I’ve Read Nearly Every Memoir by a Former Trump Official. Fauci’s Is Something Different.

In 2009 Anthony Fauci was serving as director of the National Institute of Allergy and Infectious Diseases—as he had since 1984 and would do until 2022, under seven presidents—when that fall’s supply of the flu vaccine collapsed. As Fauci writes in his new memoir, On Call, this was alarming because that year’s dominant variant, said to be similar to the kind that caused the devastating Spanish flu of 1918, had gotten off to an early start that summer. At that time, pharmaceutical companies grew the viruses needed for vaccines in eggs, a slow and failure-prone method. As a result, by early October, the companies had delivered only 11 million of 160 million promised doses. To make matters worse, one of the suppliers was in Australia, a country undergoing its own outbreak of the flu, and the government there had commandeered all the doses intended for the United States. Americans stood in long lines at pharmacies, desperate to get their shots, and Republican lawmakers described the situation as “Obama’s Katrina.”

By November, the pandemic had tapered off a bit, and there was plenty of the vaccine to go around. Yet, Fauci writes, “now that the vaccine was available, the long lines were replaced by many people saying that they did not trust the CDC, which was encouraging them to get vaccinated, nor did some trust the safety of the vaccine since it was a new vaccine and they were afraid of possible side effects.” This flip-flop he chalks up to “the inscrutability of human nature.”

On Call is full of stories like this one, drawn from four decades of working in public health, much of it at high levels. It’s clear from reading this autobiography that Fauci considers his work on HIV and AIDS to be his true legacy. He began focusing on the disease in 1981, watching his patients die slow, agonizing deaths, the cause unknown. He battled with and conferred with activists who complained that the government’s response to the crisis was inadequate. Larry Kramer once called Fauci a “murderer” and an “incompetent idiot” in an open letter published in the San Francisco Examiner, but the rabble-rouser and Normal Heart playwright ended up declaring Fauci “my hero” when Fauci came out in support of a “parallel track” of drug testing that would give desperate AIDS patients access to experimental treatments. The pinnacle of Fauci’s efforts, a program called the President’s Emergency Plan for AIDS Relief—enacted during the administration of George W. Bush—resulted in, by Fauci’s account, “the saving of 25 million lives and counting” in the developing world.

And yet all anyone wants to hear about is Trump and COVID, a period comprising only a tiny fraction of Fauci’s career. Blame it on the inscrutability of human nature. On Call is the story of a civil servant who spent most of his working life during a time when politics was more boring but also more effective. He had the misfortune that many of his final years occurred in the three-ring circus of the Trump administration, a White House that was infinitely more entertaining but far less competent—with the exception, to be fair, of Operation Warp Speed, a program that miraculously developed safe and effective COVID vaccines in less than 11 months and is the administration’s one great achievement. As a result, Fauci found himself earlier this June being grilled before Congress by the clownish Marjorie Taylor Greene, who accused him of “crimes against humanity” and other unfounded nonsense.

Some might wonder why Fauci, now retired, bothered to show up at all. On Call provides an answer to that. Greene is not the first person, after all, to accuse Fauci of having blood on his hands, as Trump’s economic adviser Peter Navarro once put it when berating Fauci for not endorsing the use of the malaria drug hydroxychloroquine for the treatment of COVID. (Hydroxychloroquine is completely useless for this and can have life-threatening side effects.) But in the past, as with ACT UP members and other AIDS activists, Fauci made a point of sitting down with his critics. Because he was the public face of the federal government’s AIDS efforts (and one of the few officials willing to be associated with the disease in the early 1980s), he became a frequent target of protesters and critics. Fauci writes that he made a point of reading their literature, and “what came through and resonated deeply with me was not their confrontational style but the obvious fear and emotional pain they were feeling as they watched their friends and lovers die horrible deaths and as they feared a similar fate for themselves. I tried to put myself in their shoes, and it became clear to me that I would have been as vehement as they were in demanding a more concentrated and effective effort against this emerging plague.”

Although Fauci’s work on HIV still has its detractors, he ended up befriending many AIDS activists and consulting some of them on public-health strategies for fighting COVID. Fauci made a rigorous habit of nonpartisanship and had warm relationships with Presidents Bush, Clinton, and Obama—the latter of whom telephoned him in concern when the extremist demonization of Fauci really ramped up. But even this carefully maintained neutrality could not withstand the tribal dynamics of our current politics, and Fauci committed the unforgivable sin of making Trump look bad by contradicting the president’s most toddlerlike statements on the pandemic—such as his insistence that it must all end by Easter 2020, or his musings about the possibility of cleaning out the insides of COVID patients with a disinfectant like bleach.

Fauci portrays himself as largely bemused by Trump, who would attest to loving him, then attack him on Twitter, then confide that other people in the administration were saying bad things about him (a common Trump tactic for undermining his staff), then chew him out on the phone. (“He Loves Me, He Loves Me Not” is the title of one chapter.) Unlike most Trump administration memoirs—and, to be fair, only the final 70 pages of this book can be labeled as such—On Call makes little effort to settle scores or detail palace intrigues, apart from the obligatory disdain for Mark Meadows, Trump’s final chief of staff, whose risibility seems to be the only subject on which all former habitués of Trump World can agree.

Nevertheless, Fauci manages to telegraph Trump’s inadequate response to the COVID crisis without voicing an overt condemnation. He describes the president’s untrammeled delight over the high ratings his press conferences on the pandemic briefly achieved, and Trump’s complaints about how Fauci’s attempts to correct his most egregious misstatements had tanked the stock market. “Anthony,” Trump said after Fauci was (erroneously) reported as advocating school closures in the fall of 2020, “you are losing me trillions of fucking dollars.” Juxtaposed with the compassionate responses of earlier presidents to the health crises they faced, Trump’s obsession with numbers over people does not go unnoticed, even if Fauci himself doesn’t overtly draw the comparison. Similarly, although On Call never acknowledges right-wing digs at Biden’s mental competence, Fauci does recount a briefing he provided to the current president on booster shots, noting, “The president listened attentively to my opinion, and as always, I was impressed with his focus on details.” Never is Trump described in such terms.

Fauci seems to have welcomed Biden as a return to the more functional and compassionate breed of elected leaders he’d worked with through the decades. But you can’t blame him for wanting to quit while he was ahead (and in his 80s). He’s done his bit, and we may not see his like again. On Call is a brisk and often suspenseful account of how a man who clearly loved his job confronted and tried to solve four decades of health crises, from HIV to bioterrorism and Ebola. It shouldn’t have to end with a chapter devoted to debunking a lot of crackpot conspiracy theories surrounding how he and other scientists handled an unprecedented and fast-moving pandemic as it evolved on the ground. It may be human nature, as Fauci acknowledges, to lash out at authorities who can’t supply ironclad answers in a time of fear and uncertainty. But that doesn’t make it any less absurd.