Ticket 2 Ride

Dr. Fauci, like Bill Gates and other influential people, seems equally praised and despised. I think he’s a fascinating person, who navigated very choppy political waters during a large number of health crises during his long career. Critics like Majorie Taylor Green, RFK Jr. and Rand Paul disagree. More on that later.

On Call, A Doctor’s Journey in Public Service (Viking, 2024), is a journey through the last fifty years of public health, because it matches Fauci’s career. Fauci writes with clarity and without a lot of medical jargon, although there is a lot of federal jargon, and many programs names that seem to blend together. While Fauci skips over a large part of his personal life, he weaves in family references as they intersect with this work. Fauci was all about the work, and extremely passionate about scientific discoveries and advancements that potentially save lives.

After reading this book, it’s apparent that human life is just one virus away from extinction, and while our species circle the drain, politicians will be debating and fundraising until the last breath.

The first major battle Fauci undertook was funding AIDS research and developing a drug, or drugs to save lives. In the early 1980s, as the disease was spreading, but still referred to the “gay disease,” not only did Fauci successfully campaign for a significant funding increase, but he fought resistance and indifference within his own agency for increased research.

The AIDS story is a good one, he takes us inside of the disease from initial blip on the radar to successful drug trials and eventually, changing attitudes. The stories he tells put names and faces to diseases and human struggles. AIDS is one of the most compelling stories of a global crisis, even though many dismissed it as an African, gay or risky behavior affliction, giving no empathy or concern about the spread through heterosexual activities and blood transfusions. I did not realize the role Fauci played in advancing research, drug trials and advocacy. The book is not about how Fauci developed miracle cures for diseases and deadly infections, he didn’t do that. As a doctor, scientist and administrator, he was a leader, facilitator, lobbyist, presidential medical advisor, as well as lighting rod for critics. Fauci was part of a team that tackled these health crises, although it was his face that often represented our health and disease efforts.

It’s no wonder that HIV/AIDS takes up a major part of the first half of the book. It was the first major challenge of Fauci’s career, and it represented a perplexing disease that required a worldwide response.

The word “vaccination” is comparable to the word “abortion” in divisiveness, an issue Fauci tried disarming. Falsehoods and conspiracy theories are pushed, and when it is by government officials, the stakes are high. “All of a sudden Peter Navarro, an adviser to the president on economics and trade, burst in and interrupted the discussion. ‘I’ve got a bunch of papers here that say it works. I have all the evidence in the world that hydroxychloroquine works. And by preventing people from getting it, you have blood on your hands!’”

“But the CDC’s syndromic approach was not adequately suited to dealing with COVID, a swiftly spreading disease in which, it would later turn out, more than a substantial portion of the transmissions come from people who are asymptomatic. The CDC was slow to recognize and act on that.”

“With COVID, however, the system failed,” Fauci writes. “Instead of immediately partnering with the diagnostic industry, the CDC started from scratch with a test that turned out to be defective.”

That sidestep was enough to allow the divisiveness and false theories to take root. When Donald Trump endorsed using bleach as a way to disinfect the lungs from COVID, Fauci did not let that go unchallenged.

“I took no pleasure in contradicting the president of the United States,” Fauci writes. “I have always had a great deal of respect for the Office of the President, and to publicly disagree with the president was unnerving at best and painful at worst. But it needed to be done.”

Trump also demanded that the country get back to normal by Easter. Fauci replied, ‘Mr. President, the virus doesn’t understand Easter. I’m sorry, sir.’”

Fauci stepped into a hornet’s nest of criticism, and threats.

“This was different,” Fauci says of the viciousness of the vitriol. “Now my family and I were barraged by emails, texts, and phone calls…As a result, I was assigned a security detail.”

Did Fauci help manufacture the COVID-19 virus? Was his influence responsible for harming children who were told to wear masks? He is responsible for a massive number of COVID deaths, and did he contribute to derailing the U.S. economy? He’s the devil, a mass murderer, a charlatan and a bad bridge player, all rolled into one. Some people believe this.

One day, Fauci nonchalantly opened an envelope and wished he hadn’t. “A fine white powder shot up from the paper and drifted down onto my face, tie, shirt, hands, pants, desk, and chair. I instantly feared anthrax, or worse.”

Fauci was alerted by several reporters who told him they had received “opposition research” on Fauci from someone in Trump’s White House.

Even today, after Fauci’s retirement, the he is still drawing fire.

“Madison Cawthorn, a Republican from North Carolina, gave a speech on the House floor calling me a ‘demon doctor’ and demanding to know ‘why the hell Americans are funding the torture of puppies in Africa.’”

Donald Trump Jr. was selling T-shirts emblazoned with messages like “Fauci Kills Puppies.”

It started with HIV, then other public health threats such as West Nile virus; severe acute respiratory syndrome, or SARS; bird flu; respiratory syncytial virus; chikungunya, a mosquito-transmitted virus that reached the Western Hemisphere in the Caribbean in 2013 and 2014; Ebola during the 2014-16 outbreak in West Africa and the 2018-20 outbreak in the Democratic Republic of the Congo; and Zika during the 2015-16 outbreak in South America. Then COVID-19.

Most of us sleep soundly at night, unless you have an angry prostate, or are responsible for protecting against a military or cyber attack, or a deadly virus or disease. Fauci’s book helps to put into perspective how vulnerable we are, and the infrastructure in place to research and respond to these massive threats. If you can sort through the alphabet soup of programs and terms, Fauci’s book is an absorbing read.

4/5