisions that are driven by fear. They rarely make me feel good. They often lead to poor outcomes when I make decisions that are driven by love, even if their risky even if the outcomes are unexpected, I almost always feel better and I almost always grow in some way as a result of those. I mentioned this in particular Tim because I think it is so important for us as a society to be able to talk not just about emotions that about love
because love is the greatest source of strength that we have, you know, I as a doctor have written many prescriptions for powerful medicines and antibiotics, but there is no medicine that's more powerful than love and you don't need a medical degree or to be a nurse to be able to deliver. The power of love to other people's lives. Will you need is the very human and Universal ability to respect and be in touch with your emotions to
It's already inside you and that's the Power of Love well said
sir, and I cannot think of a better possible time for your new book and that I say that with the utmost sincerity. I mentioned it earlier at the very top of the show but together that's the title subtitle. The healing power of human connection is sometimes lonely world. I feel like this is along with the message that you just shared.
Possibly very good medicine for our times certainly with with what we're facing which is in some ways just bringing to the surface and magnifying that which is already there. I feel the loneliness certainly a pervasive loneliness and I would love to I would love to hear anything you'd like to say about the book. It's a hell of an undertaking to write a book and him I do I specialize in writing phone books for God's sake so I said, so
So to write a to write a shorter less than phonebook is even harder since one could argue that I should better edit my own writing and I'd love to hear anything. You'd like to share about the book and why you would pursue such an undertaking given what's
involved. You know Tim. This is not the book. I thought I would write I had a couple of ideas for other books that I was convinced would be the places I should focus on but you know a funny thing happened.
To me in 2017 in the summer.
I am wrote an article for the Harvard Business review on loneliness in the workplace. And you know, I wrote it at the request of the editorial staff who thought that Their audience would be interested in loneliness. I said, are you sure and they said no, we're not sure but we think it would be of interest and I wrote that article thinking. Okay, I'll do this and I'll move on to the next thing but I was really struck by the response to that article from two groups from members of the media.
Who
said from around the world? Who said hey, we think this is a problem in our country to the messages from individuals who said, you know, I've been struggling with loneliness for a long time, but I never knew that there were so many other people out there. I never knew what the consequences of loneliness were to our health and even despite that response it the universe kind of had to whack me over the head a few times and make me realize that this is actually where I should be putting more of my efforts because even during my time in office it had just kept surfacing.
Missing again and again this issue of loneliness the stories that I wouldn't listen to in living rooms and in town halls all across the country. They were stories about addiction. There were stories about trauma and abuse stories about chronic illness and about violence in communities. But in the back of those stories almost hidden from view were these threads of loneliness that would often come up and see what people would say was not you know, hi. I'm Tim I'm struggling with
loneliness what they would say were things like this they would say, you know, I feel like
I have to deal with all of these issues in my life on my own. I feel like nobody out there really cares about me. I feel like I'm invisible. These are the kind of things that people would say again and again and what I come to realize over time is that loneliness is more than a bad feeling but it has real consequences for our health. And if you look at the research, that's out. There you find that loneliness is associated with a shorter lifespan you find that
It's associated with an increased risk of heart disease and dementia and depression and anxiety the immortality impact if you will of loneliness is similar to the mortality impact of smoking 15 cigarettes a day, it's greater than the mortality impact of obesity or sedentary living these three issues smoking obesity sedentary living these are issues. I spent a lot of time on as Surgeon General and sort of my predecessors by so far less time.
On loneliness, even though the health consequences are quite significant and you know as I just started to think about this issue more even after I came out of office I start to realize it this is an issue that doesn't just affect our health. It affects how we show up in life, whether that's how we show up in the workplace or how our kids show up in school or how we show up in the Public Square and dialogue with other people. And so it turned out that our social connection is in fact the foundation on which we
Build everything else and I came to see that I wanted to work on strengthening social Connection in the world because if we could do that, I really feel that we have a better shot at improving People's Health and enabling them to live the kind of fulfilling lives at all of us ultimately really want but I think to do that to build a world that is powered by human connection. We've got to make some difficult and very intentional choices about the kind of culture. We want to live in and about the
Of workplaces and schools that we want for ourselves and for our children, you know if I had a CREDO Tim for this book, it would be this it would be put people first that's simple philosophy put people first is I think at the heart of what we need to build a people-centered life and a people-centered world and that's the kind of world where we put our time and energy into our relationships. It's where we design our workplaces and our homes.
And our lives around relationships that matter it's where the dominant culture whether that comes through and the media or the stories that we tell recognizes the power of relationships and inspires us to be real with ourselves and with each other. It's where a culture recognizes that it's one where authentic and when we're vulnerable that we build the true connection that powers everything else that we do. That's my hope.
For the world. That's my hope for my for my children and the kind of world that they will inherit and one of things that pains me most is the data is thinking about the moments were my children may encounter hardship or pain and knowing that I may not always be there to support them or to hold their hand or to hug them. I know that that will happen every parent deals with that pain of knowing they can't always be there for their child and that's why I think it's so important that we build a kind.
World that will lift our children up when they fall down where people will reach out to them when they're feeling alone to provide them with the support that all of us need at various moments in our life. So my this is not a what I'm talking about is not a subtle change in policy. It's not a new law that we pass that suddenly changes, you know, the nature of human connection. This is a fundamental shift in how we think about our lives and how we think about our institutions and how we think about Society but
it's a kind of shift that puts people back at the center and I think can ultimately power us to a much much higher level of fulfillment achievement than what we've achieved so far and that's what I want to do to him. You know, I want to work on things that will build a better life and a better world for all of us and for our children if I can contribute in some small way to that then then hopefully I can in the final days of my life like the patient's I cared.
The end of there's I can talk about the relationships that I had I can talk about the kind of world that I hopefully made some small contribution to help create and that would feel very good.
Well the Vic I must also say thank you for not only the conversations that we've had including this one but also for your your emotional support and compassion.
Last week in my case. You're deeply compassionate kind and also calm and calming person and I appreciate you last week when I had a fever shortness of breath and track off for 24 to 36 hours. Then shortly thereafter sort of coinciding my dog having what appeared to be exactly the same symptoms that you were so available and
Are standing as of course, we ended up rescheduling given that I was feverish and not in a proper State of Mind to conduct a good interview. So I want to also just publicly say thank you for for that which is a sort of microcosm of the macrocosm in the sense that it's reflective of what you are hoping for and aiming for and helping to Foster with
You're certainly your message and also the book which is together, and I just appreciate you being you. So thank you for
Both the personal help and also what you're trying to do in The Wider World. Well,
thank you brother. I appreciate that. That's it's incredibly kind of you to say
and I know people want to wave hello and ask questions. Thank you for the interview. They could find you. I suppose the home base is the vector Murthy.com. I'll spell that VI ve K mu R th why.com. They can find you on Twitter.
I'm so self-conscious about saying your name now on Twitter at these Vic underscore Murthy and then Facebook Instagram at dr. Vivek Murthy. I think the key is just for me to say it quickly and not get too Tangled Up In My Own vocal cords.
I'm just glad you didn't call me Victor Lake
Tim. I'm saved. I'm reserving that for special occasions and the book as mentioned is together.
All the healing power of human Connection in a sometimes lonely world. I certainly recommend among other formats get it in all formats, but make sure you get an e-book so that you can highlight. I'm sure there will be ample opportunity. Is there anything else you would like to share with my audience or say before we before we close this this first conversation on the
podcast? Well, I just want to say thank you to you Tim. I think what you have done through your podcast and through the work you've done.
And through your books is you've created spaces for people to to show up to be authentic to have deeper conversations. And that's incredibly valuable in a world that's moving faster and faster and faster where we are can get lost so easily so I appreciate so deeply what you're what you're doing. And that maybe I'll leave you with a one of my favorite Proverbs and old African proverb.
it says if you want to go fast go alone, if you want to go far go together, and I'm reminded of that is we talk because I think that
We need to do in our lives but also in the world is we need to we need to go far and we're facing some pretty big challenges as a society and they won't be easy to overcome but moments like this whether we're facing a pandemic or longer term crises, like climate change moments like this. I think our opportunity is for us to find each other to re connect with each other to refocus.
On relationships and to put people first and my hope is that we will use these challenges to do that. And that when we emerge out of them that if we are intentional, you know about spending time with the people. We love of her intentional about making that quality of that time high quality time my reducing distraction and really just focusing and listening to people if we're really intentional Tim about serving and recognizing that it is through our service.
There's that we ultimately pull ourselves out of loneliness and build strong connections. And I actually think we can emerge from these crises stronger than we were even before and that's why I remain hopeful about the future of humanity because I think we were designed to be there for each other. We were designed for connection. And if we focus on the relationships in our life, I think we will go farther and have a much more fulfilling.
Filling experience than we could even imagine. So thank you for this time together Tim. I really really enjoyed it be
to thank you so much. And for people listening I will have links Galore lots of resources anything that was mentioned in this conversation will be able to find in the show notes at Tim top log forward slash podcast and you can find Vivek Vivek Murthy.com. Of course, remember your anchors
And until next time thanks for tuning in.
Hey guys, this is Tim again. Just a few more things before you take off. Number one. This is five. Bullet Friday. Do you want to get a short email for me? And would you enjoy getting a short email for me every Friday and that provides a little morsel of fun for the weekend and five. Bullet. Friday is a very short email where I share the coolest things I've found or that I've been pondering over the week that could include favorite new albums that have discovered it could include gizmos and gadgets and all sorts of weird shit that I've
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But it gives you a lot more and from smoothies and protein shakes too. Savory soups dips the NutriBullet blender combo does it all and there's a recipe book that comes with it. There's all sorts of stuff that you can play with this next. Gen NutriBullet gives you everything, you know and love about the classic to Vice. Yes. I'm reading copy in this particular sentence plus all the performance and capacity you would expect from a full-size blender don't settle for blenders that leave your smoothies filled with chunks or anything filled with chunks that you don't want.
Inks and get the NutriBullet blender combo and introduce your veggies and fruits and whatever else you might have to 1200 watts. It easily just smashes the living hell out of them and blends into whatever you would like to create and for you. My dear listeners NutriBullet is offering 20% off of all products on their website to get your 20% off. Just go to NutriBullet.com forward slash Tim. That's NutriBullet n utri EU lle t.com folks - Tim if you don't have any trouble
In your kitchen you are missing out. It does a lot in a very small package NutriBullet dot compote / Tim for your 20% off. This podcast is brought to you by Trello during tough times. Like these one thing that brings us together, of course is our common humanity and another which helps to harness that is technology. Now more than ever teams must come together and work together in virtually to handle challenges opportunities and everything in between. That's why Trello is
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