“We are all so much together, but we are all dying of loneliness.”Albert Schweitzer
We focus a great deal on “hard skills” in medicine-medical knowledge, clinical skills and competency, surgical expertise. Yet, it is often the “soft skills” that grease the wheels of our life and work. One of our most powerful soft skills is our ability to connect to others. In fact, for most people this represents way more than a skill. It embodies a deeply seated human need that is hard-wired into us. This connection extends not just to patients, but to colleagues, family and friends. yet it may be underdeveloped or subordinated to often harsh, inflexible, workplace demands that are not sensitive to vulnerability or compassion.
Results from a survey of 1,624 full-time employees, highlighted law and medicine as the loneliest professions. A multitude of factors coalesce to create and exacerbate isolation and loneliness in physicians:
- Long hours.
- Administrative and regulatory burdens.
- Never ending computer screen time.
- Lack of training or support for self-development.
- Working in a culture of shame and judgment where loneliness can be stigmatized as a personal failing.
- Lack of institutional support for processing grief and trauma.
- Feeling different from others.
- Lack of time for family, friends, social activities and hobbies.
- Lack of time to develop meaningful relationships with colleagues.
- Fear that others will not understand or be dismissive.
- Little time for self-care, including social interactions and hobbies.
- Moving away from previous supportive personal networks.
Just as it is entirely normal for human beings to desire connection, it is entirely normal for human beings to feel lonely at times. However, if loneliness persists there can be profound consequences. A 2020 study of family physicians found the overall prevalence of loneliness to be as high as 44.9%, with significant correlation to other forms of emotional distress, such as depression and burnout.
Loneliness is not the same as being alone. At times we all may crave alone time or solitude. A space for reflection and quietude can be immensely therapeutic. In contrast, is the experience of loneliness.
A working definition of “loneliness is the difference between your actual level of social connection and the level of connection that you desire”.
What we desire may differ for all of us, but we all know the feelings of emptiness, invisibility, isolation, alienation, inadequacy that can arise when we experience this disconnect. This scourge of loneliness in medicine, is reflected in the wider public. A 2020 study by Cigna surveyed over 10,000 adults 18 and older showed that loneliness is widespread ( 61% of adults report sometimes or always feeling lonely) and growing. Loneliness has been found to shorten lifespans in an equivalent way to smoking 15 cigarettes a day. It affects work performance and organizational well-being and success. It affects entry level workers, as well as those at the top.
Solving for loneliness is not about the number about social interactions that we have. It is about the quality of those connections. We can be surrounded by people all day, but without the opportunity, encouragement and skills to forge meaningful supportive relationships at work or at home, neither medicine, nor society will not be able to heal itself from the destructiveness of loneliness. We all know the double-edged sword of social media. Technology has given us many ways to touch base with people yet many of these connections are superficial and even detrimental. As human beings we need depth and meaning in our relationships. Quality over quantity.
Vivek Murthy’s, the 19th Surgeon general, book, Together, offers a heartfelt call to action on this rampant blight in our society. Individual, organizational and societal action is called for. On all levels we need to acknowledge that loneliness is a real and devastatingly important issue. We need to excise the shame and guilt that attaches itself to loneliness. preventing us from addressing the problem and moving forward. Although, we as individuals need to be engaged in our own self-development, families, schools, social organizations, healthcare, and our workplaces all have roles to play. The latter can be particularly influential in driving cultures where social connections become a priority, rather than an afterthought or worse a victim. The cost to human health, thriving and business bottom line is clear.
We, as physicians, have a duty to ourselves, our patients, our families, friends and society at large to accept and honor the fact that our need for connection is the very essence of being human. Only by doing this can we open the door to change, growth and flourishing.