The Pandemic Is Waning. Anthony Fauci Has a Few More Lessons to Share.

America’s most famous doctor on mitigating covid, giving your adversaries the benefit of the doubt and working way too much

By
June 29, 2022 at 10:17 a.m. EDT
Anthony Fauci. (Jesse Dittmar for The Washington Post)
30 min
correction

An earlier version of this article mischaracterized Ebola as a pandemic, misstated the number of HIV cases identified in a medical journal (the number was 26 not 25), misstated Mark Harrington's last name, incorrectly described the federal protection Fauci receives as Secret Service protection, and incorrectly said that his royalty payments are vaccine-related (they are for a monoclonal antibody). The article has been corrected.

You gotta f---ing suck it up,” Anthony Fauci tells me from the deck of his home in Washington, D.C., overlooking a small pool that takes up nearly the entire backyard. The secret to his obscene productivity, he says, is to simply never stop working — even when “it’s 9 o’clock at night and you really, really want to have a beer and go to sleep.”

Fauci commits acts of science 12 to 16 hours a day, seven days a week. No wonder the man wants a drink. But this schedule and suck-it-up worldview have allowed the 81-year-old — who serves as director of the National Institute of Allergy and Infectious Diseases (NIAID) and chief medical adviser to the president of the United States — to tackle one pandemic after another, from AIDS to covid-19. During the seven hours I’m at his house on a Sunday in June, I am uncomfortably aware that every moment we spend together is a moment when Fauci is not working.

I am also aware that it would be a moral crime to transmit the coronavirus to Fauci. So when I got covid two weeks before our interview, I obsessively parsed the guidelines from the Centers for Disease Control and Prevention: As long as I waited 10 days after my first positive test, I could still meet Fauci in person, right? No, I was informed by Fauci, via a member of his communications team. I would need to test negative three days in a row and wear a mask, even outdoors.

I manage to follow this guidance, but not to keep myself from extending my hand when I meet Fauci, which he shakes after one horrifying moment of hesitation. “I’m sorry I did that,” I say, uselessly. “No, it’s fine,” Fauci says with the resigned patience of a man who has dealt with many people who have made his life harder over the past few years. (Several days later, he will test positive for the coronavirus, as will two others who also attended the reunion for the College of the Holy Cross’s class of 1962, which took place the same June weekend as the dedication of the school’s Anthony S. Fauci Integrated Science Complex. For my mental health, I choose to believe the gathering of elders was the vector of infection.)

But for now, Fauci still thinks he’s avoided the virus, and suggests we relocate to the deck after he’s done cooking an egg in an ancient, teacup-size pan and smearing I Can’t Believe It’s Not Butter on an English muffin for a breakfast sandwich. It’s safer that way, where my newly negative aerosols can disperse in the fresh air.

Fauci has lived in this comfortable but modest house since 1977. Its furnishings belie the conspiracy theories that he’s made a fortune profiting off the coronavirus: There are mismatched chairs, a print of a presumably-Italian canal, a near-shabby red couch decorated by a pillow screened with a cartoon of Fauci’s smiling face. The refrigerator is festooned with cheery aphorisms held up by Beatles magnets. A whiteboard in the kitchen bears the handwritten note “TOMORROW WILL BE BETTER — I PROMISE.”

Though Fauci earns $480,654 a year at NIAID — making him the highest-paid government employee, as Sen. Roger Marshall (R-Kan.) gleefully pointed out in January during a Senate hearing about the federal covid response — the salary is set by the agency that employs Fauci and increases at federally mandated intervals. The reason no one makes as much is because people at that skill level tend to leave government to make a lot more money. Fauci’s friend Ellen Sigal, who runs the nonprofit Friends of Cancer Research, says that if he worked outside of government, “he could have been worth not tens of millions, [but] billions. He could’ve cashed out. We needed him. He didn’t need us at all. I don’t think Tony is driven by money and avarice.”

On the deck, Fauci declines to put on sunscreen, citing his Mediterranean complexion. Sitting back, glasses-less, in a gray T-shirt and jeans belted at regulation dad height, Fauci explains why he hasn’t left NIAID for a higher private-sector salary, or even to take an entire weekend off work. If he’d stayed a regular doctor, he says, things would have been different. “I pride myself in having been — with all due modesty — a fantastically good clinician,” Fauci says of his early-career internship and residency days. “My responsibility would be to the patient, and I would take care of them throughout the night. But when you were off, you knew that somebody [else] was taking care of them. I could compartmentalize. I would go to the Caribbean and snorkel and scuba dive.”

Once he stepped into the director role at NIAID in 1984, however, he found that the “responsibilities are infinite. You’re trying to develop drugs. You’re trying to come up with a vaccine.” Even when momentarily straying from his duties, like walking with his wife, the bioethicist Christine Grady, “it was always like I could never let it go completely,” Fauci says. “It wasn’t like feeling uninhibitedly free. Once something still lingers as your responsibility, then it makes it very difficult for me to pull away from it.” Today, Fauci sounds ready to relinquish the burden; the end of his time leading NIAID is coming “sooner rather than later,” he tells me.

Since March 2020, Fauci has a been a ubiquitous presence in the news. But despite the countless stories about him and his endless TV appearances, most Americans still don’t have a sense of what he’s learned in his role as their top doctor: what he’s come to understand about pandemics, about the good and bad of government service, and, really, about all of us. Now feels like the time to get his analysis of the data he’s been collecting all these decades. After all, as Anthony Fauci knows better than anyone, there’s always another disease coming. And at some point, we’re going to have to heal without him.

As a child, Fauci developed a fascination with World War II. Soldiers began returning home to his neighborhood of Bensonhurst, Brooklyn, when he entered grade school, and he would go to the theater and watch movies with battle scenes like “The Story of G.I. Joe.” It was clear which side you were supposed to root for. The right team would prevail. “It started, we fought it, it ended, we won,” says Fauci, explaining why World War II was so satisfying. “And then, the world was good again.”

Fauci’s mother worked at a dry cleaner and his father owned a pharmacy, functioning as what Fauci calls the neighborhood’s “pseudo doctor”; clients gave the older Fauci the honorific “Doc.” The younger Fauci delivered prescriptions for the business and decided halfway through high school to be a physician. At Cornell University Medical College, Fauci focused on adult internal medicine — specifically the immune system and infectious diseases. “I like the definitive nature of it,” Fauci says of the specialties, making his now-familiar hand gesture: fingers spread and hands parallel, chopping down and then rising slowly. “It’s a microbe. If you identify it, you can treat it. And it could kill the person, but if you really treat them, they get better. There was something sharp about it.”

Even when momentarily straying from his duties, like walking with his wife, “it was always like I could never let it go completely,” Fauci says. “It wasn’t like feeling uninhibitedly free.”

The field of infectious disease also carried a certain excitement. “It’s dangerous,” Fauci says. “I look upon a pathogen, a virus, as an enemy.” There was the same comfort in the clarity of good and evil Fauci felt as a child when he saw films about Allied soldiers defeating the Axis powers.

After arriving in 1968 at the National Institutes of Health, the organization that encompasses NIAID, Fauci’s first triumph was discovering how to re-dose cancer drugs to turn a 98 percent mortality rate of the autoimmune inflammatory disease vasculitis into a 93 percent remission rate — an almost complete reversal of virulence. For the next few years, Fauci experienced something rare in medicine: eureka moment after eureka moment. “If you expect it, you’re in the wrong business,” he says of those early successes. “Because you’re going to be so frustrated that you quit.” He was a rising star, but in a field where he was developing treatments for diseases that few people knew about. If Fauci had stayed in immunology, rather than switching to the splashier world of infectious disease, he says, his work “wouldn’t have been as much a global impact.” Then came AIDS.

This part of the story is famous: Three years before he became director of NIAID, Fauci read an article in a medical journal highlighting five cases of what we would later understand to be HIV, which became 26 cases. Mentors discouraged him from taking on what they felt was a niche disease contained to the population of gay men. “I was prescient enough to realize that it wasn’t going to just go away,” Fauci says. “I said: I’m an infectious-disease doc. I’m an immunologist. … It’s killing young gay men. It’s almost certainly sexually transmitted. And sexually transmitted disease is going to spread globally, because if there’s anything that’s universal, it’s sex. … If ever there was a disease that was made for me, it was this new disease.” There have since been 79 million cases of HIV worldwide.

Fauci went from curing nearly all his pre-HIV cases to, he says, a situation where “you developed relationships with your patients … but almost all of them ultimately die.” It was unendurable to emotionally process that much loss. “In order to be able to live through that, you’ve got to do a lot of suppression,” Fauci says of his preferred coping mechanism. “You can’t mourn every patient, or you spend your entire life mourning. But when you suppress everything, years later when somebody asks you to describe what you were doing, all of a sudden, it’s like you almost can’t even speak about it.” Fauci says he believes he has post-traumatic stress disorder from this experience, though he has never sought therapy. (“I’ve discussed it a lot with my wife, who’s the world’s greatest therapist,” he says.)

There were many lessons gleaned during the AIDS crisis that would become invaluable to Fauci’s work. In 1989, he began meeting with activists at the home of his NIAID deputy, James Hill. Hill was, unknown to the public, gay and HIV-positive. (He died in 1997.) There were no effective HIV drugs at the time, and people with the virus were dying as they waited for the Food and Drug Administration to complete clinical trials that could lead to the approval of lifesaving medication. Activist Peter Staley says the group was wary about falling victim to what he calls the “Full Fauch”: being so charmed by Fauci that they would capitulate on their goals for changing the government’s AIDS response. They agreed to never meet with Fauci one-on-one, lest they be seduced. After a long night discussing AIDS policy ideas over dinner and many bottles of wine, they would drive from D.C. back to New York and conduct a four-hour analysis of the evening. “I’m a decent drunk driver,” Staley says with mock pride. “We’d say, ‘What did we get? What did he stonewall?’ We had been just all wowed, and it would refocus us on exactly what we wanted to accomplish. And that’s how we handled the Full Fauch. It kept us from being co-opted by Tony.”

Meanwhile, Fauci was facing internal pressure. “I had to get rid of some of my own people,” he says of NIAID employees who thought their process shouldn’t be influenced by nonscientists who had the disease they were fighting. “I didn’t fire them in the street, because you can’t do that in the government. But I made it very clear that I don’t want to work with you anymore.”

Fauci met with other AIDS patients outside of clinical settings, including at their homes. He vividly remembers a blind, bed-bound man saying to him, “You’re telling me either, ‘Take AZT [an antiretroviral drug] and go blind or take Ganciclovir [an antiviral used for eye infections] and die’ — so you’re giving me a choice of either going blind or dying. Isn’t that f---ing crazy?” Fauci says he “finally realiz[ed] the activists were absolutely right — that what we were doing was too rigid.” Eventually, the FDA guidelines were changed to allow “parallel tracks,” where certain people could get access to multiple experimental drugs that each combated different facets of HIV and attendant secondary infections without enrolling in trials for all of them. “Once we realized we had the same enemy, and it was not each other, it was the virus,” Fauci says of the activists, “then we went from adversaries to allies.”

During the AIDS crisis, Fauci met Grady, who was then a nurse at NIH. They married and had three daughters. With a lot of help from a longtime nanny — and somewhat less help from Fauci — Grady worked part time and got her PhD from Georgetown while being the primary caregiver for their children.

To say that Fauci found it difficult to maintain a work-life balance would be incorrect; he chose to work, missing out on developmental milestones and things like soccer games. “I am sorry and sad, but I don’t regret,” he explains. Of his daughters’ athletic events, he says: “I tried as best as I could. … I didn’t miss them all. I went to a few of them. But I would’ve liked to have done what Chris did. Chris missed none of them. She sacrificed career opportunities literally every month for years because she wanted to make sure that she was there with the kids.” Grady has since become renowned in her field and leads the Department of Bioethics at NIH. Their oldest daughter, Jenny, is a clinical psychologist at Cambridge Medical Group who works with adolescent girls suffering from abuse-related mental distress; their youngest, Alison, worked at Twitter before spending time as an EMT. Their middle daughter, Megan, teaches third-grade math and science at an inner-city charter school in New Orleans and got married the weekend after Fauci and I met in D.C.; her father attended remotely, via FaceTime, because of his covid infection.

“I would do it over again,” he says, of being less-than-present for his family, “because I was doing things that are really important. When they were growing up was right in the early, challenging years of HIV, when we didn’t know what the virus was. And then we wound up with pandemic flu, and the anthrax attacks, and Ebola. It was constantly one time-consuming challenge after the other.”

By 2020, Fauci had worked under six administrations as the director of NIAID, enjoying positive relationships with both Democratic and Republican presidents. He came to consider George W. Bush a close friend. “Obviously there’s been appropriate controversy regarding decisions regarding Iraq,” Fauci says, “but his moral compass about health equity is very strong.” Fauci says Bush did “by far” the most to combat AIDS of any president he worked with, especially through the work of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), which distributed lifesaving HIV drugs across Africa. “His exact words to me were, ‘We have a moral responsibility as a rich nation to not have people suffer and die merely because of where they live and the circumstances in which they were born,’ ” Fauci says.

Though Fauci votes, he says he is an independent nonpartisan, and his voter registration confirms he is not officially affiliated with any party. “He actually got along better with Republican presidents, in [the activists’] mind[s], than he did with Democrats,” Staley says. “We always thought he leaned more right — more R than D.”

“I would do it over again,” Fauci says, of being less-than-present for his family, “because I was doing things that are really important. ... It was constantly one time-consuming challenge after the other.”

In recent years, Fauci’s work, like everything else, became politicized around whether he appeared to be pro- or anti-Donald Trump. But in the mold of generations of government bureaucrats who predated our insane current political moment, he seems to be ideological only in his fervent belief in taking action that corresponds with the available facts — and in his commitment to working productively with the people who enable fact-based work, regardless of what political sect they belong to.

Fauci was so highly regarded across parties that he was asked, several times, to run the National Institutes of Health. “There’s a lot of work that’s ‘work-work’ as a director,” Fauci says of the administrative duties that would have taken him away from the investigative science he loves. In his current role, he’s in the office before 7 a.m., Fauci says, and spends his days approving policy and reviewing clinical trials with scientists across NIAID, seeing patients and consulting with clinicians at the NIH Clinical Center, and meeting with the White House and federal agencies.

As director of NIAID, he says, “you’ve got to answer every goddamn email that comes along. You got meetings that last too long. If you become the director of the NIH, you’re responsible not only for infectious diseases, you’re responsible for cardiology. You’re responsible for mental health. You’re responsible for neurology. You’re responsible for cancer. You’re responsible for 27 institutes and centers. Whereas, as director of NIAID, I’m directly responsible for the thing I like … new and emerging infectious diseases. … And I know more about that than just about anybody.”

But Fauci’s expertise apparently did not impress Trump. “Tony was telling us that he was already shaking his head at Trump,” Staley says of the pre-covid period of Trump’s presidency. “He was amazed that he was into his sixth president [as director of NIAID], and this was the first one that he hadn’t met with, like, three years in. And he was just stunned by that.” (Trump did not respond to a request for comment.)

(Video: Jesse Dittmar for The Washington Post)

When covid emerged, the country began to share Fauci’s preoccupation with infectious disease. (While more than 1 million Americans have died because of the coronavirus so far, Fauci believes the real number is two to three times that, because so many deaths that should have been attributed to the disease were not.) Suddenly, a geriatric civil servant, mostly unknown outside the medical community, was famous. “It’s been fun to see Tony become the real rock star between the two of us,” says Bono, Fauci’s friend through AIDS activism. “Brad Pitt playing him on ‘Saturday Night Live,’ Julia Roberts swooning, Tony T-shirts and Christmas ornaments, the bobblehead dolls. … I know he thinks it’s all bizarre and some of it is, but … Tony became this voice in a very scary time that you could trust. He just says it like it is, and turns out that’s what people wanted to hear. Or at least that’s what people not swept up in conspiracy theories want to hear.”

Initially, Fauci seemed to be a great boon to the White House during the pandemic, patiently explaining complicated science in language a child could understand. (“There’s no stupid questions when it comes to covid,” Fauci told me as I barraged him with stupid questions.) He stood onstage next to Trump, lending credence to the proceedings. But Fauci’s allyship shifted when the information presented became reality-averse; he engaged in what appeared to be a mid-presser existential crisis in March 2020, literally burying his head in his hand after Trump called the State Department “the Deep State Department.” Fauci began correcting Trump when he espoused bleach as a covid treatment or suggested that the virus would just disappear. “I kept on pushing back,” Fauci says. “ ‘No, it’s not gonna end. No, hydroxychloroquine doesn’t work. I don’t care what the pillow man says.’ ” (That’s My Pillow founder Mike Lindell, an avid believer in covid- and voting-fraud cabals.) A faction within the White House led by Trump adviser Peter Navarro began conducting and releasing opposition research on Fauci. (The My Pillow press team did not respond to written questions. Reached via email through the lawyer representing him on contempt of Congress charges, Navarro said, “I didn’t need to do any opposition research to know that Fauci was both an idiot in love with his own ego and a danger to the White House, which is why I advised President Trump to fire Fauci on more than one occasion.”)

Fauci was struggling. He agonized over the question of whether to stay, take the abuse, and tacitly endorse the administration — or leave and let his half-century of work be taken over by God-knows-who in his absence. Fauci went to Grady, his live-in therapist, who said, “Well, let’s balance it. What is the advantage of this versus the disadvantage? And what’s the advantage of this [tack] versus the liability?”

Members of Congress began to blame Fauci for the increasing number of deaths from covid. “There was not a rationale to it,” Fauci says of the July 20, 2021, hearing set up to improve future pandemic responses. “This is a hearing that’s an oversight hearing. We want to make sure we look at what’s gone on and we do better the next time and understand the next time we can make things better.” Instead, he found himself on the receiving end of congressional vitriol, held responsible for millions of deaths.

Fauci has sometimes fought back, including calling Sen. Roger Marshall a “moron” during congressional testimony. (“Dr. Fauci is more concerned with being a media star and posing for the cover of magazines than he is with being honest with the American people and holding China accountable for the COVID pandemic that has taken the lives of more than one million Americans,” Marshall said via email.) As Bono says, “Maybe he popped off a few times in response to some insanities, but he’s only human, and he is Italian.” But Fauci learned he could endure this new reality to continue his work. It was his version of the personal sacrifice he was asking us to make for everyone’s collective well-being.

When Grady passes by, I ask her what she thinks of all this, both as someone whose family is receiving death threats and as a bioethicist. In National Geographic’s 2021 documentary “Fauci,” she’d said that the combination of callousness and cruelty Fauci faces has shaken her faith in humanity and affected Fauci as profoundly as the early years of AIDS, when nearly everyone he treated died. “When you’re faced with somebody who you can’t help but want to and they want help, it’s sad,” Grady says, before offering me a glass of water. “And it’s frustrating. … When you’re faced with somebody who chooses not to do the things that would help him or herself and doesn’t really want to help either, it’s frustrating also, but in a different way. I don’t know if ‘anger’ is too strong, but something in that direction.”

Fauci also says he feels something “just short of anger.” “Listening to divergent people with divergent opinions is something he’s really skilled at, and good at, and [he] doesn’t get angry when people hang him in effigy,” says his friend John Gallin, the chief scientific officer and scientific director of the NIH Clinical Center. “When people won’t work with him, that’s when he gets upset.” Fauci’s foundational belief is that people are good — even people who don’t agree with him or say awful things about him. In 1990, AIDS activists held up a Fauci mask on a pole, as if he’d been decapitated. Fauci understood: He was letting them down. He realized that he would do the same thing if he were in their position — and that helped move the science forward. “When the Peter Staleys and the Gregg Gonsalveses and the Mark Harringtons and the Larry Kramers were attacking me,” Fauci says of Staley and other prominent AIDS activists, “I [could] have done what 99.99 percent of the scientific and regulatory community did, which was pull back from them and say, ‘You guys are attacking me. Screw them and to hell with them.’ I didn’t. I gave them the benefit of the doubt.”

Fauci was able to extend the same empathy to the last administration. “I try to look for the positive aspects of people in the Trump White House,” he says. “I think anybody who says, ‘Everybody who was in the Trump White House was a bad person’ is incorrect. I mean, there were people there who were really trying their best, except that there was a prevailing motivation, with few exceptions, of ‘Defend Trump and what he does at all costs.’ ”

Fauci’s humanistic conviction has prevailed, despite the need for a federal protection detail that protects him from people who want him dead. “I don’t think it’s naivete, because I’m the least naive person you’ve ever met,” Fauci says of believing in the inherent goodness of people. “I always look and try and find out: Is there a degree of something positive about what they’re trying to do? Can I put myself in their shoes and say, ‘Do their motivations have some kernel of positivity to it, or is it all just tearing things down?’ ” He says of some of his congressional critics: “I still give the benefit of the doubt to people like Rand Paul and Roger Marshall and people like [Representative] Jim Jordan.” And yet, Fauci says, his forehead wadded up in disgust: “Even when you give them the benefit of the doubt, I still can’t find something there that is reasonable. It’s just attacking for the sake of attacking.”

When I emailed the Republican congressmen and asked whether they felt they were “attacking for the sake of attacking,” a representative for Jordan (R-Ohio) replied that it was “a ridiculous question” and that Fauci had “lied to President Trump, lied to the White House Coronavirus Task Force, and lied to the American people” about when he learned it was possible the coronavirus originated in a lab. Actually, Fauci has publicly spoken many times about his belief that this was conceivable, though unlikely. A representative for Paul wrote in an email, “Dr. Paul has painstakingly tried to get Dr. Fauci to follow the science. At the most recent committee hearing on June 16, Dr. Paul did get Fauci to admit that there are no scientific studies that indicate a booster vaccine for children prevents hospitalizations or death.” In reality, Paul asked if children would receive 10 boosters if data showed each shot produced antibodies, then asked whether Fauci had profited off royalties from vaccines. Fauci responded that, between 2015 and 2020, he made an average of $191.46 a year from patent payments. (When I followed up with an NIH spokesperson about the 2021 and 2022 numbers, she said the figure Fauci cited covered 2015 through 2022. The 2021 royalty payment was $153.01 and the 2022 amount was $259.16.)

Fauci still wakes up in the middle of the night, anxiously turning over the problems he has yet to solve. But, he says, “when you’re lying in bed and you’re half asleep, you’re not gonna work anything out meaningful.” In those minutes, Fauci allows himself to leave his responsibilities. He thinks about the sun shining through trees. He imagines a breeze in the woods, somewhere near water.

Before the time pressures of his jobs and potential threats to his safety prevented it, Fauci would go out to the Potomac River with Gallin. “He had a float that we used to [take] near the National Airport,” Gallin says. “There’s a spot where you can park your car while you’re waiting for a plane to come in, and we used to go there and fish.” Bob Seder, another close friend who works at NIAID and helped develop Moderna’s coronavirus vaccine, would take Fauci to baseball games. Seder says, “Rather than me saying, ‘Jesus, when are we going to need the next boost?’ and ‘Should we change the vaccine?’ ” they would eat hot dogs and talk about the minutiae of game play and question the umpire’s calls. They would invariably leave the games early, Seder says, but “he would always comment, ‘Bob, for two or three hours, this is fabulous. I needed this.’ Then I drop him off at 9:30 and he’s got 4,000 emails [to answer].”

Maybe there will be more time for fishing and watching sports when Fauci retires from NIH. He has said covid will be his last pandemic and that he expects deaths will drop to 100 a day, with a mortality graph featuring bunny-slope waves rather than black diamond peaks. (As of press time, the daily death count was 239.) Fauci thinks we’re in the second-to-last spike; the next one will come in the fall, perhaps, but will hopefully be accompanied by a variant-specific booster. He believes we will eventually only need yearly shots.

Fauci’s foundational belief is that people are good — even people who don’t agree with him or say awful things about him.

Fauci has started to think about his own mortality, how he wants to use the rest of his time. His mother died when he was 25, of liver cancer; his father lived to 97. “But he was not able to easily get around in his 90s,” Fauci says. “[In] the last few years, particularly the stress on my body and my mind with covid, I think I have aged. I just feel it. I’m just beaten up. I do think more now that there is a finiteness to my being.”

Considering that, as Gallin says, “his work is his hobby, to a major degree,” Fauci’s last good years will probably not be spent on a beach. He says he wants to teach and lecture, to publish the story of the covid pandemic and another, more lighthearted book about his Brooklyn youth, with hope of encouraging young people to enter civil service. Fauci proudly tells me about “The Fauci Effect”: an increase in medical school applications based on his impact on public health, or so he’s been told.

Before I started reporting, I assumed the inevitability of Fauci’s work — another pandemic always coming — inspired dread. Seder tells me I’d gotten it all wrong. “That’s what we all live for,” he says of the people in Fauci’s tribe. “You understand, that’s what we do. He loves that. It’s not like he’s going, ‘Oh, Christ.’ No, that’s what’s keeping the blood going.” “Absolutely,” Fauci agrees when I relay that exchange.

Even though his efforts feel superhuman, Fauci’s motivations, it seems clear, were earthly. He wanted to save lives, but he also enjoyed the work — and receiving credit for it. “Tony’s got a big ego,” Fauci’s friend Staley says. And yet, his ego is also “one of his very useful tools for creating change.” Fauci’s career stands as a reminder that in government — or in any endeavor — your motives don’t have to be pure in order to do good.

In the 38th year of Fauci’s tenure as America’s primary-care doctor, he imparts to me what may be the most important lesson of his career. “Your patient is your responsibility,” he says. “Whether that’s a likable person or an unlikable person or someone who’s self-destructive or someone who’s hurt others, they’re your patient. … In many respects, the country is my patient.” He explains: “I can’t see myself rejecting somebody because they get up there and say, ‘Fauci’s taken our liberties away. He’s a disgrace for democracy.’ I don’t say at all what a--holes they are.” He smiles beatifically. “I just say they’re part of this broad patient metaphor of the country, that I’m as responsible for them as I am for somebody who’s very compliant.” The idea that there are people in public service who will care for all Americans unconditionally shouldn’t be remarkable, of course — but in our current dystopian moment, it seems soothingly old-fashioned.

“You’ve been exhausting,” Fauci tells me by way of signaling the interview is over. This isn’t really what anyone wants to hear from one of the most respected people in the world, but I will later comfort myself by blaming it on Fauci’s nascent covid. For now, outside his house, under the receding sun, Fauci checks his phone for the first time in hours. “Oh s---,” he says. Problems require his attention. He needs to review a PowerPoint for tomorrow. He has “a Zoom meeting with the White House.” Fauci walks me to the door, and we say goodbye without shaking hands. He’s tired, so tired, but he has to suck it up and get to work.

Anna Peele is a writer in New York.