Celebrating 15 Years
This piece is excerpted from On Call: A Doctor’s Journey in Public Service by Dr. Anthony Fauci, a guest at Amherst College’s LitFest 2025. Register for this exciting, 10th-anniversary celebration of Amherst’s literary legacy and life.
March 2020 was the month when COVID became frighteningly real to Americans. March was also when I started waking up with a jolt at 4:00 a.m. to stare at the ceiling with worry after worry going off in my head like a machine gun. Italy was locked down on March 9, and two nights later, during an Oval Office address, the president ordered that citizens from twenty-six European countries be temporarily banned from traveling to the United States. In the meantime, Deb Birx was working nonstop behind the scenes to figure out how to protect the United States even further. She formulated a layered plan of shutting down the country for at least fifteen days to see if we could “flatten the curve” of new COVID cases by limiting people’s exposure. The idea was to prevent hospitals from becoming overwhelmed. I strongly supported Deb as she carefully refined a set of guidelines before taking them to the vice president. If he was convinced the plan was solid, the next step would be for him to present it to the president. All went according to Deb’s well-thought-out process, and on March 16, President Trump committed to a measure that no U.S. president had ever done before, announcing a program that became known as “15 Days to Slow the Spread.”
I was impressed that, although he knew there were economic considerations, the president agreed to the plan. I think Donald Trump thought that COVID would be temporary: a little time goes by, the outbreak is over, everyone goes back to work, and the election cycle can begin. He could not have imagined that the pandemic would go on for such a long time. I believe this explains why he repeatedly asked Deb, Bob, and me whether COVID resembled the flu. He desperately wanted the pandemic to disappear just as flu does at the end of the flu season.
Tragically, COVID was not the flu, and it did not vanish. Just the opposite. And so, with the ghastly reality setting in that COVID was not going to go away, Trump began to grab for an elixir that would cure this disease. Along came hydroxychloroquine. President Trump began hearing from the Fox News star Laura Ingraham and others who were touting the drug as a treatment for COVID. Hydroxychloroquine is a long-established medication that people take to prevent or treat malaria. It is also used to treat inflammatory and autoimmune diseases such as lupus and rheumatoid arthritis. Perhaps this drug would be his magic bullet, the fast way out of COVID. Soon he began touting it at our now daily press briefings. Tuning in were millions of worried Americans, hoping to put the pandemic behind them and get on with their lives.
The fact was, however, there were no clinical studies proving that this antimalarial drug would help people. And it might hurt them. The president seemed unable to grasp that anecdotes of how hydroxychloroquine might have helped some people with COVID did not translate into solid medical advice. This is when I realized that sooner or later I would have to refute him publicly.
During the early months of 2020, after a three-year hiatus following the Obama administration, I had been glad to be back working in the White House, making a difference. Then, gradually, I recognized that even though a contingent of bright and dedicated public servants filled the offices of the West Wing and the Executive Office Building, this was not the White House I had known since the Reagan administration. And the differences were going to dramatically affect the way I could do my job.
The president’s overt hostility to much of the press, particularly many of the White House correspondents from a variety of outlets sitting in front of him in the Briefing Room during task force briefings, was one glaring example. At one briefing, when Peter Alexander of NBC asked what he would say to Americans frightened by the pandemic, President Trump responded, “I say that you’re a terrible reporter.” At another briefing, he called Jonathan Karl of ABC a “third-rate reporter.” I had known Jon for years and considered him a friend, along with Jim Acosta and Kaitlan Collins, both of CNN, whom the president often verbally attacked. But even when I did not know the journalists the president insulted, I was still taken aback by his behavior. I was also con- cerned that my very presence at the lectern or sitting against the wall of the press room would be interpreted as acceptance on my part of his behavior.
More problematic for me was that I knew some of the things Trump was saying about the pandemic were false, and I had to push back when asked not only there at the lectern but in follow-up interviews. “Hydroxychloroquine doesn’t work,” I told reporters. Inevitably, they would ask me if I agreed with something Trump had said such as “Yesterday, the president said that [COVID] would just disappear like magic.” I would then have to respond with the truth: “Well, that’s not going to happen.”
I have often been asked how I got the wherewithal to publicly contradict a president of the United States. My answer is that I harked back to my identity as a physician who has cared for thousands of patients over my long medical career. I take very seriously a statement in the first chapter of the twenty-first edition of Harrison’s Principles of Internal Medicine, of which I have been an editor for forty years. In one section we quote from the 1950 edition of the textbook: “The patient is no mere collection of symptoms, signs, disordered functions, damaged organs, and disturbed emotions. The patient is human, fearful, and hopeful, seeking relief, help, and reassurance.” Understanding this compels me to abide by the principles to always be honest; to be unafraid of saying that I do not know something; to never overpromise; to be comforting, yet realistic. When I spoke to the American public in the daily White House press conferences, I tried to act as if, metaphorically, the American public were my patient, and the principles that guided me through my medical career would have to apply.
I took no pleasure in contradicting the president of the United States. 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. I realized I had a critical role to play, the person who showed up and told it like it was. And I not only had to tell the truth to the president; more important, I had to tell the truth to the American people; otherwise, I would compromise my own integrity and relinquish my responsibility to my patients—the American public.
From On Call by Anthony Fauci, M.D. published by Viking, an imprint of Penguin Publishing Group, a division of Penguin Random House LLC. Copyright © 2024 by Anthony S. Fauci.
Dr. Anthony Fauci is one of the most recognized and influential figures in public health and policy. With a career bookended by the HIV/AIDs and COVID-19 pandemics, Fauci’s impact has spanned seven presidents and touched billions of lives. He served as the director of the National Institute of Allergy and Infectious Diseases (NIAID) for 38 years and oversaw an extensive research portfolio devoted to the prevention, diagnosis and treatment of infectious and immune-mediated diseases. Fauci’s memoir, On Call: A Doctor’s Journey in Public Service, chronicles his fascinating life story from his childhood in Brooklyn to his unrivaled 50-year career of public service.
