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Source: Intellectuals Author: Zhou Yebin
United States book cover of Anthony ·Fauci's autobiography "On Call" by renowned infectious disease scientist Anthony Fauci.
In June 2024, Dr. Fauci's memoir, On Call: A Doctor's Journey in Public Service (On Call), was published. Not only does it give us the opportunity to learn about the legendary United States doctor's personal experience, but it also gives us a glimpse into the decision-making process of the United States response to various infectious disease emergencies for nearly half a century, including the new crown pandemic that has profoundly affected the world just past.
Doctor Fauci is a member of the National Institutes of Health of United States
（NIH）
United States National Institute of Allergy and Infectious Diseases
（NIAID）
The longest-serving leader to date has profoundly influenced infectious disease research in United States over the past decades. As the chief infectious disease expert of the United States, he has experienced the AIDS epidemic, Ebola and Zika and other infectious disease emergencies, and has made outstanding contributions to the prevention and treatment of major infectious diseases in United States and the world in the past 40 years.
As United States's chief infectious disease expert, he has served seven United States presidents, and has established good personal relationships with United States presidents such as Bush and his sons, but for decades, Fauci has been reminded that every time you go to the White House, be prepared for the last time you go, because one day, you need to tell the president something he doesn't like to hear, and after that, you may never be consulted again. And just as Fauci is entering his twilight years, this reminder is finally "fulfilled" and manifested in an even more brutal way.
At the age of 80, Dr. Fauci was confronted with the worst public health crisis of his life: the coronavirus. During the pandemic, Dr. Fauci became the most authoritative and honest voice, a beacon in the eyes of countless United States who were overwhelmed by the epidemic, and he became a "United States doctor" in the global spotlight; But it was also during the pandemic that Dr. Fauci became the target of many people who disagreed with the pandemic, including conspiracy theorists......
Doctor: The most important identity
Fauci's long career has spanned many infectious disease outbreaks. As the United States's chief infectious disease expert, he has served seven United States presidents, which gives this doctor so many stories to share about major public health decisions and the functioning of government. "On Call" is more than 460 pages long, and from page 60 onwards, Fauci begins to tell the story of his own career as director of NIAID. But the brief narrative of his experiences before becoming a government official does not mean that On Call is a memoir of a civil servant, on the contrary, it is easy for the reader to sense that Fauci himself values the identity of a doctor the most. This can also be seen in the title of the book "On Call".
On Call refers to the status of a doctor who needs to provide medical care to a patient at any time. Dr. Fauci often compares the all-night-working experience of a public health crisis to his own experience of On Call when he was a medical school student and a resident in New York: the book repeatedly mentions that the sleepless hours of work at a New York hospital on Call shaped his calm and calm trait in the face of a crisis.
What Fauci himself values as a doctor is the passion for caring for patients in his memoirs. He established a treatment center at NIAID to care for AIDS patients. In the '80s, AIDS was a terminal illness with no cure, and Fauci called it the "darkest hour" of his medical career: he had to care for a large number of seriously ill patients every day. But in his writing, what you feel is not despair, it is not that he avoids the pain and helplessness of patients in his memoirs, but you can feel that no matter the patient's identity, status, or condition, Fauci loves and even cherishes the opportunity to care for the patient.
This also explains why, after the Ebola outbreak in West Africa in 2014, Fauci, who was already a big leader, joined the medical team as a doctor to treat infected people in the United States. And his contact and communication with several Ebola infected people is completely the state of doctor and patient.
During the pandemic, Fauci also described himself as a doctor in the face of a confused and confused United States public, explaining what was happening to patients, the United States.
Fauci has many identities: he is the child of a Italy-American United States family in New York, a bright student who is highly expected by the nuns of a Catholic missionary school, an honors graduate of Cornell Medical College, a scientist who has made significant contributions to both autoimmune disease and HIV research, and the most influential leader NIAID has ever seen. But as you look back at Fauci's legendary life, you will find that his first and foremost identity is that of a doctor.
Of course, Dr. Fauci is not an ordinary doctor, he is calm and collected, whether he is dealing with the most complex critically ill patients in his internship or facing the most serious situations in his work. Anyone who has experienced the coronavirus pandemic in the United States should have an impression of Dr. Fauci's steady and gentle voice at the press conference.
Today, Fauci is better known as an authority in the field of HIV for his academic achievements. However, Fauci actually gave up on autoimmune disease research that had made great achievements
(Fauci was a groundbreaking contributor to the study of vasculitis treatment, making this once incurable disease rarely fatal.)
Later, he switched to HIV research.
Fauci switched to HIV, driven by the curiosity of scientists. In his book On Call, he recalls reading five strange cases of Pneumocystis pneumonia reported in the CDC's weekly MMWR report (Morbidity and Mortality Weekly) in the summer of 1981. He couldn't figure out why five otherwise healthy young people could get such a disease that only severely immunosuppressed people could get. The MMWR weekly report was the first medical report on AIDS in history, and the doubts it raised prompted Fauci, who was already middle-aged, to suddenly change careers.
However, when AIDS first appeared in Europe and the United States in the 80s, it was considered a disease that only gay men could get. Gay people, who are still discriminated against in many places today, were even more marginalized in those days. As a result, AIDS has not received mainstream attention for a long time. Fauci's persistence in the exploration and research of AIDS and HIV in that era was undoubtedly inseparable from his sincere concern for AIDS patients.
If someone had a life history like Fauci's, they would probably be able to write a memoir that would go on and on. But in "On Call," Fauci devotes an entire chapter to the AIDS campaign. Many key figures in the AIDS movement have been deeply dissatisfied with Fauci, the director of NIAID, as a representative of a government that ignores AIDS patients. They scolded Fauci in the press, caused trouble when Fauci attended an event, and even went to the NIH where Fauci worked to protest.
If you change to someone else, after a lot of tossing, you will probably become an enemy long ago. But Fauci became friends with the AIDS activists. For no other reason than because Fauci genuinely cares about these patients and is willing to listen to their feelings.
In the past few years, Fauci has been regularly attacked by some far-right elements and conspiracy theorists in the United States. Anyone who has experienced the criticisms and threats he has experienced will probably be extremely angry. But there seems to be only one place where Fauci really gets angry in "On Call": At an NIH MEETING, one of Fauci's subordinates informs people who have been allowed to sit in on the audience that they are not welcome and are not qualified to speak. Fauci, who was not present, was furious when he heard this, and he could not fire the government employee, so he had to settle for the next best thing and ask the subordinate to be transferred.
Dr. Fauci's compassion for his patients is not just about the disease, but about the lives of his patients. He is well aware that many people's fear of disease is not only the impact on health, but also the prejudice of others against disease. That's why Dr. Fauci hugged the first homegrown Ebola patient in United States who was personally involved in her treatment when she recovered and was discharged from the hospital.
Healing the sick is more than just curing. That's probably why Dr. Fauci has dedicated his entire career to public service for nearly 50 years. And his memoir aptly aptly titled: a doctor's journey in public service.
Serve the president and serve the country
In terms of public service, we cannot fail to mention another very special role of Fauci: the longest-serving director of NIAID and the longest-serving chief infectious disease scientist in the United States.
Now Fauci has become a world-famous figure, largely because during the new crown epidemic, he corrected the false claims of then-United States President Trump about the new crown and the epidemic, and became a model of intellectual conscience in the eyes of countless people. I believe that many people will also want to use the book "On Call" to spy on the palace fighting drama within the United States government during the new crown epidemic.
But it may be going to disappoint everyone. Fauci did not shy away from his disagreements with Trump and some United States government officials during the pandemic, nor did he shy away from the chaotic contradictions of decision-making at the time. But he doesn't have much drama, and the last part of the book is not as long as the HIV section, and there are even many chapters in other parts that describe the development of HIV prevention and treatment decisions.
Fauci speaks to the White House press corps about the coronavirus pandemic in April 2020 as President Donald · Trump (left) and Vice President Mike ·Pence (right) watch. Source: Wikipedia
Personally, after reading it, I feel that Fauci is somewhat conservative and polite when describing the Trump team's epidemic prevention performance in 2020 and even the subsequent personal attacks on him by right-wing conservatives with conspiracy theories about the origin of the new crown lab. In his memoirs, he made a historical record in a very objective and gentle way, but he was a little polite to many people and things.
If you read "On Call" from the beginning, it is not difficult to understand why Fauci has such "tactfulness" when it comes to the final chapter of the new crown. He has served seven United States presidents, and before Trump, he served five United States presidents, including three Republican presidents and two Democratic presidents. Fauci has maintained good relations with all five presidents, and the book repeatedly expresses gratitude and appreciation to successive presidents and parliaments for increasing funding for HIV research and supporting the global AIDS response.
There is no doubt that Fauci has a very strong belief in his home country, the United States state system, the government mechanism. For him, the United States president is not an individual who has climbed to the top of power, but represents the office of the president and is a symbol of the democratic republic of the United States country. It is not difficult to understand why he would say that he had to correct the wrong statements of President United States during the pandemic, and he personally felt no joy. Because it meant that something was wrong with the country he loved so much, and it was obviously very painful for Fauci, who had happily served every president in the past.
Contrary to the current impression of the United States right, in Fauci's memoirs, you can clearly feel that the president of the United States with whom he has a special personal relationship is the Bush father and son, two Republican presidents. The starting point of this special relationship is at least partly due to Fauci's status as a physician. Bush Sr. visited NIAID when he was still Reagan's vice president, and at that time there was a high demand in United States society to raise the importance of AIDS, and Bush Sr.'s visit was obviously in response to public opinion and preparation for his future presidential campaign. However, during the visit, the elder Bush was extremely interested in many scientific and medical issues, and this was the beginning of Fauci's acquaintance with him. After that, Bush Sr. often asked Fauci when he had some medical questions, including when his friends were sick.
Just as Fauci began to make frequent trips to the vice president's office, a senior offered him extremely important advice: Every time you go to the White House, be prepared for the last time you go, because one day, you'll need to tell the president something he doesn't like to hear, and after that, you'll probably never be asked again. Only by always treating the president as the last time can you insist on telling the truth.
It didn't take long for Fauci to come up with a time when he needed to tell the president bad news: Bush Sr. wanted to appoint him as director of the NIH after he was elected, but Fauci thought he could do more at NIAID and turned down Bush's offer for promotion. Fortunately, the rejected Bush did not change his trust in Fauci, although no United States president had much experience of rejection and told Fauci that he admired him more.
In the United States and around the world, George W. Bush is a highly controversial United States president. But in Fauci's memoirs, we can see another side of the president who was always associated with launching the wrong war in Iraq, and George W. Bush sincerely wanted to push United States to assist third world countries in improving the prevention and control of various infectious diseases, including AIDS. Launched under George W. Bush, the President's Emergency Plan For Aids Relief is the largest international health program ever developed by a single country on a single disease, saving more than 20 million lives in developing countries to date. Fauci was the main architect of the plan, and in his eyes, President George W. Bush, who spared no effort in supporting this ambitious plan, has done more to reduce the harm caused by infectious diseases.
As the chief infectious disease expert in United States, Fauci has served every United States president, but more importantly, he has served the public and has made significant contributions to the global prevention and control of infectious diseases.
A virus like no other
Fauci's story clearly can't get around the coronavirus, the largest epidemic of infectious diseases humanity has encountered in nearly a century. It can't be ignored that Fauci, who was born in 1940, was nearly 80 years old at the time of the outbreak of the new crown epidemic, which can be regarded as a twilight year.
In the more than 30 years that he had served as United States's chief infectious disease scientist, Fauci had "complaints" in his recollections. For example, when it comes to the Republican Party's linking funding for Ebola to reducing funding for female reproductive services, he mockingly argues that only politicians in Washington's capital can link the two things, but on the whole, he agrees with the way successive United States administrations have responded to infectious diseases.
This recognition is also a two-way street, and successive United States presidents have held him in high regard. Fauci mentioned in his memoirs that George W. Bush said to him when he left office, "I won't miss Washington's capital, but I will miss you very much." This is not only an expression of the Bush family's close personal relationship with Fauci, but also reflects the recognition of Fauci's work by the United States's top leadership.
As the aforementioned senior advised: Always treat your meeting with the president as if it were the last, because sooner or later you will say something that the president doesn't like to hear. Before the coronavirus, we weren't sure how many United States presidents Fauci had said that he didn't like to hear, but my guess was that when he told George H.W. Bush that AIDS was United States the number one cause of death for men aged 25-44 in 1992, that Bush had the threat of anthrax attacks after 911, and that the Ebola epidemic in Africa was getting worse, it was most likely not what presidents liked to hear. But instead of sending Fauci into the cold, they continued to consult him and plan countermeasures.
Perhaps fauci's expectation is that in his twilight years, this suggestion that the president may not be looking for you after telling the truth has "come true" and manifested itself in a more brutal way.
Fauci's conflict with Trump has long been widely reported in the media. But in Fauci's memoirs, Fauci has no personal grudges against Trump himself. Even Fauci felt that both of them were New Yorkers, and they both had the "spirit" of New York City.
But that doesn't mean Fauci doesn't have a problem with Trump, and in the book "On Call" he bluntly disagrees with Trump's constant attacks on the media. The greater contradiction lies in the unwillingness of Trump and some of his aides to adhere to the science in the face of the menacing coronavirus. Fauci did not say that the Trump team's epidemic prevention decisions were useless, such as that he believes that the March 2020 Trump rule is a very important decision and a reflection of the courage of the policymakers. However, as Fauci named the chapter on epidemic prevention during the Trump era: love me, love me not, the various contradictions of the Trump administration have brought great trouble to Fauci and made it difficult for him and other epidemic prevention related personnel to work effectively.
Trump could yell at Fauci on the phone, accusing him of destroying his economy, but soon after, his aides would tell President Fauci and Vice President that they were sorry for what had just happened and that they still loved him. Similarly, Trump can immediately agree with Fauci's suggestion when he talks to him, but in the blink of an eye, he will make a completely different statement to the public.
Fauci's observational analysis of this is similar to that of many media reports, and Trump seems to be easily influenced, often "echoing" the last person to whom he spoke. When different people give different opinions and suggestions, it leads to all kinds of inconsistencies. This is completely different from the United States presidents that Fauci has dealt with in the past: those presidents never express their position in person after he has stated the situation and gives advice, but after Fauci leaves, he consults with his staff, and then informs Fauci of the final decision-making plan.
Unfortunately, the easily swayed Trump and United States society have to face not only the new crown, but also a more different "virus": disinformation, repeated lies.
And all this, Fauci has actually experienced a long time ago. There is a chapter in On Call about AIDS denialism. In the 90s, despite numerous studies showing that HIV causes AIDS, some in the scientific community preached that AIDS did not exist and that HIV had nothing to do with AIDS. Fauci spent a lot of effort refuting these pseudo-science and conspiracy theories, but these disinformation still found a long-term survival.
During the pandemic, the virus of this disinformation has become even more proliferated. From Fauci's recollection, it is perhaps not surprising that Trump is always confused between the flu virus and the new coronavirus, and it is difficult to discern who is providing scientifically truthful information about the epidemic and who is misleading. Of course, Trump, who has a limited level of scientific knowledge, is often the source of misinformation.
To make matters worse, even after Trump stepped down, the virus of disinformation that broke out during the pandemic remained. This brings us to the final part of the book, where Fauci addresses his greatest concern for United States society: not the next public health crisis, but a crisis of truth — in a sense, the whole world is facing it.
In Fauci's words, we live today, a false information that has been repeatedly spread into everyday life begins to become as if it were true, lies are normalized, and some people even fabricate their own set of truths.
These lies and disinformation are not new, they can be said to have accompanied the entire history of mankind, but now that information can spread rapidly, their threat has increased dramatically. This also led Fauci to decide to retire from the NIH and become a civil servant in United States for nearly half a century, and then go into teaching at universities and sharing his experiences with young people.
So although at the end of the new crown section of "On Call," when Fauci drove away from the NIH after his retirement party, lamenting that his life's public service was truly an extraordinary journey, Fauci's story is not over, and he is no longer the chief infectious disease scientist of United States, but he is still serving this country and this society in his own way.
Finally, as a reader of On Call, I recommend this book to everyone. You may see many book reviews about this book, like this clumsy one, and some will also excerpt and paraphrase parts of the original book, but I am sure that none of them can restore the brilliance of the original book.
"On Call" is not perfect, and I regret as a Chinese person that Trump's "China virus" narrative and the increase in hate crimes against Asians are not mentioned at all, not to mention that these are related to the theory of the origins of the coronavirus lab, which Fauci explained at length. In the book, Fauci describes how he participated in the United States Biological Anti-Terrorism System established after 911, but the new crown chapter does not mention the closely related United States Strategic Reserve, which seems completely unreliable. This undoubtedly also makes the narrative of the new crown part less an important dimension, after all, in the first half of 2020, the lack of masks in the whole United States and the lack of ventilators in hospitals are unforgettable, but there are few traces in the book.