I

If on" individual can be singledout who epitomizesthe benefitsof a pol-

icy of supportingbasic biomedical researchand its links to clinicalmedi-
cine, then surely that person is Tony Fauci.

[NrHoN\
S. FAUCI,
M.D.

M a x w e l lF i n l a n dA w a r d R e c i l l i e n t
1989
 ogy at CeorgetownUniversitySchoolof
Medicine.Dr. Rubinis head of Castro-
enterologyat the Medical College of
Pennsylvania. Dr. Schlesinger is at the
Universityof California in SanFrancisco.
Dr. Jeffrieshaslust retiredas Chairman
of the Departmentof Medicineat the
Pennsylvania StateUniversityCollegeof
Medicinein Hershey.Dr. Queenanre-
callsDr. Faucias "one of the most in-
s first the nation, and later the quisitive and hard-workingpersons I
world,cameto gripswith the AIDS haveever known.Which is not particu-
epidemic,scientists involvedin unravel- larly surprisingwhen you consider
ling the derangements the diseasein- where he is now."
flictson the immunesystemfrequently But when Dr. Fauciwas at medical
pointedto the fact that the speedwith school,immunologywas, as the NIAID
which so much knowledeeabout the Director points out, in its very early
diseaseaccumulatedwasd"ueto yearsof stagesof development."ln those days
basicscientificknowledgeaccumulated immunology occupied only one lec-
long beforeanyonehad ever heard of ture," he notes."At the sametime it was
the Acquiredlmmune DeficiencySyn- clearto me that thiswasa field that was
dromeor the virusthat is its cause. goingto explode,and in my fourthyear
Advancesin scienceare not achieved at medicalschoolwhen I appliedto the
by one personalone,but if one individ- Nationallnstitutes of Healthfor appoint-
ual can be singledout who epitomizes ment asa clinicalassociate, I decidedto
the benefitsof a policyof supportingba- try for the Laboratory of ClinicalInvesti-
sic biomedicalresearchand its linksto gationat the NationalInstituteof Allergy
c l i n i c am
l e d i c i n et,h e n s u r e l yt h a t p e r - and InfectiousDiseases whose chief at
sonisAnthonyS.Fauci,M.D.,directorof the time was Dr. SheldonWolff."
boththe NationalInstituteof Allergyand Dr. Wolff,who is now Chairmanof the
InfectiousDiseasesand the Office of Departmentof Medicine at Tufts Uni-
AIDS Research at the NationalInstitutes versitySchoolof Medicine,recallsthat
of Health. this was a time when governmentser-
Fromthe time he was a medicalstu- vice was a very popular way for young
dent at CornellUniversityMedicalCol- physicians to fulfilltheir nationalservice
Iege in the mid-1960s,Dr. Fauci has obligations. "We had lots of applicants,
beenactivelyinterested in the immuno- far more than we had positions.I think
l o g i c a l a s p e c t so f h u m a n d i s e a s e . the year Dr. Fauciappliedwe had 140
"When I wasat Cornellbetweenmy first applications for sevenpositions."
and secondyear,I workedon an immu- Dr. Fauciwas one of theseseven.He
nologyprojectwith Dr. John Queenan joined Dr. Wolff'slab in .1968,and ex-
involvingRh disease,"he says."Then, cept for one yearbackat Cornellwhere
during my secondyear I worked with he was Chief Residentand Instructorof
Drs. Walter Rubin,Marvin Schlesinger Medicine, he has been at NIH ever
and CrahamJeffrieson celiacdisease, since."When he cameto work with us,
w h i c h i s a n i m m u n o l o g i c a lm l ye d i a t e d it was readily apparent that he was a
disorder.From my very first days as a mostunusualpersonin that he was both
medicalstudent I was fascinatedwith adeptin the lab and alsotook very good
immunology." careof patients,"Dr. Wolff says.
Dr. Queenanis now chairmanof the "He hadthen the sameincredibleen-
Departmentof Obstetrics and Cynecol- thusiasmand excitementabouthiswork
ashe hastoday.He waswillingto under- and Dr. Faucipraisesthe Jesuitical sys-
take almostanything.In the nine years tem of educationas being highlyintel-
that we worked together,beforeI left to lectual,highlylogicaland intenselycuri-
go to Tufts,I can't remembera single ous.
moment wl-renI was disappointedin "The Jesuitshave alwaystrainedone
proudto have
him. I am extra-ordinarily to have precisionof thoughtand econ-
beena partof his career."Dr. Faucide- omy of expression. Today,I tell my fel-
scribesDr. Wolff as the one man who lows:'Be very precisein what you have
has been the most influentialin his ca- to say and say it in a way that's very
reer. c l e a r .I' t h i n kt h i st r a i n i n gh e l p e dm e i n
that regard,althoughI believeI naturally
had this abilityto be preciseand eco-
nomical. Nevertheless,I think this
Dr. rauci'swork into schooling gaveme a realfeelfor life," he
says.
the fundamentalmech- Dr. Fauci'sfeelfor lifewas not limited
to a classical education, however.Before
anismsinvolving the he went to medicalschoolhe workedfor
regulationof the hu- four summersas a constructionlaborer.
One of the jobs he worked on was the
man immune response buildingof the SamuelWood Memorial
has been felt to consti- aLibrary at Cornell."Laterwhen I became
m e d i c asl t u d e nat n ds p e n th u n d r e d o sf
tute someof the most hoursstudyingin the library,I would re-
member that it was only a couple of
important advancesin yearspreviouslythat I was working on
the managementof pa- was the gangthat had built the very stacksI
now goingthrough.
tients with these im- "Of courseI did it for the money. lt
was well paid work. But I alsodid it for
mune-mediateddisor- the experience. I knew I wasgoinginto a
ders over the past 20 highly intellectuaa l c a d e m i ca t m o -
s p h e r e - m e d i c asl c h o o l - s o I t h o u g h tI
years. shouldget a feelfor what a lot of people
needto do to makea living."
The periodwhen Dr. Wolffwasat NIH
and Dr. Faucibecamea clinicalassociate
AlthoughDr. Faucisaysthat he was i n h i sl a bw a sa u n i q u et i m e i n i m m u n o l -
alwaysinterestedin medicine,his pre- ogy. "l think we were the first to study
medicalschooleducationwas classicalthe interfaceof immunologyand infec-
ratherthan scientific.Born in Brooklyn, tious disease,"Dr. Wolff points out.
New York,he went to Catholicschools " U n t i l t h e nm o s ti m m u n o l o g i sw t se r ei n -
that were stronglyorientedtowardsclas- terestedin either the treatmentof the
sicallanguages and philosophy. diseaseor the organismthat causedit.
"At school I read the Creek and Latin We were interested in the host.
classics,translatingsuchworksasthe //- "Tonywas lookingat what happened
iadand Odysseyfrom Greekto English.when you gavesteroids.I was lookingat
It wasa verybroadliberalartseducation what happenedwhen peoplegot fever.
both in high school and college," he Others were looking into what hap-
says.One of his schools,RegisHigh penedto the white cellsand so on. We
School,is a Jesuitschoolin Manhattan,werereallyone of the first,if not the first,
 labsto be devotedentirelyto lookingal beenfelt to constitutesomeof the most
the interaction betweenthe hostandihe importantadvancesin the management
i n v a d i n go r g a n i s m - t h e i m m u n o l o g i c of patienlswith thesedisorders o-verthe
responseof the host to an infectious past20 years.
agent." I n 1 9 8 0t h e f r u i t so f t h i sw o r k w o n D r .
Dr. Faucicallshimselfa basicscientist. Faucithat year'sFlemmingAward.The
but he is particularly interested in prob- h o n o r , n a m e d a f t e r D r . A r t h u r
l e m s t h a t h a v e c l i n i c a lr e l e v a n c eH
. i s Flemming,a former Secretaryof the-
work at NlH, beforeAIDS pushedhim then Departmentof Health,Education
into prominence,illustrates this.He de- and Welfare,is made every year to 10
veloped protocolsfor the use of im- o u t s t a n d i n gF e d e r a le m p l o y e e su n d e r
munosuppressive drugs,such as cyclo- the ageof 40. ThatsameyearDr. Fauci,
phosphamide,in the managementof afterservingas Dr. Wolff'sdeputy,was
p a t i e n t sw i t h i m m u n e - m e d i a t eddi s o r - made Chief of a new laboratoryat the
ders.His findingsare now recognized as lnstitute-the Laboratoryof lmmuno-
important in delineatingthe precise regulation.The followingyear the first
m e c h a n i s mbsy w h i c h i m m u n o s u p p r e s clinical
- observations on a rare and un-
sive agentsmodulatethe human im- usualcancerin homosexualmen were
mune response. r e p o r t e dT . h e A c q u i r e dl m m u n e D e f i -
c i e n c yS y n d r o m e h a de m e r g e d .
A l m o s tf r o m t h e b e g i n n i n gD r . F a u c i
recognizedits importance."l first be-
came interestedin AIDS at the end of
1 9 8 1 ,a n d w e s t a r t e dw o r k w i t h A I D S
p a t i e n t as t t h e N I H C l i n i c aCl e n t e r , "D r .
" D"rpite the fact that F a u c ir e c a l l s ". E v e n t h e n , a n d t h i s o f
coursewas well beforethe human im-
AIDSis a terrible epi- mune deficiencyviruswasdiscovered. I
demic, it is one of the felt this was going to become a major
public health hazard throughout the
most extraordinaryand world. There was no question in mv
mind about that.To be suretherewere
exciting evolutions in o n l y a h a n d f u lw h o f e l t a s I d i d : D r .
sciencethat I have ever JamesCurranof the Centersfor Disease
Control,Dr. RobertCalloat the National
heard of, much /ess ex- C a n c e rI n s t i t u t eD , r . W i l l i a mH a s e l t i n e
and Dr. Max Essex in Massacusetts
perienced." amongothers.In thosedaystherewere
just a few of us.
"Despitethe factthatAIDSisa terrible
epidemic,it is one of the mostextraordi-
nary and excitingevolutionsin science
"These diseasesrange across the that I haveever heardof, much lessex-
whole spectrum of the vasculitides,perienced.In those early days,literally
Wegener'sgranulomatosis, polyarteritiseveryweek or monththat went by there
n o d o s aa n d s o m eo f t h e o t h e ra u t o i m - w a s s o m en e w i n s i g h itn t o t h e i m m u n e
mune diseases," he says."At the same system.There was an electric atmo-
timewe wereengagedin basicwork into sphere;you could almost palpate it.
t h e f u n d a m e n t aml e c h a n i s mi sn v o l v i n e Evennow, when AIDSis a maiorfieldof
t h e r e g u l a t i oonf t h e h u m a ni m m u n er e l r e s e a r c ihn v o l v i n gt h o u s a n dos f i n v e s t i -
sponse."Dr. Fauci's work in thisareahas gatorsworldwide,the excitementhasn,t
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d i m i n i s h e dl t.' se x h i l a r a t i nsgo, m e t h i n Ig o n t h e N I H c a m p u si s a n i n c r e d i b l e x -
feel I can neverget tired of." oerience,"he observes."The intellec-
ln N o v e m b e r1 9 8 4 , D r . F a u c i w a s i u a l a t m o s p h e rteh,e h i g h l yq u a l i f i e d
sci-
namedDirectorof the NationalInstitute entistswith whom you interactevery
of Allergyand lnfectiousDiseases. He day,and the very high standards of per-
was the youngest among the-then 12 formance are just a natural part of the
N I H i n s t i t u t de i r e c t o r sN. o w ,i n a d d i t i o n intramuralprogramhere.
t o h i s l a b a n d c l i n i c a ls t u d i e s h, e h a s
heavy administrative burdens.Despite
this,Dr. Faucistillseespatients, pointing
or-rtthat he is a practiciing physician. "To be hereon the
He admitsto beingsurPrised at how
m u c hh e l i k e sa d m i n i s t r a t i ol n .a r e c e n t
NIH campusis an in-
interviewwith the CornellMedical Col' credible experience.
lege Alumni Quarterly he said that he
manages to organizehis day so "l don't The intellectualatmo-
wastea minute," and finds he has the
energyto work 14 hoursa day,sixdaysa
sphere, the highly qual-
'Don't
week. "l have been asked: you ified scientistswith
ever get tired?Aren't you burningout?'
W e l l I d o n ' t t h i n k l ' m a n y w h e r en e a r whom you interact ev-
tiredof it. The intellectual excitementis ery day, and the very
too great.Thingsare going well," he
says."Our lab is very productive,and I high standardsof per-
t h i n k w e a r e m a k i n gs o m e m a i o rc o n -
tributions to understanding the formance are just a
i m m u n o p a t h o g e n eosfi A s lD S . " naturalpart of the in-
It wasduringthis period,too, afterhe
becameInstituteDirector,that Dr. Fauci tramuralprogram
found time to get married.His wife is
C h r i s t i nGe r a d ya, n u r s ei n t h e N I H C I i n -
here."
icalCenter.Theyhavetwo children,Jen-
nifer age three and Megan now eight
months.His wife continuesto work at "Here, it's excellenceall the way, and
NIH oftenwith AIDSpatients. you muststrivefor nothingshortof that.
Dr. Fauciemphasizes the importance To live as I havewith that experiencefor
of the scientificatmosphere at NlH, es- 21 yearshasbeen highlygratifying. I am
peciallythe intramural program.He says very fortunateto be partof the intramu
that this is somethinghe wishesevery ral program,and I look forward to re-
scientistcould experience."To be here mainingwith it for a longtime to come."