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    Anthony Fauci, MD: Science as a voice of reason

    A medical student reflects on why the country so admires Dr. Fauci — and why his role as a purveyor of truth and scientific fact is one that all medical students should take on.

    Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, testifies at a hearing of the U.S. House Committee on Energy and Commerce on Capitol Hill on June 23, 2020, in Washington, D.C.
    Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, testifies at a hearing of the U.S. House Committee on Energy and Commerce on Capitol Hill on June 23, 2020, in Washington, D.C.
    Credit: Kevin Dietsch-Pool/Getty Images

    Editor’s note: This essay was a winner of the 2020 Lasker Foundation Essay Contest and has been lightly edited from the original. The opinions expressed by the author do not necessarily reflect the opinions of the AAMC or its members.

    One year into medical school, my current skill set includes an assortment of physiology and microbiology factoids and the ability to perform a well-patient exam, skills that unfortunately leave me just as helpless as the average American who waits on edge as the COVID-19 pandemic unfolds. Early in the pandemic, the dozens of news cameras positioned outside my medical school, reporters lining up to speak about the first case of community spread in the country, should have alerted me that we were entering into uncharted territory. As industries have slowed to a crawl, many Americans, including myself, have turned to leaders for guidance — in particular, 2007 Lasker Laureate Dr. Anthony Fauci.

    As the director of the National Institute of Allergy and Infectious Diseases, Dr. Fauci has appeared at nearly all the White House briefings next to President Trump. His measured Brooklyn rasp and tell-it-to-me-straight demeanor have garnered the admiration of the country and even inspired fan merchandise (“Fauci” t-shirts in Gucci-style fonts), as well as generated vitriol from online conspiracy theorists (see: #FauciFraud).

    Through the past 40 years, Dr. Fauci has led efforts against epidemics as both a scientist and public figure. In today’s pandemic, his devotion to tempering too-rosy predictions and fearlessness in calling out testing efforts as “failing” have earned him the rarest resource of public trust. When Dr. Fauci missed one White House briefing, tweets began flying, asking, “Where is Dr. Fauci?”

    Dr. Fauci represents a role of physicians and scientists that has diminished in recent years: a voice of reason, “a representative of truth and facts.” Historically, physicians were community keystones — they provided your care from birth to death, and that of your family and friends, too. In this way, physicians and researchers have always been public figures. With the modernization and subsequent specialization of physicians and scientists, science began to be practiced in isolated and sterile environments, such as research done in the ivory tower or 15-minute appointments with a doctor your insurance assigned to you — a depersonalization and erosion of trust. Dr. Fauci’s appearance in media, particularly web content, brings us closer to the days of knowing your physician or knowing the faces of scientists and cultivating a relationship of respect. Moreover, Dr. Fauci highlights another crucial role of science, not just in times of pandemic: the essential need for scientists to speak with politicians, even when “you have to say things one, two, three, four times.”

    The argument remains that the role of a scientist is to be quiet and do the work. Dr. Fauci has certainly done the work as a leading HIV/AIDS researcher with more than 1,100 publications. But he has also leveraged his expertise into a role as a public servant, advising several presidents and designing the international health program PEPFAR for HIV/AIDS treatment and prevention, among other government programs. His advocacy helped funnel funds into implementing the interventions and research he helped discover and fostering real world change.

    In his 2007 Lasker Awards Ceremony acceptance remarks, Dr. Fauci said, “I realized early on that when you deal in the heady company of presidents, cabinet secretaries and members of Congress and are asked for advice, you must be prepared to disappoint people with the truth and risk never getting asked back into the inner circle. I accepted that concept. Science is truth, and as a scientist I told the truth.”

    Prior to medical school, I considered careers in print journalism and clinical research, seemingly disparate fields, but to me, both centering around truth-seeking. Dr. Fauci reminds me that truth-seeking is not absent from medicine either. It is central to it. In Albert Camus’ The Plague, the protagonist Dr. Rieux asks Tarrou, a community member, why he is so willing to risk his life and volunteer to fight the plague. Tarrou answers: “My code of morals … comprehension.” Only by telling the truth as we know it, rooted in science and research, can we give the public and policymakers the knowledge they need to make educated decisions about their health and the health of others and, hopefully, inspire them to make the right choices.

    More than ever, we need science communication education in our medical school and graduate school curriculums. It is not enough to just do the work. We need to know how to advocate for truth, how to navigate the machinations of politics, and how to build relationships with policymakers, stakeholders, and the public. In the words of Dr. Fauci, we all have to keep pushing — for policy changes that focus on preventing pandemics and chronic disease, and for research advances to benefit patients in ways that are truly accessible. More than ever, our country and our patients depend on it.