“Who do you talk to?” 

By Maxwell Droznin, MD, MPH, Johns Hopkins Medicine 

Mrs. Patterson sat on the exam table, hands folded tightly in her lap. It was her second visit in two months. Her blood pressure was controlled. Her labs looked fine. I had my hand on the door when I noticed her eyes were wet. I almost missed it. 

When I asked if something else was going on, she didn’t answer right away. Then her voice cracked as she told me she hadn’t had a real conversation with anyone in weeks. Not since her husband passed. Her daughter called sometimes, but she was busy with her own life. Mrs. Patterson described sitting at the kitchen table each morning where she and her husband used to have coffee together. She still set out two cups without knowing why. 

I sat back down. Her loneliness wasn’t a side note. It was the diagnosis I had almost walked away from. 

Why this matters 

The Harvard Study of Adult Development tracked 724 men for over 85 years. The finding that stands above all others? Relationships predict health and longevity more than cholesterol, genetics, or wealth. Robert Waldinger, the study’s director, sums it up plainly: “Loneliness kills. It’s as powerful as smoking or alcoholism.” 

Social isolation increases mortality risk by 26%. It accelerates cognitive decline and drives inflammation. Yet we rarely screen for it. We ask about smoking, alcohol, and colonoscopies but forget to ask who our patients actually talk to. 

We feel it too 

Loneliness doesn’t spare those of us in white coats. We entered medicine craving connection. Somewhere between the documentation and the inbox messages, we lost that. We eat lunch alone. We sacrifice friendships for call schedules. We tell ourselves relationships can wait until after residency, after the next professional milestone, after retirement. 

The Harvard study says otherwise. Participants with strong relationships at 50 were the healthiest at 80. If we want to address burnout, we must stop treating relationships as luxuries. The colleague you grab coffee with, the friends outside medicine, the family dinners you protect fiercely aren’t distractions from your career. They’re what sustain it. 

What we can do 

For our patients, it starts with one question: “Who do you connect with regularly?” When patients acknowledge isolation, we can validate it as a real health concern. Senior centers, support groups, and faith communities can become part of the treatment plan just like medications. 

For ourselves, the prescription looks similar. Protecting one recurring social commitment each week builds resilience. Nurturing friendships outside medicine gives us space to be someone other than a doctor. These aren’t indulgences we earn after the work is done. They’re how we stay well enough to keep doing it. 

Mrs. Patterson didn’t need another medication adjustment. She needed someone to stay and listen. Our clinic connected her with a grief support group. Three months later, she told me about a woman she met who’d lost her husband the same month. They have coffee on Tuesdays now. She finally stopped setting out that second cup. 

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.