>> the surgeon general of the united states, a position to which he was appointed by president biden in previously held the same position under president obama. recently i had a chance to sit down with him to discuss a number of health issues affecting the united states including covid-19 and mental health. i'm here today with dr. morthy, the surgeon general of the united states. thank you very much for giving us this time. >> of course, i am glad we are

having this conversation. david: as you probably heard, i did come down with covid. i managed to dodge it for two years. i guess my luck ran out. is covid still a major problem with people like me are still getting it? >> first, i am sorry that you have covid. the worst experience, it is a serious thing. sometimes you can have these breakthrough infections and have symptoms. i wish you the best in your recovery. here's where we are. we have certainly come a long way in the last couple of years. in march of 2020, more and more people were getting sick, hospitals starting to fill up. we were seeing terrible scenes from new york city in the months that followed, and they didn't know a lot about the virus or have treatment for vaccines. fast forward now a couple of years forward, and we actually have these vaccines that are

incredibly effective at keeping people out of the hospital and saving their lives even if you do get an infection after a vaccine, it will likely -- the likelihood of you having a really bad outcome, much, much lower. combine that with the treatment that we now have available and you find that most deaths from covid-19 should be preventable at this point. so that is a long way to come from where we were. with that said, we are still losing several hundred people per day to covid-19. they tend to be predominantly individuals who are not up-to-date on their vaccines or who never received treatment, so we still have more work to do. especially with winter coming, there has been an increase in cases. that is why we want people to be up-to-date with their vaccines, we got outdated vaccine right now that is tailored for the new omicron variant. we want people to get that and to make sure they have maximum protection when winter comes.

david: in the early part of the covid problem, people were dying enormous numbers in the united states. more than one million people have died in the united states, 5 billion around the world. with that in part because they were not vaccinated, and the vaccination has made those not as bleak as we would have been without the vaccination? dr. murthy: it is a really good question. early on, people didn't have protection, they didn't have prior infection. this was a new virus that had emerged on the scene. now, thankfully, those vaccines do give protection against the worse outcomes of covid. that is an important point. what is the goal of a vaccine? some people think if i get a vaccine and i get sick, he vaccine didn't work. but the most important goal is to save their lives. the protection the people had is

to stay updated with their vaccines, and we've seen that over time, the covid vaccine, like many other vaccines, the effectiveness can wane over time which is why you get an annual flu shot. it is important to be up-to-date. the bottom line is these are life-saving tools that we now have. depending on what calculation you look at, we see hundreds of thousands of lives in the united states alone saved because of the vaccination made available and through the vaccination campaign. david: did you ever get covid? dr. murthy: i did. earlier this year, my wife and my kids and i all got covid and we actually know how it happened. turns out, my four-year-old daughter was in pre-k at the time. she ended up catching the virus from somebody in her classroom. it is really challenging if you're a family, especially a

family with small children, to prevent yourself from getting infected. it is worth trying, but at the end of the day, if you are taking care of your child, you have got to hold an income for them and that puts you at great risk. many parents of experience this. thankfully, we were all vaccinated except my daughter at the time, there was not a vaccine yet. but the rest of us were vaccinated. we had a mild illness, but it gave me enormous respect that they should be taken seriously because even with the protection we had, we were knocked down for several days. david: did you tell your four-year-old daughter that she had infected the surgeon general of the united states, and that you recognize the consequence? dr. murthy: i am just her dad who she sometimes pays attention to what her mom is not around. i'm not sure she is aware of what i do. it was just a very humanizing moment. i've been working on covid for

the better part of a year. to be able to go through this experience, it gave me even more understanding and empathy for folks out there who are not just getting sick, but trying to manage their family responsibilities while they are ill, whether it is getting kids into school, making sure they are managing work, taking care of relatives. the ripple effects of getting sick are significant and it is certainly something that i have kept with me ever since.

francine: let me ask you -- david: let me ask you about what it means to be the surgeon general of the united states. you're not a surgeon or a general, so why are you called surgeon general? dr. murthy: the reason why where this uniform is so i oversee the u.s. public health commission core. this is one of eight uniform services in the united states government consisting of 6000 officers dedicated to improving public health each and every day in their day jobs. but we also deploy them during times of emergency. we send them when there are hurricanes or tornadoes that hit towns. we will send officers to help provide basic care. routinely drink covid-19, we deployed thousands of officers to help with everything from vaccinations to supporting health care systems. so that is one of the jobs of the surgeon general. the other job is to inform the public about vertical public health issues that arise, and this could be informing --

informing them about how to prevent yourself from getting sick, how to manage illness when it arises. with covid, that has been an important part of my work. increasingly, my focus has been on the wider inset -- well-being which were a real struggle for the country even before then. david: you were the surgeon general under president obama and you served under president obama, did a very good job. and then president left office after eight years and president biden came in four years later, and he asked you to be surgeon general again. did you tell him you had already done that once, and why would you want to do it again? were you surprised that they wanted you for the same job again? dr. murthy: i certainly had not planned to come back and serve as surgeon general again. i had always told myself i had a privilege serving the first time and it is a once-in-a-lifetime

experience. but the pandemic of the scrambled everyone's lives including mine. while it was not a difficult position when he asked me to serve, it had big implications for my family. but i tell you, it was one of those moments where in the throes of a crisis that was upending our country in the world, i felt that it was my responsibility and our collective responsibilities to do as much as we could to address this crisis. i was given the opportunity to serve and hopefully to help and i wanted to make sure i did that. what was in my head at that time was the voice of my parents, the example they had set for me growing up, which they send more through what they did rather than what they said. whenever your community is in need, it is our responsibility is to step up and do as much as we can. it might only be a little, but all of us have to step up and

serve in some way. david: let's talk about your parents and your background. dr. murthy: i grew up in miami, florida. i went to public schools all throughout high school. my parents, they ran a medical practice. my mom and dad had set that up when i was in elementary school and that was a pivotal experience for me because i spend a lot of time there as a kid. it shaped my excitement and interest for pursuing medicine. david: and were both of your parents medical doctors? dr. murthy: my father's is a family medicine doctor. my mother did her degree in english literature, but we like to say that she is a healer herself because it comes naturally to her. as somebody who ran my dad's clinic for many years, the patients all came to know her and to trust her. david: did you always want to be a doctor when you were in elementary and high school? did you know that what you're calling?

>> i was always inspired by my parents early on. for much of grade school, it was clear that that is what i wanted to do. toward the end of high school, things changed a little bit. i started to get really interested in english literature and history, economics as well. i went to college thinking i might want to pursue something one of the three fields. i took classes in economics and history and was really trying to get a sense of whether that would be my path. but what happened in between, was that my freshman year, my father called me and he said you know, there are this philanthropist was looking for a cause that he wants to support, but he doesn't know what the cause is. if you have any ideas you want to work on, there may be an opportunity for you to build something. and i thought about it and i had been working on some hiv projects when i was in high school and had been visiting india where my family is originally from and realize after high school that the crisis was really exploding.

so my sister and i ended up developing an idea to build an education program around hiv in india. it is commonplace now, but it was more unusual then. the idea of bringing pierce together into training them to go out and inform college and high school students around the community was novel than in india, but it is something we decided we wanted to try to build. that was the part we were ultimately able to get funding for. we ran it for eight years, and that changed my perception and how i felt about what i wanted to do in the world and it brought me back to health and to wanting to not only become a doctor, but to build programs in communities that would hopefully have a large-scale impact on public health. david: i think you were valedictorian of your class, is that right? dr. murthy: guilty as charged. david: did you want to go to harvard, was that your first choice? dr. murthy: the reason i came to

learn a little bit about harvard, my best friend in high school, she was interested in this summer school program at harvard. we all went to this program between jr. and senior year, and it was a really wonderful experience, but that is what made me think maybe this va good place to come to college if i am lucky enough to have the opportunity. that is why i went to harvard, i was given the opportunity to attend and i had a great periods. david: and you went to medical school at yale. dr. murthy: i did, i did. david: and how did you happen to get gail, you got tired of cambridge? dr. murthy: [laughter] this was an interesting experience. i actually wanted to go to harvard medical school. i decided for myself of that with the right place for me to be. even though i did have exposure to other institutions. it turned out i did not get into harvard medical school.

opening the letter and seeing it was a rejection, i was so crushed. and i called my father and he said to me, he's like, i know you are overly upset about this, but something good will come of this because you will be able to go somewhere else and did a different kind of exposure that is going to help you grow. and i was fortunate to be able to attend yale. became one of the most powerful educational experiences of my life. not just from what i learned in the classroom, but the incredible relationships that i built in this community that i was a part of. david: have you ever seen the admissions officer from harvard medical school and told him that he missed on the two-time surgeon general? dr. murthy: no, i haven't. but i know that there is a degree of randomness to the admissions process, and i always tally on people now are going to school that you should never assume that whether or not you get into a school is a measure of your work and your value

because again, having now served on the committee, i know that there is a degree of randomness. there are people who don't get in and that is just the way it is. david: many people in your class went into something important, private equity. you were never attended by that? -- tempted? dr. murthy: i was interested in a lot of things. after i finished my residency, i ended up taking some time in building a technology company that i ran with some colleagues for about seven years to help use technology to ashlee vance clinical research and clinical trials in particular. so i've always had an interest in building businesses and thinking of innovations to bring to scale. who knows what the future holds, but maybe one day i will come and get some advice from you. david: what advice would you have for a young person who says i want to aspire to a career like yours? dr. murthy: find a problem that

you care about and try to help address it in whatever small way you can. david: you've been the surgeon general twice. what would you like to see at the legacy that you leave behind for future surgeon generals? dr. murthy: that is a great question. my greatest concern is actually more around the core set of values that we bringing side society around. this is a very personal thing for me because i think about my two children in the world they are growing up in and i worry at times. i look at the vitriol in the polarization in so much of the hatred in our world and i asked myself, is my child going to grow up in a world where people don't condemn my child because they made one mistake, for they give them the benefit of the doubt?

we need to build a society that is firmly grounded in kindness and compassion and in love. we need to build a workplace culture to reflect that. we need to build our education systems to support that. and we need to also support parents because they are struggling right now as they seek to give support on a foundation for well-being to their kids. my hope is that i could emphasize and underscore those values as we seek to redesign our lives in society. we have a once in a generation opportunity in this pandemic where people are taking stock of their lives, we ask ourselves what kind of world we really what to live in. how do we want to re-center our lives around a core set of values?

david: today, what do you consider the biggest health challenge facing the people in the united states? dr. murthy: it's a great question. there are so many challenges we are dealing with. obviously we are still dealing with the pandemic and we need to make sure we are preparing for the next one that may come down the line. we have a whole bevy of chronic illnesses that people are struggling with. but the one that is most of my mind and which i am most deeply concerned about that i see is the mental health crisis that we have in our country. it turns out that when you struggle with your mental health, as certainly i have at point in my life and i've taken care of many who have, but when you struggle with mental health, it doesn't just impact how you feel. it impacts your physical health, how you show up at work. it can impact productivity,

absenteeism, and it also impacts have children perform at school and how they learn. however you cut it, i think environmental health is the fuel that allows us to show up for our family and friends, for our community. and when mental health is negatively impacted, it compromises all those friends. that is what we are dealing with right now. if you look at the numbers, they are really staggering, especially among the youth. about 5% of people in 2020 had suicidal ideations, contemplated taking their own life. kids in particular, there was a 57% increase in suicide rate in the 10 years preceding the pandemic david: periods when i worked in the white house for president carter, his wife had a mental health task force. it was seen at the time as somewhat unusual.

she recognized it was a stigma attached to mental health. do you think there is still a stigma attached to mental health as opposed to physical health? dr. murthy: i certainly think it has gotten better but i still see that stigma all the time. especially with my generation, older generations. i still see a reluctance to talk about needing help and about being a victim of abuse, but the other piece that is important, it is not just in our words and actions that i see that stigma. i see it structurally as well. we look at how we reimburse for mental health care in our country. despite passing into thousand eight mental health parity law,

it needs to be stronger, so it is harder for people to actually get mental health care intersystem and it is for them to get physical health issues. we still have a long way to go to close the data -- gap. david: if you are working remotely, are you going to be more lonely, and is that going to cause a bigger problem? is it better for mental health for people to actually be coming back to the office and so forth? dr. murthy: i do think that our workplaces have a really powerful effect on our mental health and well-being. it is one of the reasons i just issued a surgeon general framework on workplace mental health and well-being. right now, almost 80% of people are saying there is some aspect of the workplace that is contributing the negative to their mental health and well-being. this is our chance to really figure out how to make workplaces engines for good well-being. when it comes to working from

home, there are some benefits to working from home. they can be there more for their family. many people can actually be home to drop their kids off at school. they are not spending as much time commuting. that is an important positive. on the downside, it is harder to connect with your coworkers when you're not having some in person interaction. and workplace, he used to have conversations with employees about the strike that balance, how do have some time where they may be able to gather in person to collaborate, to build stronger working relationships. it is not black-and-white. finding that balance is important because we know would people are fulfilled outside of work it has a huge impact, positive impact on the mental health. that positively impacts their productivity in the workplace. david: i am part of the baby

boomer generation and this generation is increasing the deal with problems related to alzheimer's, dementia, and so forth. not my age, but maybe some people my age or even younger. obviously in their late 70's, 80's, and 90's, we are reading about alzheimer's. is this an epidemic that you can't really do anything about, or is it something we can deal with? dr. murthy: i have a 90-year-old grandmother at home who is struggling with dementia, and providing care for her has been a real challenge. we love her dearly, we want to be there for her, but is painful for us to see the toll it has taken on her. this is rightfully a concern for families across the country. not just alzheimer's, but other forms of magic to understand what is driving it. there interestingly, there's also some research taking place on the impact of social

connection, physical activity and sleep on dementia as well. the professor at the university of san francisco has been one of the key folks leading some of that research on the effect of dementia and this is a promising area, and i certainly think we should expect this to be a concern for many families across america in teacher. it is not just about the people impacted by dementia, it is about their families as well. when you look at what pulls people away from work, what makes it harder for them to be there for their community, it is often caregiving responsibilities, and the caregiver burnout crisis in america is real and dementia is a big part of that. david: for a young person who says i want to be the next surgeon general, what advice would you have for a young person who says i want to aspire to a career like yours. go to medical school? do what? dr. murthy: find a problem that

you care about and try to help address it in whatever small way you can aid don't be limited by the amount of training you have for the experience that you have. a lot of times, when i began my first nonprofit organization, i was 17 years old at the time. i didn't know a lot about a lot of things and i made a lot of mistakes. my sister and i tried to build a news entity. but we learned a lot along the light and what we lack experience we made up for in enthusiasm and a willingness to learn. so i would just encourage young people to fight a fight you really care about and start trying to address it in whatever small way you can. start trying to help right away. don't wait until you are done with their education.

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