Book SummaryTogether, by Vivek H. Murthy

1-Page Summary1-Page Book Summary of Together

In Together (2021), Vivek Murthy argues that loneliness is not an individual problem, but a large-scale public health crisis that needs to be addressed. Through research and personal stories, Murthy shows how our evolutionary need for connection shapes everything from our brain chemistry to our societal structures, and he offers practical solutions for rebuilding meaningful relationships in our increasingly isolated world.

Murthy served as the 19th and 21st Surgeon General of the United States under Presidents Obama and Biden. Harvard-educated with M.D. and M.B.A. degrees from Yale, Murthy co-founded VISIONS Worldwide, an HIV/AIDS education program in India and the US, and Doctors for America, a nonprofit organization focused on...

Together Summary Part 1: The Loneliness Epidemic

According to Murthy, loneliness is a hidden epidemic affecting millions of people. During his tenure as Surgeon General of the United States, he discovered that behind many of the country’s health crises—addiction, violence, depression, anxiety—loneliness was often an unacknowledged but important underlying factor.

In this section, we’ll discuss Murthy’s definition of loneliness, why loneliness has become so pervasive, and who is most impacted.

Defining Loneliness

Murthy defines loneliness as the feeling of having insufficient or insufficiently meaningful relationships. (Shortform note: While Murthy's definition captures the essence of loneliness, psychologists often add important distinctions regarding how long someone feels lonely. For example, they differentiate between transient loneliness (temporary feelings), situational loneliness (triggered by life changes), and chronic loneliness (persistent feelings lasting years). Researchers are often more concerned with chronic loneliness, as it’s most likely to result...

Together Summary Part 2: Why Humans Need Connection to Survive

The prevalence of loneliness across such diverse populations suggests that our need for social connection transcends cultural boundaries and demographic differences. This raises a crucial question: Why does social disconnection affect humans so deeply and consistently? According to Murthy, the answer lies in our evolutionary history, where deep connections with others have been essential for survival. In the next section, we'll explore how our bodies and minds still react to loneliness as if it were a serious threat.

(Shortform note: While Murthy emphasizes our evolutionary need for connection, cultural factors also shape people’s experiences of loneliness. Research suggests that collectivist societies like Japan experience loneliness differently than individualist cultures like the US. In collectivist cultures, loneliness often stems from not meeting group obligations, while in individualist cultures, loneliness comes from lacking personal relationships.)

The Role of Social Connection in Human Evolution

Murthy argues that social connection has been key to human evolution. Drawing on the work of...

Together Summary Part 3: The Consequences of Loneliness

Our evolutionary hardwiring for connection explains why lacking meaningful relationships profoundly affects our well-being. Murthy explains that when we’re socially disconnected, our bodies and minds respond as though facing a survival threat. (Shortform note: While loneliness may no longer pose the same physical threat it did to early humans, it continues to be a survival threat—social isolation increases the risk of premature death by 29%.)

In this section, we'll examine both the immediate neurobiological effects of disconnection and the long-term consequences of chronic loneliness on physical health, mental well-being, and broader social structures.

The Physiological Response to Loneliness

Loneliness leads to harmful physical changes: Your brain interprets prolonged social isolation as a threat, which triggers the release of cortisol and other stress hormones. These stress hormones are bad for your health in a number of ways—for example, they suppress immune function, increase inflammation, and raise blood pressure.

(Shortform note: Studies show that mindfulness-based stress...

Together Summary Part 4: Strategies for Reconnection

According to Murthy, the mental and physical health consequences of chronic loneliness, coupled with its economic implications, make loneliness a public health crisis that requires multiple levels of intervention—from the personal to the institutional. In this section, we’ll discuss strategies to address the crisis of chronic loneliness.

Individual Strategies

To break through loneliness, you need strong connections with others and yourself. Let’s explore some of Murthy’s strategies for building authentic relationships—moving from internal awareness to community engagement.

Get to Know Yourself and Practice Self-Compassion

According to Murthy, understanding yourself helps you connect with others. He recommends asking yourself questions about your values and interests, considering what causes you stress, and reflecting on how you respond to challenges. He also suggests examining where you fall on the introversion-extroversion spectrum to better understand your social interaction preferences. Murthy believes that recognizing these preferences allows you to meet your needs as you maintain meaningful connections with others.

(Shortform note: There are several tools...

Together Summary Hope for the Future

Murthy acknowledges that addressing the loneliness epidemic can feel like a daunting task, but he argues that the future is hopeful. The human drive to connect is fundamentally resilient, deeply ingrained in our nature. Despite the challenges of modern life—technological isolation, changing social structures, and increasingly fragmented communities—our innate capacity for empathy, compassion, and meaningful relationships remains undiminished. According to Murthy, our emerging awareness of loneliness as a critical public health issue is itself a source of optimism. By recognizing social connection as essential to individual and collective well-being, were taking the first steps toward meaningful change.

(Shortform note: Murthy's optimism is supported by historical adaptation patterns. Past technological disruptions—from the Industrial Revolution to...

Shortform Exercise: Map Your Connection Types

According to Murthy, we need three types of connections to thrive: intimate connections, relational connections, and collective connections. Identify strengths and gaps in your social landscape.

Consider your intimate connections (close relationships characterized by mutual vulnerability and emotional support). List two people with whom you share this type of connection. What qualities make these relationships meaningful to you?

Shortform Exercise: Implement Connection Strategies

Murthy outlines various strategies for reconnection on the individual, community, and institutional levels. Develop a plan for strengthening connections in your life.

Murthy emphasizes that creating routines for connection is crucial for maintaining relationships when life gets busy. Identify one regular activity you could establish to prioritize meaningful social connection (for example, technology-free family meals, scheduled check-ins with loved ones, joining a weekly community group). How will you incorporate this into your schedule?