In “Fauci,” a doctor whose work has been shaped by politics

For a moment it appeared as if reality had come home to roost in the White House.

The president, who has long denied the severity of COVID- 19, who waved away a question about 1,000 Americans dying every day (“It is what it is”), who hawks quackery and discourages preventive measures like maskwearing, contracted the virus last week, along with several others in his orbit.

In the midst of the clamor and speculation was the occasional forlorn question: Where is Dr. Fauci?

Anthony Fauci has been at the helm of the National Institute of Allergy and Infectious Diseases through the emergence of HIV, SARS, avian bird flu, swine flu, Ebola and Zika. He is “America’s doctor,” Michael Specter, a staff writer at The New Yorker, says in his new audiobook, “the essential first biography,” according to its publishers.

“We don’t have an actual leader,” Specter said in April. “Fauci is the closest thing.”

Before being sidelined in recent weeks, he was regarded as the adult in the room, with his quaint fondness for facts and evidencebased science. Of recent events, he noted with wry, habitual circumspection: “I think it’s obvious that I have not been involved.”

Biography might be a generous description of this book. “Fauci” faithfully follows Specter’s profile of the doctor published in The New Yorker this spring. The White House tightly controlled his access to Fauci; despite having known each other for decades, the men were not able to meet in person. It is the story of the public life we receive, delivered in broad, reverent strokes, frank hagiography.

Fauci would graduate first in his medical school class. From there, he moved to the National Institutes of Health in 1968, where he has remained. It’s a story of drive, discipline and smooth ascension. The antagonist has yet to arrive.

In the early 1980s, reports began to surface of gay men dying of a form of pneumonia. Although Fauci was quick to raise the alarm and to investigate the role of the immune system in the new syndrome, he became the public face of the medical establishment’s sluggishness and indifference to the plight of gay men, the poster boy for the agency that denied dying men experimental drugs. Playwright and ACT UP founder Larry Kramer was relentless in his criticism. Fauci was a murderer, he raged. Fauci was Eichmann.

Fauci did embody the paternalism of medicine at the time, Specter writes. Patients were rarely consulted in their treatment, not even AIDS activists so formidably self- educated about the disease. But their anger made an impression on the doctor. He flinched from it, yet wanted to understand. Fauci began to listen. He went to ACT UP meetings. He heard stories of desperation, of men boiling their blood and shooting it back into their veins.

Fauci changed course, confounding his colleagues. He advocated for the activists and revamping the clinical trial system. He was persuaded by the facts, Specter says, “a vanishing art in this country.”

“They were all New York guys,” Fauci has recalled of the activists. “I had a little affinity to them because I’m a New Yorker. And I said, ‘ What would I do if I were in their shoes?’ And it was very clear: I would have done exactly the same thing.” They’re all New

York guys in this story — Fauci, Trump, Kramer. The reason to listen to, rather than read, this story is for the texture of the voices, the archival audio that distills the panic and resolve of the era.

Specter’s own voice — a bit breathless, a bit reedy — turns out to be one of the book’s most effective instruments. On the page, he can be as professionally impassive as Fauci at a news conference. But in the recording, there is no tamping his emotion and exasperation. The book becomes an indictment of Fauci’s great adversary, the adversary he shares with Kramer and with Specter, too. That adversary is not a virus or a particular administration. It’s apathy.

“Our continued existence depends on just how angry you can get,” Kramer wrote in a fiery

1983 editorial, addressing gay men. “Unless we fight for our lives we shall die.” In his milder way, Fauci has been making the same point for years where viral epidemics are concerned. Why aren’t we more prepared? Why isn’t there a universal vaccine for the flu, which kills tens of thousands of Americans each year? Where is the political will to make this a reality? Why has America had so many lucky breaks — spared the worst of avian flu and SARS — while learning nothing?