Matt Austin ’13 and Jimmy Simmons ’13
Editor’s Note: The following is a transcript of a telephone interview conducted on November 2, 2010. This transcript has been edited to publication level and for readability while preserving the character, meaning, and flavor of spoken expression.
Austin: When did you decide you wanted to go into medicine? Was it something you knew your whole life? Was it something you decided in high school or college? When was that?
Dr. Fauci: My decision to pursue a medical career actually began in high school. I had some ambivalence about it; not the ambivalence of ultimately wanting to go into medicine, but I was very strongly attracted, as you know, from the background that all of us had. I went to Regis High School which was fundamentally the same sort of classics and humanities emphasis that we had at Holy Cross. So, I did not want to get too far away from my footing in the humanities at the same time that I pursued a career in medicine. But, that’s sort of a roundabout way of saying that the direct answer to your question was that it was in high school. But the reason I was excited about doing what was called then the “AB Greek Premed” at Holy Cross was because then I could get both the training that was necessary to get me into medical school at the same time that I was able to pursue further my interest in the humanities and the classics that I developed in my four years at Regis High School in New York City.
Simmons: Would you mind speaking more about that humanities/premed program? What was it like back then? How rigorous was it?
Dr. Fauci: It was pretty rigorous! I compare it to my daughters who have gone to different schools besides Holy Cross—Harvard, Columbia, and Stanford—that the number of courses that they take, or at any college takes, are relatively few comparative to what we took at Holy Cross where we had very large numbers of credits in different categories: philosophy, classical languages—Latin, Greek, French—and then many, many credits in philosophy followed by, or taken together with, the fundamental essentials of the sciences: embryology, biology, chemistry, physics, etc. So the idea of studying the Classics intensively, not just as an elective, but as an integral part of your educational program at the same time that we were pursuing seriously the science in order to be able to continue on in a medical career was a very interesting—and I think balanced—experience. You didn’t feel like you were just burying yourself in science and dissociating yourself from the other important things in life. And, on the other hand, you didn’t immerse yourself so much in the humanities that you didn’t get a good scientific education. And it was very clear back then, and I’m sure even currently today, that the pre-med program at Holy Cross was as good as any program in the country. Just looking at where we all went when we went to medical schools, we went to the best medical schools in the country.
Austin: I would definitely agree with you. From personal experience, I’m actually an English major and I’m also in the pre-med program and I definitely feel like it’s a great approach preparing students for medical school and any profession in the health sciences.
Dr. Fauci: Right.
Simmons: How about outside the classroom at Holy Cross? What was your social experience here? I know you were on the basketball team at Regis, but what clubs and activities did you join at Holy Cross?
Dr. Fauci: Well it was mostly intramural things. It was sports, but it was all intramural sports. We used to just go out and play touch football. We used to go up to the gym and play a fair amount of basketball. Socially, at that time, it was an all men’s school; it was not exactly the kind of easily accessible social life that you have with young women. It was always technically difficult to pull that off because you couldn’t have a car until you were in your senior year, so underclassmen did not have cars. It was kind of tough to drive someplace to a girls’ school and easily develop a social life that wasn’t logistically difficult. So I would say that on the normal twenty-first century social life scene, it was kind of restricted…
Austin: Were there any specific classes or professors that really stuck with you or really influenced you while you were here?
Fauci: Well the people that I remember. . . I mean it’s been a very long time. I graduated in 1962, so you’re talking a very long time—48 years. But there was a Dr. Callahan, who was our English teacher, who was an extraordinary person in his relationships with the students. He really had a profound influence in teaching you to love literature. Fr. Bosom was the head of the biology department at the time. He was really quite a character, who was really quite enjoyable. I’m sure that people still remember the legend of Fr. Bosom, the biology teacher. There were a few others, but one I still remember is Fr. Ahearn, who was a Latin teacher, was a very impressive guy. There were a bunch of them.
Simmons: What dorm did you live in when you were here at Holy Cross?
Dr. Fauci: The one that I was in first year was Wheeler? Was there a Wheeler?
Dr. Fauci: I was in Alumni in my second year. And then my third and fourth years, we went to the new dorms that were up on the Hill that were near the practice fields. Was it Hanselman? Is that still there?
Dr. Fauci: So that’s where I was my third and fourth years. So it was from Wheeler to Alumni to Hanselman.
Austin: Do you have any advice for Holy Cross pre-med students who are trying to start their careers?
Dr. Fauci: Well, it depends on where you are in your thoughts. I always tell people that…one of the things I can say for sure is that there are a number of elements that are under your control, and not under your control. First of all, I assume that everybody who is in the program is a pretty smart person because otherwise (a) you would have never gotten into Holy Cross, or (b) you would have never survived in a pre-med program. So I’m assuming that everyone is reasonably bright. You’re going to get, and are getting, excellent training as you will get excellent training when you go off into medical school. But there are some things that you can control, and there are some things you can’t. And what my advice would be is first of all, always pursue what your gut tells you you’d like to do. There are many, many things in the field of medicine. In fact, medicine is the most potent potential field that I know of. You can go into it, you can be a clinician, you can be a scientist, you can do international medicine, administration, public health, global health, local health, teaching—anything you want. So keep an open mind to try to gravitate towards the things that are what you want to do. But your first goal, at your stage, is that if you want to go to medical school and you want get a good education, I would say enjoy it because it really is an amazingly enjoyable profession. I mean you’ve got to put in a lot of hours and you’ve got to work to learn because you have an enormous quantity of things to learn. But rather than look at it as an obstacle to where you want to go, look at it as sort of a pathway to where you want to go. Take advantage of it. Enjoy it as much as you can. Once you get to medical school, then you start trying to figure out what you ultimately want to do—what kind of internship you want to take, what kind of residency you want to do. So at each stage in your career, you’re going to have multiple choices. Right now, the thing you want to do is to enjoy your experience at Holy Cross. Work, you know, at whatever level of intensity you feel you want to work. Do as best as you can, get the best possible training you can, and then later on, as the years go by, you will have more and more opportunities to make choices. Right now, you don’t have many choices except what medical school you want to go to.
Simmons: Looking back on some of those choices that you made in terms of your education, is there anything that you, at this stage in your life thinking back in hindsight, might have done differently?
Dr. Fauci: You know, no. But I have to tell you, that doesn’t mean that we all don’t make mistakes in our lives. But I, actually, when I look back on my years at Holy Cross and what I would have done, I can’t think of anything I would have done differently. I went to a great medical school that I really wanted to go to for a number of reasons, not only because it had a great education, but because of the spirit of collegiality at Cornell. I was very impressed by it from the people that I met there. So I went to, absolutely, the medical school that I wanted to go to. So I wouldn’t have done that any differently. And then, as I mentioned to you just a moment ago, what happened to me after that was really a combination of opportunities that presented themselves—luck, fate, and what have you—and just keep going and pursuing and keep your antennas up for opportunities that come your way. In my professional career—particularly after medical school and into internships and residency and fellowship, and when I came to the NIH—really was the exploitation of a number of opportunities that kind of fell in my lap, things like the emergence of the AIDS epidemic, which is a public health tragedy, but it was something that completely transformed the direction of my career.
Simmons: Just in terms of your career, is there one thing in particular you might be able to pinpoint as the inspiration for you to go into public service in medicine, as opposed to private practice?
Dr. Fauci: You know, that’s a very good question. I was always feeling to a greater or lesser degree, even in my early years, both at Regis and at Holy Cross and even in medical school, but it really came to fruition, and allowed me to fully recognize what that almost subliminal instinct that I had was to have a broader impact, as opposed to something that would be personally self aggrandizing—you know career advancement or making a lot of money or doing something like that. I always wanted a broader impact on larger numbers of people, and that’s really what spurred me on to do things in the arena of public health and global health—both from a clinical and scientific standpoint—as opposed to going into practice. Now there’s nothing wrong with going into practice; I have phenomenal respect and admiration for the people that go into practice. I still see patients every week. I just don’t see them as patients that I charge money to. I see patients in clinics here at the NIH, and it’s all protocols for research and development for drugs and things like that. So my instinct had always been to do things at 40,000 feet and try to have as broad an impact, particularly in the arena of global health, as I possibly could.
Austin: HIV and AIDS, those obviously have a huge effect on minority groups and the poor, so did your Jesuit education, did that really influence you to…
Dr. Fauci: Oh yeah. I think it was a combination of my own parents and how they felt about doing things for others, but it was very clearly influenced by my Jesuit education—both at Regis High School and then confirmed and amplified at Holy Cross—that it was a noble thing, and an enjoyable thing, a desirable thing to do things for other people. It was something that I almost cannot remember not having that feeling. It would have been almost inconceivable to me to go into finance or business—again, not that there’s anything wrong with that—but for me, that never would have been an option. It was always doing something that would be benefitting society, and I felt that medicine was a very good avenue to do that.
Simmons: That mindset is so admirable, especially from our perspective here as students at Holy Cross, but, unfortunately, when you look at the broad ramifications of your work on HIV and AIDS, there was especially immense criticism which had come during the early stages. How do you react when you get criticized for your work, when you’re just trying your best for the widest group of people?
Dr. Fauci: Well, that’s a good question. That was an important part of my development as a human being, and as somewhat of a philosopher, I knew that the criticism was due to the fact that there were people who were very frustrated and suffering. So rather than taking it as a personal affront, I realized that it was frustration, pain, anger, and fear that made activists strike out against the government, against the scientific community, and against me because I was the one who was out there upfront trying to do something about this. So I became the so-called “face of the federal government,” and the government is generally faceless to most people. When you get a face, then you have somebody to criticize. But I knew very well that it was not a personal issue, that they were very concerned about important issues. And then, things turned around completely. I went from becoming the object of criticism in the activist community to becoming the hero of the activist community. And I was the same person, I was doing the same things, and I went from the person they were burning an effigy of to the person who they were praising as a hero. And there was no change in what I was doing. I was just proving to them that I had their wellbeing as my major objective, and, when they finally understood that, all the criticisms went away.
Simmons: In your role working for the government, and receiving government funding for your work, do you ever feel that your work is politicized in any way? Do you ever feel political pressure?
Dr. Fauci: No. Not at all as a matter of fact. I’ve been, I would say, fortunate, or I became fortunate, because I stuck by my principles. I had the fortune of being able to meet and become friends with the last five presidents. Only because early on when President Reagan and President George H.W. Bush wanted me to brief them about when this new emerging public health catastrophe was coming, mainly HIV/AIDS, I was very honest with them. I didn’t give them the answers they would have liked to hear. I developed gradually over years—with Reagan, George H.W. Bush, Clinton for eight years, George W. Bush for eight years, and now with Obama—the reputation of somebody that’s going to tell you exactly what the truth is and not going to be influenced or intimidated by any political pressure. Once you get that reputation, then people don’t mess with you, they don’t try to influence you because they know you’re so respected that you’re not going to give into any political pressure, and that you will give them the straight facts, based on the truth and based on what’s real. So I’ve been very fortunate that I’ve been able to assume that position with the federal government, where I don’t have political affiliations, I don’t have any ideology politically, and I merely am doing what I feel is right for the public health.
Austin: Right. I know you said honesty is very important in your profession. What do you think is really the most important attribute that a doctor could have?
Dr. Fauci: I think it’s commitment—unselfish commitment to the care of the patient—whether it be an individual patient that you’re taking care of or the aggregate of a cohort of patients that you may be responsible for either individually, in the sense of taking care of them, or doing research that is aimed at bettering their fate, their health, alleviating pain, discomfort, and disease. If you devote all of your attention to that, that’s the single quality, I believe, of a physician. You know, I’ve written in and I’m the editor now for more than 25 years of Harrison’s Principles of Internal Medicine, and there’s a quote in the preface of that book that one of the most important things for a physician is that the secret to taking care of a patient is caring for the patient, and I think if a physician does that then everything else falls into place.
Simmons: Dr. Fauci, thank you so much for taking the time out of your busy schedule to speak with us today.
Dr. Fauci: You’re quite welcome. I look forward to seeing you next week.
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