The Healing Power of In-Person Real-Life Connection: More Hugs, Fewer Drugs
“If we have no peace, it's because we have forgotten that we belong to one another.” —Mother Teresa
For 300,000 years, our survival depended on close daily interaction with family, friends, and tribe or community. Even today, relationships are the essential pillars upon which a well-adjusted and stable emotional life is built. But real-life connection is being quietly replaced by solitary activities, like working all day on a computer, answering emails, streaming entertainment, exchanging texts on mobile phones, and scrolling social media. For many people, especially among younger generations, time spent streaming digital entertainment, social media, and online gaming has replaced in-person hangouts. While online activities can be somewhat social, they generally lack the depth and emotional richness of real-life person-to-person contact.
Fundamental changes have been taking place in the world of relationships too. In generations past, you couldn't get out of your family, your church, your community, or your marriage. Renowned psychologist and therapist Esther Perel describes how historically, relationships were seen as “tight knots” that were difficult to undo, so that everybody knew their place, their role, and what was expected of them. This restricted one's freedom but fostered a sense of security and belonging. In the past (and still too often today), many people—especially women and LGBTQ+ people—were trapped in toxic or dangerous relationships because of those tight knots. Dr. Perel describes relationships today in America as more like loose threads, or fluid networks where people can enter and exit with ease.
The price of all this freedom, along with the replacement of real-life interaction with solitary digital engagement, is increased loneliness, where kindness and empathy are in short supply. This transformation isn't just a cultural change—it's a national health crisis. Studies consistently report that loneliness and social isolation dramatically increase risks for heart disease, stroke, depression, dementia, and even premature death. The U.S. Surgeon General, Vivek Murthy, MD, recently issued an advisory stating that we are facing an epidemic of isolation and loneliness that is harming our well-being and health. He writes that “chronic loneliness can be as dangerous to your health as smoking 15 cigarettes a day.”
Close relationships are more essential now than ever to give people a sense of belonging and to lead meaningful, fulfilling, and healthy lives. Face-to-face connection is one of the most powerful and underrated medicines we have. When we interact with someone in person—share a story, a smile, or a meal, or go for a walk or engage in other interactive play—we activate systems in the brain and body that reduce stress, strengthen the immune system, heal the heart, and stimulate new connections in the brain. Building and maintaining a life rich in real human contact isn't just good for the soul—it's vital for long-term health.
I Am Because We Are
Ubuntu is an African concept from the Bantu tribe that translates to “I am who I am because of who we all are.” Humans are wired to thrive best when we are woven into a network of personal relationships. Homo sapiens are among the most social species on Earth. Like ants, bees, dogs, wolves, and dolphins, humans are pack animals, and we need to be emotionally connected and physically interacting with the people and other living organisms flourishing around us.
Strong relationships provide emotional support, boost self-esteem, foster a sense of belonging, and infuse life with meaning. In Okinawa, Japan, locals call it ikigai — roughly translated as “reason for being.” In Nicoya, Costa Rica, it's known as plan de vida or “life plan.” In both regions, people with a strong sense of purpose not only live longer but stay mentally sharp well into old age. Scientists think it works by lowering stress, encouraging social connections, and giving people a reason to be enthused to get out of bed each morning.
The first two Star Wars movies were released when I was a college student, and I was enthralled and inspired by the notion of The Force as a mystical energy field that binds all living things together. It's a source of strength that can be harnessed by those who tune into it and channel its power, allowing them to perform extraordinary feats. The Force as depicted in Star Wars reflects a concept that echoes through many ancient myths, religious systems, and philosophical traditions across cultures, making it resonate cross-culturally and timelessly. To me, “to become one with The Force” means aligning your will with nature and selflessly investing time and energy into a noble cause bigger than yourself, such as nurturing the wellbeing of life around you—your family, friends, coworkers, neighbors, community, pets, and plants. By the way, I'm certain The Force does not flow through the internet or Wi-fi.
I am more grateful than ever to be in a profession that heals. I love caring for my patients—as with my family and friends, they bring meaning to my life. And I am humbled and thankful to be a part of Saint Luke's Cardiovascular Consultants, one of the best cardiology practices in the nation. I have never been more enthused to see patients, especially in our CardioWellness Center, where we take the best of both worlds, recommending diet, exercise, pets, lifestyle strategies, and a few select supplements, in addition to deploying the latest and best drugs where and when needed. Using this hybrid approach, we are much more effective at optimizing robust health and promoting longevity than ever before.
Home Alone
In 2020, 28% of U.S. households contained only one person, up from just 7.7% in 1940. This trend is also observed globally, where Sweden has more solo dwellers than any nation, with 47% of households having just one occupant—typically a child-free, single adult. Sweden, one of my very favorite places to visit, ranks #4 among all nations for quality of life for its citizens and has one of the best life expectancies in the world at 83 years. The Swedes are proving that it is quite possible to be happy and healthy living alone (see side bar).
The Swedish Paradox: Alone, But Not Lonely
Sweden has the world's highest proportion of adults living alone—47% of households are single-occupancy—yet Swedes rank near the top globally in life expectancy, happiness, and overall quality of life. So how do they stay so healthy and content while living solo?
The key is this: In Sweden, living alone doesn't mean being disconnected. It often reflects independence and self-sufficiency, not social isolation. Swedish culture encourages regular face-to-face interaction with friends, family, and community—even when one lives alone.
Here's how the Swedes pull off this paradox:
Social safety net: Universal healthcare, paid parental leave, free college, and generous pensions reduce life stress and support well-being.
Urban design for connection: Walkable neighborhoods, bike paths, and public transit systems encourage people to get out and mingle.
Cultural rituals: From daily fika (coffee breaks) to seasonal festivals, Swedes build regular in-person contact into daily life.
Work-life balance: Long hours are discouraged; time with friends and nature is prioritized.
Contrast this with the U.S., where living alone often means being more socially disconnected, especially for older adults. The U.S. work culture, car-based infrastructure, and screen-heavy lifestyle can make it harder to maintain meaningful in-person relationships.
Sweden's example shows us that solo living doesn't have to mean lonely living—but it requires intentional social engagement, strong community design, and cultural support for human connection.
Bottom line: It's not about how many people you live with—it's about how connected you are to your tribe.
In our increasingly screen-based virtual world, it's key to keep up your social fitness by prioritizing face-to-face interactions and real-world relationships. Studies consistently show that people with close social connections have better memory, sharper thinking, and a reduced risk of dementia. Face-to-face interaction keeps your mind engaged, usually reduces stress, and stimulates release of feel-good neurotransmitters like oxytocin and dopamine.
Women tend to be better at building and maintaining social networks outside of work than men. My mother, Leatrice, and my grandmothers, Dorothy and Alice, each lived alone for 20 or 30 years after their husbands died. However, Dorothy had 10 different grandkids living with her at different times in her cozy stone cottage in Grand Forks while they were attending the University of North Dakota. I was the first grandchild to live with her and did so for four years. Each of these women prioritized doing what they could to help and support their family, friends, churches, and neighborhoods. They routinely had coffee or happy hour dates with their friends, neighbors, and family, and volunteered for various causes and organizations.
There is a massive broadband connection of nerves between the heart and the brain, so that your emotions are quickly and powerfully registered in your heart and vascular system. When you experience stress, anxiety, or anger, your pulse and blood pressure rise, your chest may tighten, and your breathing quickens. In contrast, when petting your dog or cat, happily visiting with a friend or family member, or enjoying time in nature, your heart calms down, your arteries relax and expand, and your blood pressure and heart rate ease back into nice low normal ranges. Having someone to confide in or a beloved animal by your side is essential for reassuring us that everything is going to be okay.
Heart-to-Heart Connections: The Key to Healthy Longevity
The latest science shows that the heart is the secret to longevity, not only its pumping capabilities, but also our ability to make heart-to-heart connections. Dr. Robert Waldinger, Director of the Harvard Study of Adult Development (HSAD), the longest-running scientific study of adult health, was surprised when his study revealed that the strongest predictor of who was going to live long and stay healthy was “how connected you were to other people and particularly the warmth of your connection to others.”
In 1938, HSAD enrolled 724 participants in this comprehensive longitudinal study and put them through detailed checkups every two years for their whole lives. According to Dr. Waldinger, the crystal-clear message that emerged from this landmark study that has been going on now for 86 years was, “Close relationships, more than money or fame, keep people happy, protect against life's dangers, help to delay mental and physical decline, and are better predictors of long and happy lives than social class, IQ, genes, and everything else.”
You intuitively understand that you can't expect to be physically fit without putting some work into it. Why should relationships be any different? To have good relationships, we must be actively involved in staying in touch with people and investing time and energy into nurturing our relationships. Dr. Waldinger reminds us that we tend to take our relationships for granted, but he says becoming intentional about keeping in touch and fostering relationships is a superpower that flies under the radar. Waldinger says that our modern culture may not always steer us in the right direction when it comes to health and happiness. He says, “These badges of achievement that we all set out for ourselves—money, awards, followers on social media—those badges of achievement are quantifiable, so they look like they're going to make us happy, but they don't.”
Re-engage with the Real World
My mother, Leatrice, used to tell me, “If you want to have a friend, you need to be a friend.” Hang out with your friends more. Invite someone over for dinner. Join an exercise group or volunteer locally. Get a dog, tend a garden, befriend your neighbors. The path to a longer, healthier, and happier life is a wandering one where you're often hanging out with your people, frequently stopping to smell the roses, or letting your dog smell the fire hydrants. Below are some strategies to help you spend less time on digital devices and more time interacting in person.
Set clear tech-free zones and times. For example, no phones at the dinner table or in the bedroom after 9 p.m. or during weekend outings.
Schedule regular appointments for social time. For example, weekly dinner with family or friends, a Sunday walk with family, weekly play dates for interactive sports like pickle ball, or monthly game nights.
Substitute low-stress social activities for screen time. This could be joining a book club, attending classes for yoga, art, or cooking, going to a religious service regularly, volunteering for a cause you care about, or joining a local club or hobby group.
Limit passive screen time. Consider tracking digital usage on your phone. You may be surprised by how much time you are devoting to staring at your phone, computer, and other screens.
Prioritize high-quality digital interactions. Reduce time spent passively scrolling or watching others' photo-shopped lives on social media. Instead, video call a friend or engage in an online community, do group chats or play online co-op games with friends. If you are feeling lonely, real-time digital interactions are better than nothing for meeting emotional needs, though they generally don't substitute completely for in-person interaction.
Animal Connections Count!
“A house is not a home until it has a dog.” —Gerald Durrell
One of my all-time favorite studies came from Sweden in 2017. Scientists followed 3.4 million people over the course of 12 years and found that adults who live alone and owned a dog were 33 percent less likely to die during the study than adults who lived alone without a dog. Furthermore, the single adults with dogs were 36 percent less likely to die from cardiovascular (CV) diseases like heart attack, stroke, or heart failure. Individuals who lived in a multi-person household also significantly benefited from owning a dog, with an 11% decreased risk of dying from any cause, and a 15% decreased risk of dying from a CV disease during the study. So dog ownership was especially effective at protecting against heart disease and premature death for persons living alone, which indeed, is a group that has been shown to be at higher risk for serious health issues than individuals living in a multi-person household.
Blue is an 11-month-old puppy we rescued from the pound. He is the most affectionate animal I have ever owned. He's smart, easy to train, and eager to please. Blue just became our certified therapy dog at the CardioWellness and CardioMetabolic Centers. For the staff and the patients, Blue's tail-wagging love with kisses brings smiles to our faces, warms our hearts, and brightens the day. Studies have shown that interacting with dogs, even just petting them, can lower blood pressure and reduce stress hormones like cortisol. The presence of a dog, especially a sweet-natured pup like Blue, can create a sense of comfort and security, helping to reduce stress and anxiety. Bonding with a canine companion can increase happiness and engender a more positive outlook.
Dogs can provide constant companionship, alleviate feelings of loneliness and isolation, encourage a more active lifestyle, improve mood, and boost mental and physical health. I love coming home to a dog who always greets me with enthusiastic unconditional love and support. Studies report that pet ownership may be associated with less cognitive decline in individuals living alone and can lead to increased interaction with other dog owners and pet enthusiasts, expanding social connections and reducing social isolation. Caring for a dog can provide a sense of purpose and routine, which can be particularly helpful for individuals living alone. I often write out a prescription that reads, One Dog, taken for a walk once or twice daily. Refill as needed. Substitution permitted; then hand it to my patient saying, “Doctor's orders.”
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