Surgeon General Urges Americans to 'Rethink How We're Living Our Lives' in Closing Letter to the Country (Exclusive)

My father told me he never felt emptiness — that painful, gnawing feeling that something is missing in your life — until he left his farming village in rural India. It was a remarkable statement from a man who grew up with no running water or electricity and whose family scarcely had enough to put food on the table each night.

But in the village, people took care of each other. They shared food, looked out for each other’s kids, and helped out in a crisis — like when my father’s mother died when he was just 10 and neighbors stepped in like surrogate parents. People also knew each other, not just their names, but their stories and families, and they chose to spend time with each other over meals, games, and celebrations for the many festivals that dotted the calendar.

I have found myself coming back to my father’s story as I’ve grappled with a central question during my two terms as Surgeon General: What are the deeper root causes of the pain and unhappiness I encounter so often across our country? Answering this question is urgent because the status quo is harming our physical and mental health, robbing us of our optimism, and contributing to division and polarization.

There are well-known contributors to stress and discontent – economic hardship, worries about the future, the negative headlines that dominate our feeds – but even when these and other issues are addressed, there is often still something missing.

After years of reflecting on the stories I have heard, delving into scientific data, and convening researchers, I have come to see there are three essential elements that fuel our fulfillment and well-being: relationships, service, and purpose.

Relationships keep us grounded and bonded to each other. Service, from formal volunteering to informal small acts of kindness, is about helping each other. And purpose gives our life a sense of direction and meaning. Together, these elements form the triad of fulfillment.

Each of these can significantly impact our physical and mental health, reducing our risk for heart disease, depression, anxiety, and premature death. They also allow us to connect with something bigger than ourselves, a universal human need that brings us perspective and support and helps avoid the excessive rumination and focus on self that often contributes to mental distress.

Yet all three drivers of fulfillment have diminished in many of our lives. One-third of adults and about half of young people are struggling with loneliness. The majority of our country is not engaged in formal or informal service to each other. A majority of young adults say they have little or no sense of purpose or meaning in life.

Perhaps this is because so many of the messages coming at us tell us to prioritize a different triad, the triad of success: fame, wealth, and power. While there is nothing inherently wrong with these elements, on their own, they rarely bring lasting fulfillment. Young people feel like they must constantly hustle and chase accomplishments, recognition, and followers on social media, hoping it will lead them to success. Inside many of us are wondering, is this what life is about?

We need a clear and explicit shift that puts relationships, service, and purpose at the heart of society — and our lives.

How can we do this?

We can take one action each day to help someone. We can reach out to one friend each day to check on them. We can be more intentional about having conversations with friends and our children about how we cultivate purpose rooted in contributing to the lives of others.

As a nation, we can strengthen and expand participation in national service programs. We can support local initiatives that bring people together to build relationships and serve. Both employers and schools can build a focus on relationships, service and purpose into their recruitment criteria and organizational culture. Finally, we can lift stories of purpose through music, movies, books, and sermons, so we see the purpose-driven life as worthy, inspiring, and within our grasp.

The profound change we are living through isn’t easy to manage. But it presents an opportunity to rethink how we are living our lives. We have a choice: the status quo marked by pain, disconnection and division, or a different path of health, happiness, and fulfillment. Choosing the latter will require rethinking what defines success and a good life. It will require building our lives around the time-tested triad of fulfillment, grounded in relationships, service, and purpose.

Like most people, I sometimes find myself worried about whether I’m achieving enough. In those moments, I think about the patients I cared for at the end of their lives. I think about what they shared with me about what made for a fulfilling life. It was never the size of their bank accounts, the number of their followers, or their list of accomplishments. It was always about people. The people they loved. The people they served. The people whose lives they touched. In the end, when only the most meaningful strands of life remain, this is what matters.

As I complete my term as Surgeon General, this is my parting prescription for the country I love: to remake and recenter our lives around relationships, service, and purpose. This is the path to health, well-being, and fulfillment. It is what will help us find our way home.

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