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The Career of Dr. Anthony Fauci · CareTalk: Healthcare. Unfiltered.

• 0:00
  David: He captain his high school basketball team despite being five seven, and then cured vasculitis and became head of a federal agency where he was admired by six presidents and he went from enemy to hero among AIDS activists.
• 0:13
  David: Who am I talking about?
• 0:14
  David: Well, Dr.
• 0:15
  David: Anthony Fauci, of course, who's just announced his retirement after 54 years.
• 0:20
  David: Welcome to CareTalk, America's home for insightful debate about healthcare, business and policy, and a Top five Health podcast.
• 0:28
  David: I'm David Williams, president of Health
• 0:29
  John: Business Group.
• 0:31
  John: And I'm John Driscoll, the president of Walgreens Health.
• 0:33
  John: David, you aspire to become five seven.
• 0:37
  David: Well, John I, with my basketball shoes, I do think I make it there by the.
• 0:42
  John: So what is going on with the, the, the, the wonderful Dr.
• 0:46
  John: Fauci, he's retiring.
• 0:48
  John: Who, who, who said he could do that?
• 0:50
  David: That's what people said.
• 0:51
  David: You know, is Dr.
• 0:52
  David: Fauci retiring?
• 0:53
  David: He's only 81 now, John.
• 0:54
  David: The thing is, he says he's actually not really retiring.
• 0:56
  David: He's just moving on, you know, to the next step in his career, which is, which is not yet announced.
• 1:01
  David: But he actually stayed on because President Biden asked, I think he was probably ready to retire at the, at the end of the previous, uh, administration.
• 1:08
  David: But no, he's, uh, he's stepping down.
• 1:11
  John: I think it's a brutal job to be helping lead the country through a pandemic crisis that, you know, has it became, it went, it went from a pandemic to kind of a political battle where you're, you're not just.
• 1:26
  John: Playing a role as the, uh, leader of the scientific and public health efforts, which he's extraordinarily successful at, but really getting hung up with some sort of bizarre political challenges.
• 1:39
  John: Although this isn't the first time that public health has become political,
• 1:42
  David: David.
• 1:43
  David: John, I think it's a good opportunity to go through and just talk about, you know, Dr.
• 1:48
  David: Fauci achievements and accomplishments.
• 1:50
  David: He started actually in the federal government when he was 27.
• 1:53
  David: Now he's 81, which quick math John means he spent two thirds of his life, uh, there and he's accomplished a lot, uh, over that time.
• 2:00
  David: And I think this episode gives us a chance to go beyond what people have heard in the most recent public health emergency and talk about the, really, the arc of his, of his career, because there's
• 2:08
  John: a lot there.
• 2:09
  John: It, it's a great point.
• 2:10
  John: You know, it's a, he's a great immigrant success story.
• 2:13
  John: His, his, uh, his Italian parents immigrated to the, or grandparents immigrated to the us.
• 2:19
  John: His father was a, a pharmacist, and he went to one of the Fable Jesuit free high schools that you can only get into, um, based on admission, but they charged no tuition at all, egregious where he be, you know, the, the whole notion of being of service.
• 2:34
  John: Was the reason why he committed to become a doctor, uh, while actually in high school.
• 2:39
  John: And then he went to the, uh, holy Cross.
• 2:42
  John: Um, and then, uh, while Cornell for his, uh, medical background.
• 2:46
  John: But, but throughout his career, even early on, he was deeply committed to healing and helping improve the ways we heal.
• 2:55
  John: Uh, folks who are.
• 2:57
  David: John, there's a lot of people, there's a good number of people that are committed, you know, to that kind of a course of action.
• 3:02
  David: There are very, very few, if any, that have actually had, uh, the same level of accomplishments.
• 3:06
  David: So, you know, sometimes people ask me, you know, what are Dr.
• 3:09
  David: Fauci achievements?
• 3:10
  David: Because they, here, I defend him sometimes in the, in the current crisis, there's a whole bunch of things.
• 3:14
  David: Maybe I'll take off a few and then we can discuss them a little more depth.
• 3:17
  David: One thing is that he actually created effective treatments or cures for a number of formerly fatal immune diseases, including
• 3:24
  John: vasculitis.
• 3:24
  John: Yeah.
• 3:24
  John: He's not just, he's not just a talking head.
• 3:26
  John: That's a really important point.
• 3:28
  John: He was actually, um, you know, of the, the, the two or 3 million scientists who have published at, you know, in the, in the eighties, he was ranking as the 13th.
• 3:40
  John: Quoted, which is to say he's published such effective and important articles across many domains of infectious diseases and particular diseases that he's one of the most, one is widely referred to scientists in the world.
• 3:56
  John: Uh, and, and then there's the, and then he literally went, I think the vasculitis.
• 4:01
  John: Can you explain what vasculitis is, David?
• 4:03
  John: I know the statistics on it, but do you know what it is?
• 4:06
  John: Yeah.
• 4:06
  David: Well, it's, luckily we don't have to worry about it too much, but it's sort of an immune, uh, response that used to kill something like 90% of people, uh, that got it.
• 4:15
  David: Uh, and with a new drug regimen that Dr.
• 4:17
  David: Fauci put in place, it's now it's like 95%, uh, remission rate.
• 4:21
  David: Sure.
• 4:21
  David: A lot of his, uh, a lot of his.
• 4:23
  David: His, um, his research in the area of, of immune response, including autoimmune.
• 4:27
  David: So there's also a number of rare, uh, diseases that he was able to basically, uh, you know, develop treatments for,
• 4:35
  John: including by, but even, but even, even more common ones, David, I mean, he was one of the innovators around.
• 4:41
  John: Uh, uh, tuning up the doses of can anti-cancer drugs that have churned some of these drugs from treatment to sort of managing the disease.
• 4:50
  John: I mean, cancer's pretty common.
• 4:51
  John: Um, in rheumatoid, the rheumatoid arthritis, which is a, which is a, a really painful.
• 4:58
  John: Condition that affects a lot of people.
• 5:00
  John: Uh, the association identified him as probably the most important scientist affecting the many people, uh, uh, who are suffering with ra, with novel treatments, but perhaps his biggest, you know, the public got to know him with slightly longer hair and slightly, uh, uh, and, and, and with different glasses.
• 5:21
  John: Uh, during the AIDS epidemic, uh, the, the, just, just the early stages under Reagan.
• 5:26
  John: Do you wanna talk a little bit about that?
• 5:28
  John: Because this is, this, you know, very few people have more than one kind of dance in the public where they're, where they're, where that, where that kind of, you become that prominent, particularly as a
• 5:38
  David: doctor.
• 5:39
  David: Uh, Well, John, as you know, as we said, he'd been in the government for over half a century, and he's been the director of the National Institute of Allergy and Infectious Diseases for 38 years.
• 5:48
  David: So that takes us back to the, uh, to the aids, hiv, uh, pandemic.
• 5:52
  David: And in that time, uh, he was very involved, um, with, uh, with this disease as it came out.
• 5:59
  David: And it was a real kind of a mystery what was going on.
• 6:02
  David: Uh, and he made a lot of enemies in the lgbtq uh, community, Larry Kra.
• 6:07
  David: Famously called him an incompetent idiot and a pill pushing tool of the medical establishment.
• 6:13
  David: Um, and basically the AIDS activists were, were very, uh, um, you know, very hopeful and very aggressive about getting experimental treatments made available.
• 6:24
  John: Yeah, I mean, let's, let's, let's put it in context though.
• 6:26
  John: Larry Kramer was a very famous AIDS activist and and writer.
• 6:30
  John: I believe he actually had aids, I, I can't recall precisely, but he was a really.
• 6:34
  John: Thoughtful, aggressive, prominent, but, but at the time, there was a real fear among the, the, the, the LGBTQ community that people weren't taking this disease seriously because it was sort of a gay disease, not a disease that affected as it actually does the, the rest of the population, and they were being singled out and perhaps not properly served.
• 6:55
  John: What they were pushing for is the aggressive use to your point of new treatments, and frankly, Needed to, uh, through organizations like Act Up and others, make sure that people were focused and prioritizing this, uh, this at, at the time absolutely deadly mortal disease.
• 7:13
  John: And so I think they were motivated by the deaths of their friends.
• 7:16
  John: And, and, and of course anybody would've, would've, they probably would've attacked.
• 7:21
  John: Anybody who would be perceived to be slow walking, whether they were, they were not treatments.
• 7:28
  John: But what's remarkable about that one, David, is that now he's seen as a hero in the community about pioneering drugs and, and, and, and helping kind of, uh, shotgun them through the system.
• 7:41
  John: And Larry Kramer actually ended.
• 7:45
  John: Identifying, uh, Dr.
• 7:47
  John: Fauci as one of the heroes of the crisis.
• 7:49
  David: Yeah, he said he was the only, uh, true and great hero there.
• 7:52
  David: And what, you know, Dr.
• 7:53
  David: Fauci did is he made these experimental treatments available widely.
• 7:57
  David: Uh, you know, he wasn't in charge of approving drugs, he wasn't working for the fda.
• 8:01
  David: That's their job, the Food and Drug Administration.
• 8:03
  David: But he had an opportunity in order to move things through quickly.
• 8:06
  David: Now, interesting contrast,
• 8:07
  John: John.
• 8:07
  John: The other, the other, the other interesting thing, I think from that period is he also made a.
• 8:13
  John: Offline without the cameras presence of directly meeting with activists, and he never lost track of how the importance of a public narrative that's tied to a private narrative about what he could do and what they needed to see and what they should do as a, as a government.
• 8:29
  John: He's a deeply committed connector and, and, and really felt very personally, I think that he needed to talk to the activists and the people who were, who were.
• 8:39
  David: John, let's actually note a parallel from that time and see what's, what's changed.
• 8:43
  David: And I think it's more what's changed in terms of technology, um, and the environment we're in.
• 8:47
  David: And rather than what changed with Dr.
• 8:48
  David: Fauci, there were some things that Dr.
• 8:50
  David: Fauci had said toward the beginning of the AIDS epidemic, uh, that didn't end up panning out.
• 8:55
  David: So one was that he warned that he thought that routine close contact among family members could potentially spread aids.
• 9:02
  David: Now, he corrected that within about a year, which was noted as sort of very fast for anything that you're publish.
• 9:08
  David: You know, in a medical, uh, journal, if we contrast that to what happened with a more recent public health, uh, emergency where he had, uh, made some comments, ironically saying about, you know, didn't expect that there was asymptomatic spread.
• 9:20
  David: Didn't think necessarily that masks, uh, were needed.
• 9:22
  David: He corrected that a whole lot faster as the data became available.
• 9:26
  David: But in this era of social media where there's, you know, instant analysis, Everyone's all of a sudden, you know, an expert, plus you have, uh, you know, people, especially in, in the Senate, uh, from the, uh, from the other party that, uh, or from, you know, from the president's party at the time, uh, that are ready to attack you.
• 9:43
  David: And it's a whole different, uh, a whole different ballgame.
• 9:46
  David: Plus, with the lack of, um, effective leadership, uh, from the very top, you know, he really got himself into a bad.
• 9:53
  David: Yeah,
• 9:53
  John: I think that the, the, the, there, there is a really interesting, and Peter Hotez mentioned this in one of our earlier Dr.
• 10:00
  John: Peter Ho's earlier, uh, podcasts.
• 10:03
  John: There is a, um, a demonization, um, and, you know, and, and, and political backlash for anybody who's going to be.
• 10:12
  John: Sort of taking, um, you know, there's a, there's a, there's, you know, there's a reason why we have the Statue of Liberty, uh, not the Statue of Social Order in, uh, in New York.
• 10:21
  John: I mean, we are a country of that, that really, of people that, um, fervently and sometimes violently protect their own per what?
• 10:31
  John: Personal liberties.
• 10:32
  John: And so, you know, obviously the, the, there's a, there's gonna be politics associated with public health cuz it's, it's public health.
• 10:40
  John: Uh, but there's.
• 10:41
  John: Science is not perfect.
• 10:43
  John: Um, it is an evolving narrative of the truth as we know it right now, and there will be inconsistencies if we are actually continuing to do research to tune up and improve what we know to care for and heal.
• 11:01
  John: More people.
• 11:02
  John: I, I, I do think that there, that one of the challenges in public health is finding a way to frame the fact that this is the truth as we know it right now, but perhaps not the in the final or the ultimate truth.
• 11:15
  John: Uh, because otherwise activists on any side will as assume that inconsistency means insincerity or dishonesty.
• 11:23
  John: And it doesn't, it, it, it often just reflects the facts of the.
• 11:27
  David: Well, John, I think, you know, this isn't about Dr.
• 11:30
  David: Fauci specifically, but if we look at the whole public health establishment and why, for example, the Center for Disease Control wasn't so well prepared to deal with a recent public health emergency, it's that they are used to saying, okay, here's a problem.
• 11:41
  David: I'll go study it, and I'll come back and I'll tell you the answer once I've had a chance to properly analyze it.
• 11:45
  David: Now that leaves a big vacuum.
• 11:47
  David: When people need information to be able to act on, and then if you sort of say what the truth is at the time, as you know it, it leaves you vulnerable to g or inconsistent or whatever later.
• 11:58
  David: Now it's, they, I think the public health agencies can do a better job, but it's also the case that others are looking to attack and it's, that's only partly what the public e health agencies can do.
• 12:08
  David: We also need, uh, some goodwill from others.
• 12:11
  David: It was interesting what Dr.
• 12:12
  David: Fauci said in is.
• 12:14
  David: Press conference and he said, you know, this is a quote.
• 12:16
  David: When I see people in this country because of the divisiveness not getting vaccinated, for reasons that have nothing to do with public health, uh, as a physician, it pains me.
• 12:24
  David: I don't wanna see anybody hospitalized.
• 12:26
  David: I don't wanna see anyone die.
• 12:28
  David: Whether you're a far right Republican or a far left Democrat, it doesn't make any difference to me.
• 12:33
  David: Yeah,
• 12:34
  John: I mean the, the, the, the reality is he's, he's, he was, he was beloved and respected by Reagan and the Bushes, and he was beloved and respected by, you know, Obama and Biden and Clinton.
• 12:47
  John: I mean, this is a guy who's not political at all.
• 12:50
  John: And I think one of the interesting things and challenges for Dr.
• 12:54
  John: Fauci, who we gotta just thank him for his service, that's a long service to, to, for all of us and for his amazing achievements.
• 13:01
  John: You know, he really is actually one of the better communicators I've ever seen on public health issues.
• 13:07
  John: He comes across very sincerely and believable, even amid the most, the biggest attacks on him in 2020.
• 13:15
  John: Uh, you know, he still was one of the most trusted people in America.
• 13:18
  John: I still think he is one of the most trusted public professionals in the country.
• 13:22
  John: Um, and it's because he's plain spoken.
• 13:25
  John: He, he speaks directly and he, and he, he, he can explain the facts in a way that's, that, that the average American can consume.
• 13:34
  John: And I think the vast majority of people thought, you know, he's, he's, uh, he's, he's, he's someone that he trust.
• 13:40
  John: In fact, I would say other than Ashish, Ja, he's probably the best.
• 13:44
  John: Public professional, public health professional we've had in the last 20 years.
• 13:49
  John: I mean, I, the CDC director, Linsky, has a real problem communicating and people don't trust her and it was
• 13:56
  David: a fact, just cuz she's from Massachusetts, don't give her a hard time.
• 13:59
  David: Now, here's another contrast, John, but we,
• 14:01
  John: we, we should also talk about, like, we've talked about aids.
• 14:05
  John: What about Dr.
• 14:06
  John: Fauci achievements in Mers?
• 14:08
  John: Ebola?
• 14:09
  John: Sars?
• 14:10
  John: I mean, he's been involved in some of the toughest things we've had to deal with
• 14:14
  David: for sure.
• 14:14
  David: You know, so one area was after nine 11.
• 14:17
  David: Where there was concern about attacks, um, you know, with white powders and, and, and so on.
• 14:21
  David: He was involved in leading the drug development, uh, you know, in that, in that period of time.
• 14:26
  David: And luckily we haven't really had to use it, but he kind of quickly mobilized, uh, you know, drugs for, for bio defense.
• 14:31
  David: And there's a number of things that, uh, didn't, didn't get to the same level as the
• 14:35
  John: recent, but I mean, by white powder.
• 14:37
  John: You're not talking about cocaine, you're talking about Anth Thra.
• 14:41
  John: The, the, there was a real fear post nine 11, that it was easy, relatively easy to develop designer drugs in a and the, and on, on a bio basis.
• 14:51
  John: And he was, he was involved in actually creating a pretty massive infrastructure around biodefense.
• 14:57
  John: And there are all these fake anthrax or, and real anthrax.
• 15:01
  John: Um, uh, uh, threats.
• 15:03
  John: Uh, and I, you know, again, he, the range of things he's been involved in to help protect us against that.
• 15:10
  John: The, you know, hemorrhagic bleeding disorder, the Ebola, that is just so terrifying.
• 15:15
  John: You know, the, the abian flu, um, I mean, just it's, it, the swine too, John, some places with swan.
• 15:21
  John: Yeah.
• 15:22
  John: No, it's, it's, it's just remarkable and.
• 15:24
  John: I think that the, there's a reason why, you know, uh, you know, George W.
• 15:30
  John: Bush gave him the, the, the, uh, the, the, the president's, um, medal of Freedom.
• 15:36
  John: Do you remember what that was about?
• 15:37
  John: Or is that, have you lost track of that one?
• 15:40
  John: David?
• 15:41
  John: David: Well, John, I think you can, you could get that for sucking up to the, the president, right?
• 15:47
  John: But, uh, that wasn't why he got it.
• 15:50
  John: do remind us.
• 15:51
  John: Do you remember What, do you remember
• 15:52
  David: what he got it?
• 15:54
  David: Uh, was it for
• 15:55
  John: pepfar?
• 15:56
  John: It was.
• 15:57
  John: And what is pep?
• 15:59
  David: So, John, one of the things that, that happened, I think we have a couple contrasts here we can go out on.
• 16:02
  David: Uh, one is that, uh, after fighting, you know, hiv aids in the US it was a realization, hey, uh, we need to be able to look at the rest of the world, which is actually where there's, you know, very high, uh, incidents and, uh, and huge impact, uh, from AIDS and particularly in Africa.
• 16:18
  David: So, PEPFAR was actually called the, uh, the President's emergency plan for aids.
• 16:23
  David: And actually I don't like a lot of acronyms.
• 16:25
  David: I like that one cuz like pep providing some, you know, some energy and far for something, uh, far away and really made a huge difference of allowing essentially, uh, generic drugs, uh, to be developed.
• 16:37
  David: And manufactured, distributed with all the infrastructure that's needed, um, to really make a difference on, uh, HIV in Africa.
• 16:44
  David: And that's extremely well, you know, deserved.
• 16:47
  David: John, I wanna add, uh, maybe to end things with a, a little bit of a contrast.
• 16:51
  David: You know, there's been a lot of discussion about who's gonna testify before various committees in Congress and so on, resistance even to subpoenas for that.
• 16:58
  David: I asked Dr.
• 16:58
  David: Fauci about what's gonna happen now that uh, you know, republicans are, you know, some of his biggest critics are.
• 17:04
  David: The House of Representatives if only barely, and he said, you'll be happy to testify.
• 17:08
  David: He says, if there's oversight hearings, I'll absolutely cooperate and testify before the Congress.
• 17:14
  David: Obviously you may not know, but I testified before the Congress a few hundred times.
• 17:18
  David: Over the past 40 years or so, Saul will have no trouble testifying.
• 17:21
  David: We can defend and explain and standby everything that we've said, so I have nothing to.
• 17:27
  John: I love that guy.
• 17:27
  John: I mean, one of the things that, that, um, he said in one of his, uh, later interviews was that he, the people ask, what, what, what do you want your legacy to be?
• 17:36
  John: What do you wanna do?
• 17:37
  John: And he talked about teaching and he hopes that his legacy will be an inspiration for others to serve in public health.
• 17:43
  John: And gosh, with the kind of achievements he has, curing diseases, protecting the United States with taking, with sending withering attacks, helping.
• 17:51
  John: Create breakthrough, uh, uh, uh, uh, solutions for deadly diseases and then helping protect.
• 17:58
  John: I mean, I think the pepfar, Pete, Pete thing alone has saved up through 2020, over 20 million, uh, lives largely in sub-Saharan Africa from the ravages of aids.
• 18:09
  John: Uh, he, he really is an
• 18:10
  David: inspiration.
• 18:11
  David: Well, that's it for yet another edition of Care Talk.
• 18:14
  David: We've been speaking today about a five foot.
• 18:16
  David: Giant of public health, Dr.
• 18:18
  David: Tony Fauci.
• 18:19
  David: I'm David Williams, president of Health Business
• 18:22
  John: Group, and I'm John Driscoll, the president of Walgreen South.
• 18:24
  John: If you liked what you heard or you didn't, we'd love you to subscribe on.