In this exclusive video interview, Jeremy Faust, MD, editor-in-chief of MedPage Today, talks to Anthony Fauci, MD, former director of the National Institute of Allergy and Infectious Diseases (NIAID), about his new memoir, On Call: A Doctor’s Journey in Public Service.
In this video, Fauci discusses his relationship with former President Donald Trump and life after retirement from the NIAID.
Watch Part 1, Part 2, and Part 3 of this interview here.
The following is a transcript of their remarks:
Faust: Let’s turn a little bit more to COVID and the politics of that.
You got through some really interesting moments, but I couldn’t help but notice that you devoted a lot of time to your relationship with then-President Trump. I had this interesting realization that he was really worried about what you thought, and I know he couldn’t fire you, but he kept saying, “We’re good, right? We’re good, you’re getting these things about masks in schools.”
Why do you think he was so worried about your relationship?
Fauci: You know, Jeremy, I don’t know exactly why, but one thing that I described in one part of the memoir was we had a certain positive rapport between us. I wasn’t sure whether it was, here’s a guy from Queens and here’s a guy from Brooklyn and they both have that kind of New York-ishness about them that you can relate to. We really related to each other quite well in the beginning. He’s a very charismatic guy. You know, we had not yet gotten into the January 6th, which completely turned me around about it. So I was able to tolerate some of his narcissism and some of his braggadocio and stuff like that.
Our relationship was good enough that when it became clear that I had to speak out against him, he actually got angry with me and said, “Tony, what the hell are you doing? You have to be more positive.” He was uncomfortable that we would all of a sudden be at odds with each other. That’s why he said multiple times, “We’re okay, aren’t we? We’re still good, Tony, we’re still good?” And I said, “Fine, we are good.”
It wasn’t until the very, very end of his fourth year when it became clear that there was trouble with the election and that wasn’t going the right way, did he then start believing what many people were chanting: “Fire Fauci. Fire Fauci.” But right to the end, he never wanted to fire me. In fact, he even said, “You have too illustrious a career. I don’t want to fire you, but a lot of people really are angry with you.” That’s what he said. He didn’t say, “I’m angry with you.” He said, “A lot of people really are angry with you.”
So it was really an interesting dynamic that we had with each other. His staff was much, much more angry with me and disliked me for telling the truth than he was. He just blew by and kept the relationship going.
Faust: You know, there’s an opera about Scalia and Ginsburg, but I think the psychodrama between Fauci and Trump might be the more interesting one.
Fauci: Maybe.
Faust: In terms of going back to the response to COVID and thinking about just the early days — reading your book, there are two names that popped out as people who might other than yourself have saved the most lives of anyone out there. And I’m curious who you would say — of people you worked with, by virtue of their scientific or contributions or something else — I’ll name Debbie Birx, Deborah Birx, for getting a longer period of shelter-in-place or what we call a “shutdown.” Another surprising one is Stanley Chera, a person you mentioned in your book. Can you tell everyone who that is, if you remember?
Fauci: Yeah. He’s the friend of Donald Trump who actually died of COVID and got Trump to realize that, “hey, this is a serious disease. I was talking to him one day and the next thing I knew he was on a ventilator and I couldn’t speak with him.”
You know, it’s very interesting. We get criticized, I get criticized because they think I did it, but Debbie really worked her butt off in the White House despite some difficult circumstances, particularly when they brought Scott Atlas in who tried to undermine everything that she said and did. But when she put together the program for the 15-day shutdown followed by the 30-day extension, we get criticized for having done that, but that saved a lot of lives. A lot of lives.
Faust: What do you think about the NIH’s direction and any reforms that are going on there?
Fauci: Well, it depends. I mean, obviously you should always intermittently look at what reforms you might do to make it a better place. I think the NIH should do that. I’m afraid that some of the proposed reforms need to be carefully looked at before you enact them. I mean, the idea of all of a sudden consolidating 27 institutes into one-third the number, I’m not so sure that’s a good idea.
Having restrictions on the type of research, I think you have to be responsible and accountable for what you do, but I get a little bit concerned about outside non-scientific political people determining what kind of research can and should be done. I get a little bit concerned about that.
Faust: If you had to appoint the next CDC director, who would be in your top three if Mandy Cohen decides to step down with the next administration?
Fauci: I’m not going there, Jeremy. I’ll leave that to a search committee.
Faust: Okay, fair enough.
Fauci: By the way, I think Mandy’s doing a really good job.
Faust: Really? Tell me, what do you think she’s doing so well?
Fauci: Well, I think she’s out there trying to reestablish the credibility of the CDC. She’s out there very publicly going around, traveling a lot, just showing that the CDC really cares, that it’s a really very top-notch organization and has committed people. I think she’s really good for the institution.
Faust: I thought it was really interesting that you spoke a lot about growing up in Brooklyn — parochial schools, Catholic upbringing, Holy Cross undergraduate — and how the Jesuits taught you about public service and helping others, and that’s what drove you to medical school.
But for a guy who worked with Francis Collins for his entire career, I don’t even know if the word God appears in your book. Tell me about your views on faith and religion, Dr. Fauci.
Fauci: I don’t usually talk about it, and I won’t talk much about it, but I rely a lot on the fundamental principles that I learned in the context of my Catholic upbringing, predominantly with the Jesuit priests in high school and in college, who really instilled upon me something that I learned from my parents that I described in the memoir — that they were steeped in service to the community.
It was out of our pharmacy in the middle of the Bensonhurst section of Brooklyn, where he was kind of like the doc for the neighborhood and was the neighborhood psychiatrist and marriage counselor, or what have you, was always of service to others. So that was kind of in my DNA from the beginning, but I am not a religious person in the sense of call upon God in prayer. I don’t do that. I mean, I just try and live by the principles that are fundamental to the Catholic Jesuit spirit, but I don’t wear religion on my sleeve. That’s not me.
Faust: And another place where I thought about this in reading your book was actually in the infamous powder incident. Where in the anthrax scare, there comes an envelope to your office, you open it, it flies in your face, and you think, “Oh, God, this is either baking powder or ricin or anthrax. I might die.”
Of course, thank goodness, it was just a hoax, it was nothing. But you said that you don’t fear death. You do not fear death. Tell me about that. You know, you’re a person who’s been thinking about life and death in a very serious way and you’ve seen a lot of death. Why aren’t you afraid of death? It all goes away in an instant, right?
Fauci: Each individual, as you know, Jeremy, has their own outlook towards life and what it means and what death means.
I said that and I meant it. I don’t fear death. I’m 83 years old. I have a lot of life in me. I have a wonderful family. I’m proud of what I did in my career. I’m still active now. I enjoy being on the faculty at Georgetown. So, I really want to live, I want to live a lot longer. But, you know, death is interesting. I see friends all around me that die, and a natural evolution of life is death. So I don’t want to be afraid of it, and I’m not.
When I was sitting there waiting for the results of that anthrax, I said there are three possibilities. Either it’s going to be anthrax, so I’ll go on Cipro for 30 to 60 days, or it’s going to be ricin and no matter what I do, I’m going to die. So rather than sit down and get myself all bent out of shape, I’ll just say it is what it is.
And luckily, as you said, it turned out to be nothing, just plain old commercially available powder.
Faust: And are you done writing? Was that a one-off? That was a big book, but I feel like there’s more.
Fauci: I don’t know. Right now I’m still in the process of the rollout of this book, but I enjoyed it, Jeremy. I was surprised by how much I really enjoyed writing and editing and getting it perfect, getting the sentences as crisp as you can and getting the continuity and the flow from paragraph to paragraph, from chapter to chapter, that was fun.
So I could see myself somehow doing that again. I don’t know exactly what topic it would be, but I very much enjoyed the process of writing the memoir.
Faust: It’s been a year and a half, I think, since you stepped down from NIAID. How do you feel about your own health? Do you feel better than ever? Do you feel like you’ve recovered in some way?
Fauci: I feel really good, thank goodness. I mean, I feel energetic. I do take better care of myself.
I was chronically, Jeremy, truly chronically sleep deprived for several years where I was getting ridiculous amounts of sleep in the middle of the crisis. Four hours, sometimes less. It was only the insistence of my very insightful wife, Christine, who essentially insisted that I get more than 4 hours of sleep a night, and that I drink water and stuff.
So right now I get 7 and a half to 8 hours sleep, which I hadn’t done for a very long time. And that makes me feel much, much better.
Faust: And you don’t miss the adrenaline?
Fauci: No, I got a lot of adrenaline out of the book, to be honest with you. I don’t mean to say this in a way to blow off these things, but there’s a little bit of a been there, done that feeling. And yeah, the adrenaline is nice. But I’ve had a lot of adrenalization in my life.
Faust: Indeed you have. And I’m glad that you’re still working with the next generation as well. So thank you for the book and for all your service, Dr. Anthony Fauci.
Fauci: Thank you so much, Jeremy. It’s always great being with you. Take care.
Jeremy Faust is editor-in-chief of MedPage Today, an emergency medicine physician at Brigham and Women’s Hospital in Boston, and a public health researcher. He is author of the Substack column Inside Medicine. Follow
Emily Hutto is an Associate Video Producer & Editor for MedPage Today. She is based in Manhattan.
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