ON CALL: A Doctor’s Journey in Public Service, by Anthony Fauci, M.D.
In his new memoir, Dr. Anthony Fauci bares all. After he’s unthinkingly opened a typewritten letter containing a mysterious white powder that could be anthrax (treatable with Cipro), ricin (almost certainly fatal in an Agatha Christie kind of way) or perhaps confectioner’s sugar, guys in hazmat suits arrive and order him to strip.
Following a “Silkwood” shower, Fauci has a few tense if resigned hours with his wife, Christine Grady, a nurse and bioethicist, and adult daughters before getting the all-clear. Having personally eased many patients’ passage into the Great Beyond over his almost six-decade career, he writes, “I do not fear death.”
Aside from this episode, “On Call” is a well-pressed gray flannel suit of a book with a white coat buttoned over it: a calm reply to deranged calls for this distinguished public servant’s head on a pike. Is it measured and methodical in sections? Sure. So is science.
These days, Fauci is most closely associated with Covid-19, hero or rogue depending on your political persuasion, under repeated and heated scrutiny for his messaging about masks, vaccines and the lab-leak theory. (“We must keep an open mind to the origin of Covid,” he writes with seeming weariness. “As I do.”) People blame him for their bad pandemic experience, as if he’s a waiter who served them the wrong meal and might be hiding what is going on in the kitchen.
Gently, “On Call” reminds us that Fauci oversaw an entire Seder plateful of plagues, from AIDS to Zika, as the longtime director of the National Institute of Allergy and Infectious Diseases in Washington, D.C., saving millions of lives around the world before stepping down in 2022.
He speeds through his early background. Born on Christmas Eve 1940, to first-generation Italian immigrants living in Bensonhurst, with a sister three years older, Fauci recalls the “extraordinarily soothing” sounds of foghorns in Gravesend Bay and his mother crying over photos of the mushroom cloud on the front page of the New York Daily News after the bombings of Hiroshima and Nagasaki.
His father was a pharmacist working long hours for whom Anthony, a tippety-top student, sometimes delivered prescriptions on his Schwinn bicycle. He won admission to Regis, the elite Jesuit high school in Manhattan, where he was captain of the varsity basketball team despite being 5’7,” and the College of the Holy Cross, where he studied classical Greek and spent summers working on a construction gang.
By Page 21, his mother has died of cancer at 56 and Fauci has graduated first in his class at Cornell Medical School. There are a few glimpses of his life as a young doctor: the mentor who offers him soft shell crabs fried over a Bunsen burner and the time he treats a tear-gassed Vietnam War protester.
But the story really begins after Fauci, following a decade in the field at the at the N.I.A.I.D., reads about outbreaks of pneumocystis pneumonia among gay men in California and New York. His increasing preoccupation with the rapidly spreading, catastrophic human immunodeficiency virus helps to torpedo his brief first marriage, and he’s appointed to lead the organization in 1984.
“On Call” contains many shout-outs, not just to respected friends and colleagues but also to patients like Ron Rinaldi, who went blind after cytomegalovirus “literally chewed up the critical sight elements of his retina from the time we had made morning rounds to the time we walked into the room that evening.” Despite the help of a collaborator, Linda Kulman, stories like this are somewhat diluted by bureaucratese like “pushing the envelope,” “proof of the pudding” and so on. You kind of wish Fauci’s elementary-school nuns, who “introduced me to the experience of tough love,” had stood over him with a ruler.
But the narrative sharpens when, as he did playing point guard on the court, Fauci goes one-on-one with formidable adversaries.
In the AIDS era this was Larry Kramer, the writer and activist who in an open letter to The San Francisco Examiner called him a “murderer” for not moving quickly enough with research into the disease. This too turned out to be a kind of confectioner’s sugar. Even as they sparred in the media, the two men came to develop a private relationship, and “reminisced like two aging warriors” while dining together at Kramer’s apartment. Fauci helped an actor prepare to play a thinly veiled version of himself in Kramer’s 1992 play “The Destiny of Me” and eventually oversaw his liver transplant. In their last phone conversation, he relates, they exchanged tearful “I love yous.”
In a weird way, the hotheaded Kramer’s push-pull of the calmer Fauci presages Donald Trump’s. In the early stages of the pandemic, the president would tell the physician that he “loved” him, then denounce him on Twitter if the stock market didn’t spring properly to attention after encouraging news. About this chaotic administration, whose supporters have vilified him, Fauci is restrained. (On Jared Kushner: “a lot of positive attributes,” including “good common sense,” although the president’s son-in law “knew very little about infectious diseases and he did not always get everything right.”)
Fauci is equally controlled about Barack Obama, with whom he also has an “I love you, man” moment. If there were a KN95 mask that protected against partisan politics, Fauci would snap it on. The warmest fuzzy in “On Call” comes when George W. Bush signs the President’s Emergency Plan for AIDS Relief (Pepfar) in 2003.
During that period, the actress Bo Derek shows up in the West Wing, “looking as stunning as she did in that iconic scene in the movie ‘10’ when she and Dudley Moore were running toward each other on the beach.” Fauci is delighted to see her: “The White House is always full of surprises!”
Unlike many who’ve passed through there, Fauci has earned a victory lap. He easily clears the hurdles thrown up by his detractors; his eyes stay trained on the finish line, not the commotion in the bleachers.
ON CALL: A Doctor’s Journey in Public Service | Anthony Fauci, M.D. | Viking | 480 pp. | $36
