Our graduates have demonstrated what resilience is being students during the COVID-19 pandemic. It has given them, I hope, the ability to take the lemons that have been presented to them and make lemonade, because we can either choose in our life to see things as opportunities to grow, or we can see things as problems that are going to overwhelm us. And I believe they have taken this opportunity to grow.
As we recognized our graduates for their resilience and for their work during commencement, I talked about an issue that is near and dear to all of us, which is mental health and burnout in our health professions.
As we look at the United States of America, our surgeon general, Dr. Vivek Murthy, has said that the real pandemic we have that is superimposed on the COVID pandemic is that of loneliness. In a survey done by Cigna Insurance Company in 2018 before COVID, we found that 66% of respondents reported feeling lonely.
We know loneliness is a perceptional frame. Feeling isolated, not being seen. Feeling like we are in threat mode all the time. Our sympathetic nervous system, our fight or flight mode all the time, then increases our risk of early death by 30% and significantly increases our high-risk activities, including drug use, alcohol use, reckless driving and even suicide.
Indeed, this has been such a problem that the United Kingdom has created a minister of loneliness. And so, as we look at that frame of how people feel separated, then let's look at what kind of information we can find from the most cutting-edge science that gives us some solutions to the problem we're seeing.
At the same time that we're seeing this problem with mental health, we also recognize that we have seen the sharpest drop in life expectancy in the United States since the beginning of this century. We have lost five years of life during the COVID pandemic versus other rich western countries. And we've lost two and a half years of life from what our historical numbers were in the United States during COVID.
But this reduction in life expectancy actually started before COVID-19 and started with a group of people in Appalachia and the Ohio River Valley who are dying at a rate that had not been seen since the peak of the AIDS epidemic.
They were initially found to be dying of suicide, overdose and alcoholism, and then as research was done further, it was determined that they were dying of hopelessness and despair. The thing that correlated most centrally to their symptoms was the loss of jobs and the fact that the government and other entities didn't come in to try to help them. They felt that nobody saw them, they felt separated, they felt lonely, and they were dying at a very high rate.
As we start to look at the impact of how we see the world, if we see the world as stressful, if we see the world as threatening, what does that do for us? We turn to a Nobel Prize winner named Elizabeth Blackburn who did a study in San Francisco looking at a group of women who were highly educated, who had a very high standard of living, women average 38 years old, and they gave them a stress questionnaire. They were able then to take the results of the way that these women saw the world, and then they took blood cells, lymphocytes, from their bloodstream, and they were able to measure their telomere length. Telomeres are like the caps of our shoelaces. Every time our cells divide, if you imagine our shoelace ends, they get shorter and shorter and shorter and shorter, which means we are getting older and older and older and older, until our shoelace ends are done, and that's when we're done as well.
So, we can measure in a quantitative manner how old these women were – biologically, how old their real age was and their bodies. If you look at the women who answered that questionnaire with the least amount of stress and the women that answered the questionnaire seeing the most amount of chronic stress, there was a 17-year difference in biological age. Again, these women were average 38 years old, and the most biological age, the body’s age, was 17 years older in the women who saw the world as threatening.
As we look at West Virginia, we have the second lowest life expectancy in the country at 74.5 years. Mississippi is lowest at 74.4 years. If we look at our worst county for life expectancy, which is McDowell County, and compare that to the best county in the country, which is Summit County, Colorado, there is a 17-year life span difference – 17-year lifespan difference.
If we go to the studies that look at people that have lived long and well, people that have lived well into their 80s and 90s, we might think that the secret to their long age is that they ate better, that they exercised more, that they didn't smoke. Well, it turns out that in a number of these studies, that are the best-done studies, there's really agreement about three things that separate people that do well into their 80s and 90s, and it's not eating better, it's not exercising more, and it's not even not smoking. Although certainly it's a good idea to eat well, exercise well and not smoke.
It turns out that the three secrets to these long-lived people are, number one, they maintain very strong relationships with others. So having friend groups. We are meant to be together. If you look at the root word of heal, which is the same root word as health, same root word as holy, same root word as holistic, it means whole – W-H-O-L-E, coming together. So, the first thing is they had very strong networks of friends and people who loved them just because of who they were.
Second of all, they saw the world like taking lemons and making lemonade versus having the lemons drown you. They saw the problems that they faced as opportunities still to grow, and they didn't mind being challenged.
The third thing is they had a great sense of higher purpose. As we start to look at the way that we live our lives, then in many ways everything is about competing and competing as an individual. It is me versus you. It's if we say somebody is beautiful, that implies somebody is not beautiful. So, everything is done in a way where we are seeing ourselves as a separate entity against others, all the way from competing for a position in classes, to doing well in classes, to getting jobs, to finding somebody to get married to, if that's what you want to do, et cetera, et cetera. And remember, ‘I’ is in illness, but ‘we’ is in wellness. So, as we look at the secrets to how we might change our own lives, how might we change others’ lives?
I give you a few challenges to consider for your own life.
Number one is when you go out into the world, please try to adjust the lens that you see things through so that you see things as opportunities for you to grow. See your life as a great adventure, not like a jail sentence.
As we look at philosophers, the philosopher Rumi said, “You are not a drop in the ocean. You are the entire ocean in a drop.” If you see yourself as having the capacity to deal with whatever life throws you and see that as an opportunity for you to grow and get better, then automatically you're going to be more successful and you're going to be happier. The poet Anaïs Nin said, “We don't see things as they are, we see them as we are.”
So, the first challenge for you is to see the world in a way where life is an adventure and abundant. Rumi also said, “act as the universe is stacked in your favor.”
The second challenge is to find your purpose. Your purpose is your true north. Steve Jobs’ purpose was to put a ding in the universe. Abraham Lincoln's purpose was to put the country back together. West Virginia University's purpose is to improve the lives and well-being of all of our citizens and then try to take any of our solutions that work and share them with anybody anywhere that we can.
Find your own purpose.
The persistence of higher purpose really was one of the critical features of people living long and well. In fact, in the Blue Zone areas of the world, the five areas of the world where people live particularly long and well, in Okinawa, Japan, they even have a name for purpose. It's called ikigai, which means the reason for being.
The third challenge I'd like to ask you to consider is to really pay attention toward others. Make sure that you look at each other as friends and not foe. The more we can stay together, the better you will do and the better other people around you will do. We are hardwired for connection. In fact, the anthropologist Robin Dunbar came up with Dunbar's Number, which is 150, which is about the most people that you can know well. That's because in our evolutionary times, 150 was about the biggest group of people that you could survive with that was small enough to feed each other and big enough to protect each other. We are hard wired for connection.
The fourth challenge I would have to you is a quote that Brad Montag said, which is, “be somebody that makes everybody feel like somebody.” Be inclusive. Don't be restrictive in the people that you will embrace and help because like the starfish story, the little child walking down the beach, seeing all the starfish washed up on the beach and throwing them back in the ocean one by one, and an adult walks by and laughs at the child because the child will never get all the starfish back in the ocean. The child wisely looks at the adult who criticizes the child for even trying and says, ‘You might be right. I might not get all of them back, but for the ones that I do, it will make a great difference.’ The Tao says that big events are made up of small things. So, remember that everything you do makes a difference in this world and in your life.
The next thing I would like you to consider will be to really remember your simple gifts, because many times we mistake stuff that's important for stuff that's not important. I'm a critical care physician and at the end of people's lives, and I've spent time with a lot of people who have died, nobody says, ‘I want more power, I want more money, I want a bigger house, I want another paper published.’ They want another meal with their family. They want another day outside to feel the sun in their face. They want to listen to music that they love. They want the people who love them and who they love with them as they're dying. We have that opportunity every single day and almost never see that as a great privilege, but it absolutely is. And when it's gone, you can't get it back. Please take advantage of really, really embracing those simple gifts.
And lastly, I would ask you to be kind. Be kind to each other. Be kind to yourself. The anthropologist Rutger Bregman wrote in the book “Humankind” that humans have evolved as the dominant species on earth because we learned to be kind to each other.
Follow these challenges and it will take you to a place of growth and fulfillment. Like Henry Ford said, “If you think you can or if you think you can’t, you are right.”