July 2, 2022 Wayne Northey

The Pandemic Is Waning. Anthony Fauci Has a Few More Lessons to Share.

America’s most famous doctor on mitigating covid, giving your adversaries the benefit of the doubt and working way too much

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By Anna Peele

June 29, 2022

image above: Anthony Fauci. (Jesse Dittmar for The Washington Post) 

WN: Great insights about Dr. Fauci in the article highlighted below.

Near the end, the author writes:

The idea that there are people in public service who will care for all Americans unconditionally shouldn’t be remarkable, of course — but in our current dystopian moment, it seems soothingly old-fashioned.

excerpts:

Since March 2020, Fauci has a been a ubiquitous presence in the news. But despite the countless stories about him and his endless TV appearances, most Americans still don’t have a sense of what he’s learned in his role as their top doctor: what he’s come to understand about pandemics, about the good and bad of government service, and, really, about all of us. Now feels like the time to get his analysis of the data he’s been collecting all these decades. After all, as Anthony Fauci knows better than anyone, there’s always another disease coming. And at some point, we’re going to have to heal without him.


After arriving in 1968 at the National Institutes of Health, the organization that encompasses NIAID, Fauci’s first triumph was discovering how to re-dose cancer drugs to turn a 98 percent mortality rate of the autoimmune inflammatory disease vasculitis into a 93 percent remission rate — an almost complete reversal of virulence. For the next few years, Fauci experienced something rare in medicine: eureka moment after eureka moment. “If you expect it, you’re in the wrong business,” he says of those early successes. “Because you’re going to be so frustrated that you quit.” He was a rising star, but in a field where he was developing treatments for diseases that few people knew about. If Fauci had stayed in immunology, rather than switching to the splashier world of infectious disease, he says, his work “wouldn’t have been as much a global impact.” Then came AIDS.
This part of the story is famous: Three years before he became director of NIAID, Fauci read an article in a medical journal highlighting five cases of what we would later understand to be HIV, which became 26 cases. Mentors discouraged him from taking on what they felt was a niche disease contained to the population of gay men. “I was prescient enough to realize that it wasn’t going to just go away,” Fauci says. “I said: I’m an infectious-disease doc. I’m an immunologist. … It’s killing young gay men. It’s almost certainly sexually transmitted. And sexually transmitted disease is going to spread globally, because if there’s anything that’s universal, it’s sex. … If ever there was a disease that was made for me, it was this new disease.” There have since been 79 million cases of HIV worldwide.

“You can’t mourn every patient, or you spend your entire life mourning. But when you suppress everything, years later when somebody asks you to describe what you were doing, all of a sudden, it’s like you almost can’t even speak about it.” Fauci says he believes he has post-traumatic stress disorder from this experience, though he has never sought therapy. (“I’ve discussed it a lot with my wife, who’s the world’s greatest therapist,” he says.)

Fauci seems to be ideological only in his fervent belief in taking action that corresponds with the available facts — and in his commitment to working productively with the people who enable fact-based work, regardless of what political sect they belong to.

Fauci went from curing nearly all his pre-HIV cases to, he says, a situation where “you developed relationships with your patients … but almost all of them ultimately die.” It was unendurable to emotionally process that much loss. “In order to be able to live through that, you’ve got to do a lot of suppression,” Fauci says of his preferred coping mechanism. “You can’t mourn every patient, or you spend your entire life mourning. But when you suppress everything, years later when somebody asks you to describe what you were doing, all of a sudden, it’s like you almost can’t even speak about it.” Fauci says he believes he has post-traumatic stress disorder from this experience, though he has never sought therapy. (“I’ve discussed it a lot with my wife, who’s the world’s greatest therapist,” he says.)

During the AIDS crisis, Fauci met [bioethicist Christine Grady], who was then a nurse at NIH. They married and had three daughters. With a lot of help from a longtime nanny — and somewhat less help from Fauci — Grady worked part time and got her PhD from Georgetown while being the primary caregiver for their children.
To say that Fauci found it difficult to maintain a work-life balance would be incorrect; he chose to work, missing out on developmental milestones and things like soccer games. “I am sorry and sad, but I don’t regret,” he explains.

“I would do it over again,” he says, of being less-than-present for his family, “because I was doing things that are really important. When they were growing up was right in the early, challenging years of HIV, when we didn’t know what the virus was. And then we wound up with pandemic flu, and the anthrax attacks, and Ebola. It was constantly one time-consuming challenge after the other.”


By 2020, Fauci had worked under six administrations as the director of NIAID, enjoying positive relationships with both Democratic and Republican presidents. He came to consider George W. Bush a close friend. “Obviously there’s been appropriate controversy regarding decisions regarding Iraq,” Fauci says, “but his moral compass about health equity is very strong.” Fauci says Bush did “by far” the most to combat AIDS of any president he worked with, especially through the work of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which distributed lifesaving HIV drugs across Africa. “His exact words to me were, ‘We have a moral responsibility as a rich nation to not have people suffer and die merely because of where they live and the circumstances in which they were born,’ ” Fauci says.
Though Fauci votes, he says he is an independent nonpartisan, and his voter registration confirms he is not officially affiliated with any party. “He actually got along better with Republican presidents, in [the activists’] mind[s], than he did with Democrats,” Staley says. “We always thought he leaned more right — more R than D.”
In recent years, Fauci’s work, like everything else, became politicized around whether he appeared to be pro- or anti-Donald Trump. But in the mold of generations of government bureaucrats who predated our insane current political moment, he seems to be ideological only in his fervent belief in taking action that corresponds with the available facts — and in his commitment to working productively with the people who enable fact-based work, regardless of what political sect they belong to.
Fauci was so highly regarded across parties that he was asked, several times, to run the National Institutes of Health. “There’s a lot of work that’s ‘work-work’ as a director,” Fauci says of the administrative duties that would have taken him away from the investigative science he loves. In his current role, he’s in the office before 7 a.m., Fauci says, and spends his days approving policy and reviewing clinical trials with scientists across NIAID, seeing patients and consulting with clinicians at the NIH Clinical Center, and meeting with the White House and federal agencies.

But Fauci’s expertise apparently did not impress Trump. “Tony was telling us that he was already shaking his head at Trump,” Staley says of the pre-covid period of Trump’s presidency. “He was amazed that he was into his sixth president [as director of NIAID], and this was the first one that he hadn’t met with, like, three years in. And he was just stunned by that.” (Trump did not respond to a request for comment.)

Initially, Fauci seemed to be a great boon to the White House during the pandemic, patiently explaining complicated science in language a child could understand. (“There’s no stupid questions when it comes to covid,” Fauci told me as I barraged him with stupid questions.) He stood onstage next to Trump, lending credence to the proceedings. But Fauci’s allyship shifted when the information presented became reality-averse; he engaged in what appeared to be a mid-presser existential crisis in March 2020, literally burying his head in his hand after Trump called the State Department “the Deep State Department.” Fauci began correcting Trump when he espoused bleach as a covid treatment or suggested that the virus would just disappear. “I kept on pushing back,” Fauci says. “ ‘No, it’s not gonna end. No, hydroxychloroquine doesn’t work. I don’t care what the pillow man says.’ ” (That’s My Pillow founder Mike Lindell, an avid believer in covid- and voting-fraud cabals.) A faction within the White House led by Trump adviser Peter Navarro began conducting and releasing opposition research on Fauci. (The My Pillow press team did not respond to written questions. Reached via email through the lawyer representing him on contempt of Congress charges, Navarro said, “I didn’t need to do any opposition research to know that Fauci was both an idiot in love with his own ego and a danger to the White House, which is why I advised President Trump to fire Fauci on more than one occasion.”)

Fauci was struggling. He agonized over the question of whether to stay, take the abuse, and tacitly endorse the administration — or leave and let his half-century of work be taken over by God-knows-who in his absence. Fauci went to Grady, his live-in therapist, who said, “Well, let’s balance it. What is the advantage of this versus the disadvantage? And what’s the advantage of this [tack] versus the liability?”

When Grady passes by, I ask her what she thinks of all this, both as someone whose family is receiving death threats and as a bioethicist. In National Geographic’s 2021 documentary “Fauci,” she’d said that the combination of callousness and cruelty Fauci faces has shaken her faith in humanity and affected Fauci as profoundly as the early years of AIDS, when nearly everyone he treated died. “When you’re faced with somebody who you can’t help but want to and they want help, it’s sad,” Grady says, before offering me a glass of water. “And it’s frustrating. … When you’re faced with somebody who chooses not to do the things that would help him or herself and doesn’t really want to help either, it’s frustrating also, but in a different way. I don’t know if ‘anger’ is too strong, but something in that direction.”

Fauci also says he feels something “just short of anger.” “Listening to divergent people with divergent opinions is something he’s really skilled at, and good at, and [he] doesn’t get angry when people hang him in effigy,” says his friend John Gallin, the chief scientific officer and scientific director of the NIH Clinical Center. “When people won’t work with him, that’s when he gets upset.” Fauci’s foundational belief is that people are good — even people who don’t agree with him or say awful things about him. In 1990, AIDS activists held up a Fauci mask on a pole, as if he’d been decapitated. Fauci understood: He was letting them down. He realized that he would do the same thing if he were in their position — and that helped move the science forward. “When the Peter Staleys and the Gregg Gonsalveses and the Mark Harringtons and the Larry Kramers were attacking me,” Fauci says of Staley and other prominent AIDS activists, “I [could] have done what 99.99 percent of the scientific and regulatory community did, which was pull back from them and say, ‘You guys are attacking me. Screw them and to hell with them.’ I didn’t. I gave them the benefit of the doubt.”

Fauci was able to extend the same empathy to the last administration. “I try to look for the positive aspects of people in the Trump White House,” he says. “I think anybody who says, ‘Everybody who was in the Trump White House was a bad person’ is incorrect. I mean, there were people there who were really trying their best, except that there was a prevailing motivation, with few exceptions, of ‘Defend Trump and what he does at all costs.’ ”

Fauci’s humanistic conviction has prevailed, despite the need for a federal protection detail that protects him from people who want him dead. “I don’t think it’s naivete, because I’m the least naive person you’ve ever met,” Fauci says of believing in the inherent goodness of people. “I always look and try and find out: Is there a degree of something positive about what they’re trying to do? Can I put myself in their shoes and say, ‘Do their motivations have some kernel of positivity to it, or is it all just tearing things down?’ ” He says of some of his congressional critics: “I still give the benefit of the doubt to people like Rand Paul and Roger Marshall and people like [Representative] Jim Jordan.” And yet, Fauci says, his forehead wadded up in disgust: “Even when you give them the benefit of the doubt, I still can’t find something there that is reasonable. It’s just attacking for the sake of attacking.”

Before I started reporting, I assumed the inevitability of Fauci’s work — another pandemic always coming — inspired dread. [Bob Seder, another close friend who works at NIAID and helped develop Moderna’s coronavirus vaccine] tells me I’d gotten it all wrong. “That’s what we all live for,” he says of the people in Fauci’s tribe. “You understand, that’s what we do. He loves that. It’s not like he’s going, ‘Oh, Christ.’ No, that’s what’s keeping the blood going.” “Absolutely,” Fauci agrees when I relay that exchange.

Even though his efforts feel superhuman, Fauci’s motivations, it seems clear, were earthly. He wanted to save lives, but he also enjoyed the work — and receiving credit for it. “Tony’s got a big ego,” Fauci’s friend [Activist Peter Staley] says. And yet, his ego is also “one of his very useful tools for creating change.” Fauci’s career stands as a reminder that in government — or in any endeavor — your motives don’t have to be pure in order to do good.

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