Acknowledgments
This book is the story of my life through my more than eight decades on this planet. I have been blessed by my association with a number of people who have made this story possible either indirectly through their impact on my life or directly by their encouragement and input into this book. It would be impossible to recognize everyone by name who touched my life during these eighty-three years. Here are a few of them, and I apologize for not naming them all.
My journey in public service was inspired by my parents, Stephen and Eugenia, who taught me the importance of helping others beginning in my early childhood. I thank my sister, Denise, and her late husband, Jack Scorce, and their family whose support never faltered over the years. I was fortunate to have been educated by Dominican nuns at Our Lady of Guadalupe elementary school in Brooklyn. They always expected more of me, which fed into my need to continually do better. I give profound thanks to the Jesuit priests and priests in training and the lay faculty at Regis High School in Manhattan and the College of the Holy Cross in Worcester, Massachusetts, who nurtured in me the concept of and desire for serving others. I cannot overestimate this positive impact on me.
I thank my professors, the attending physicians, and fellow trainees at Cornell University Medical College (now Weill Cornell) and The New York Hospital–Cornell Medical Center, who provided the environment that fostered my love of medicine and who helped teach me the science and art of patient care. Many of my extraordinarily talented classmates at Cornell remain friends to this day.
I spent fifty-four years at the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, my professional home and the setting for most of this memoir. It would be impossible to adequately thank the large number of people who were mentors to me, my mentees, and the other administrators, physicians, nurses, and health-care personnel with whom I worked closely and learned from. You know who you are, and for those no longer with us, your families and friends know. I am in debt to the many members of my lab, the Laboratory of Immunoregulation, who were integral to any and all of my scientific accomplishments. I give specific thanks to the late Sheldon M. “Shelly” Wolff, who recruited me to NIAID. Shelly became one of my closest friends, and I learned more from him than from any other individual physician-scientist, not only about medicine and science but about the importance of asking critical questions. Of course, I thank my late dear friend and principal deputy Jim Hill, my relationship with whom I describe in great detail in this memoir. I also thank the late James F. Dickson III, M.D., for his friendship and sage advice on how to navigate the complexities of the White House. I thank Dr. Jack Whitescarver and the late Dr. Richard Krause for their unflinching support of me. I thank Dr. Henry Masur for being part of the original NIAID AIDS team with me and Cliff Lane.
Among my colleagues at NIAID, I would like to single out a few who stood by me through tribulations and triumphs and without whom I could not have achieved what I did. John Gallin and his wife, Elaine, have been Christine’s and my closest friends for decades and served as reliable sounding boards. I could not have performed as effectively as director and chief of a research laboratory without having the immensely scientifically and clinically talented Cliff Lane, my colleague, dear friend, and trusted confidant, by my side. Greg Folkers, unselfish, loyal, and a man of the utmost integrity, helped me wear my multiple hats by serving as a walking encyclopedia of valuable information. I thank my late principal deputy John LaMontagne, who opened my eyes to the dangers of emerging infectious diseases, and his successor, the steadfast Hugh Auchincloss. I thank Jill Harper, my most recent deputy director for science management. I thank my former deputy director for science management John McGowan and my former executive officer Mike Goldrich for teaching me how to navigate government bureaucracy. I thank the NIAID division directors who served during my tenure, particularly Jack Killen, Carl Dieffenbach, Carole Heilman, Emily Erbelding, Dan Rotrosen, Kathy Zoon, Steve Holland, Matthew Fenton, Gary Nabel, and John Mascola together with their talented staffs, as well as the several division directors who preceded them over my almost forty years as NIAID director. I also thank the many talented individuals who served as assistants and advisors in my immediate director’s office. I thank the many NIAID office directors and their talented staffs, especially Courtney Billet, director of communications and government relations, and her amazing staff who served me so well over many stressful years. A special thanks to Laurie Doepel for her sharp editorial eye.
I am grateful to Patty Conrad, my special assistant extraordinaire, my wonderful assistant Kim Barasch, and their talented predecessors who served my office over the years. After I left the NIH, Jenn Kuzmuk took the baton as my indispensable special assistant. A very special thanks to my talented and totally reliable IT person, David Awwad.
I thank the many hundreds of patients whom I took care of directly or consulted on at the NIH Clinical Center over my more than half a century at this extraordinary facility. It was a privilege to care for them, and they taught me so much about medicine and about humanity.
I could not have asked for better colleagues than the directors of the twenty-six other institutes and centers at the NIH. While I was NIAID director, I was fortunate to serve under five permanent and five acting (interim) directors. Among these uniformly brilliant individuals, some became good friends, including the late James B. Wyngaarden, who appointed me as NIAID director, the late Ruth Kirschstein, Elias Zerhouni, Harold Varmus, Francis Collins, and Larry Tabak.
As I describe in this memoir, I had the privilege of serving seven presidents of the United States, their vice presidents, their immediate staffs, and members of their cabinets. I want to thank them for an honor that I could never have conceived of as I took the Hippocratic oath in 1966.
I particularly want to thank people at the Department of Health and Human Services who became my friends and continued to support and encourage me long after they moved on. I am indebted to the following HHS secretaries as well as their staffs: the late Louis Sullivan, Donna Shalala, Tommy Thompson, Michael Leavitt, Kathleen Sebelius, Sylvia Burwell, Alex Azar, and Xavier Becerra. I am particularly grateful to Donna Shalala, Tommy Thompson, and Sylvia Burwell for their enduring friendship and to Sylvia for choosing me as one of three speakers to celebrate the hanging of her portrait in the Hubert H. Humphrey Building. I am especially indebted to Stewart Simonson, who was assistant secretary for preparedness and response under Tommy Thompson and who became a close family friend and trusted confidant, always providing sound advice.
Others who served in various administrations deserve special thanks for their friendship, encouragement, and assistance, particularly those involved in the creation of PEPFAR. I thank Mark Dybul, Josh Bolten, Gary Edson, Jay Lefkowitz, Kristen Silverberg, Margaret Spellings, and the late Michael Gerson. I also want to thank Secretaries of State Condoleezza Rice and the late Colin Powell for their help with PEPFAR. The latter also gave me important tips in writing this memoir. I thank Bono for his encouragement and friendship. I thank Vice President Dick Cheney and his chief of staff Lewis “Scooter” Libby for trusting and helping me put together the post-9/11 biodefense plan. I thank Ron Klain for his guidance during Ebola in the Obama administration and his leadership as chief of staff during the Biden administration. Special thanks to my dear friend Susan Rice, who served in multiple roles in both the Obama and the Biden administrations. I also thank Denis McDonough, whom I first met when he was a staffer for Senator Tom Daschle more than twenty years ago. He has been a friend and supporter during his multiple roles in the Obama and Biden administrations. I thank Lisa Monaco, who was so supportive during the Ebola and Zika crises during the Obama administration and who went on to serve in the Biden administration. I thank Hillary Clinton, who was helpful to and supportive of me during various public health challenges in her multiple roles as first lady, senator, and secretary of state. I thank all the leaders and members of the coronavirus task force during the Trump administration, particularly Deb Birx, who has been a friend and colleague for decades, as well as the other physicians on the task force, Jerome Adams, Bob Redfield, and Stephen Hahn. I also thank Marc Short, Katie Miller, Olivia Troye, and Alyssa Farah Griffin for their support during difficult times. I thank the Biden COVID-19 Response Team, including Ashish Jha, Lisa Barclay, Vivek Murthy, Rochelle Walensky, David Kessler, Marcella Nunez-Smith, Bechara Choucair, Cyrus Shahpar, Andy Slavitt, Natalie Quillian, Courtney Rowe, Ben Wakana, Kevin Munoz, and Kate Berner, among others.
A very special thanks to the immensely talented and universally admired Jeff Zients, with whom I worked daily during his tenure as the coordinator of the COVID-19 Response Team. I got to know Jeff when he was at the National Economic Council and OMB during the Obama administration. Jeff and his wife, Mary, have become cherished friends. He closely advised me on important career decisions during my last two years at the NIH.
I thank the large number of my colleagues and other friends, some of whom were in government for a period, for their support and friendship. Special thanks to the long line of CDC directors, together with their talented and dedicated personnel, alongside whom I had the privilege of serving for so many years. I also point out the late Paul Farmer, Hilary Marston, Tom Frieden, Bill Gates, Larry Corey, Bart Haynes, Rob Califf, Bob Seder, Julie Gerberding, Giuseppe Pantaleo, David Morens, Lorenzo Moretta, Margaret (Peggy) Hamburg, and Eric Goosby. I thank the late Rob Stein and Ellen Perry for their years of friendship and support. I am grateful for the love and support of Christine’s family, including her late parents, John and Barbara Grady, and her four siblings, Joanne, Barbara, Jack, and Bob, and their families. I thank Neal Katyal, David Schertler, Danny Onorato, Drs. Alec Whyte, Theodore Li, David Hellmann, Stephen Yang, and Andrew Lerner for their advice and care.
I thank the many members of the AIDS activist community for pushing me to do better and for their unflinching support over the past few years. Particular thanks to my close friend and comrade in arms, Peter Staley, as well as to David Barr, Mark Harrington, Gregg Gonsalves, Lawrence (Bopper) Deyton, and the late Marty Delaney and Larry Kramer.
Over my almost forty years as NIAID director, I had the privilege of testifying before the U.S. House of Representatives and the U.S. Senate literally hundreds of times and have encountered many fine people in both bodies, many of whom became friends. I thank them.
I believe strongly in the importance of the press, the legitimate press, that is, which is integral to our democracy. Over the past forty years, I have had the opportunity to work with some of the finest print, TV, radio, and digital journalists, many of whom have become friends. There are so many of them that I hesitate to single out only a few, but you know who you are.
Special gratitude goes to my security details. The HHS security team included, among others, Brett Rowland, George Adams, and Andre Jacobs. I am profoundly grateful to Brett, who spent three years with us and became a treasured friend. Shawn Larson and Urbino “Benny” Martinez led the U.S. Marshals Service team. I extend my deepest thanks to them for keeping me and my family safe.
With the encouragement of many of the people mentioned above, I began writing my memoir full-time after stepping down as director of NIAID. I had been working on drafts nights, weekends, and holidays at home for years. I needed to find out if the book was going in the right direction. One person among several stands out as a critical figure in my pushing forward with the project. That was Rick Atkinson, an old friend and two-time Pulitzer Prize winner, once for journalism at The Kansas City Times and again for history as the author of An Army at Dawn: The War in North Africa, 1942–1943. Rick was the first person to read the manuscript. I will be forever grateful to him for his literary suggestions as well as his friendship and generosity.
I had known the attorney Bob Barnett for more than twenty years, mostly through Washington, D.C., social events. I also know his wife, Rita Braver, who interviewed me several times as a CBS News correspondent. Almost every time we met, Bob reminded me to see him when I was ready to step down from the NIH and write a book. And so, when I was ready to take the plunge, I contacted Bob, and that was one of the best decisions that I have ever made. Bob guided me through the process of writing a book proposal and choosing a publisher. But more than that, he was available on a moment’s notice to help me negotiate other career decisions such as joining the faculty at Georgetown University. Bob has become a dear friend and confidante.
I thank Dr. John “Jack” DeGioia, president of Georgetown University, who visited me at the NIH years ago and suggested that I join the Georgetown faculty after I stepped down from NIAID, whenever that would be. Soon after my retirement, he offered me a position as Distinguished University Professor with a joint appointment in the School of Medicine and the McCourt School of Public Policy. I accepted with great enthusiasm. He graciously allowed me the time to finish my book even as he welcomed me into the outstanding Georgetown academic community. I thank Jack for his kindness and flexibility.
I thank Brian Tart, president and publisher of Viking, for taking me and my project on. I thank my extremely talented and tough editor, Wendy Wolf. She pushed and pushed, getting me to cut stories that I loved and people I wanted to include. “You may love it,” she stated firmly, “but your reader does not really care. Cut it.” After I stopped grumbling about her under my breath, I realized that she was correct. This book is considerably better because of her input.
I was not planning to have a “collaborator” to help me line edit the 80 percent of the book that I had already written and write with me the 20 percent that needed to be completed. Bob Barnett and a close friend, Liz Whisnant, persuaded me to engage a collaborator. Enter Linda Kulman, a former journalist and experienced wordsmith. Bringing on Linda is one of the best decisions I made about the book. Besides being extremely talented and knowledgeable, she was great fun to work with. She made the sometimes-tedious task of going over every line of the book together (more than once) actually enjoyable, and I wound up with a new good friend.
I thank the people who generously took the time to read what I have written. My wife, Christine Grady, an excellent writer herself, read the entire manuscript carefully and made several critical suggestions, all of which I followed closely. Cliff Lane, who lived through much of the story with me, offered excellent recommendations for which I am grateful. Greg Folkers, who helped edit almost every scientific and policy paper I have written and almost every lecture I have given over the decades, applied the same sharp eye to my memoir. Peter Staley read the chapter on HIV activism and made valuable suggestions.
My daughters, Jenny, Megan, and Ali, read the chapter on the family (“La Famiglia”) and reminded me of moments I had forgotten. I am particularly appreciative of Jenny’s very precise pen. I thank my daughters, whose unconditional love never prevented them from telling me an inconvenient truth that I might not like to hear. It has made me a better father and person.
Finally, I thank Christine, the love of my life and my inspiration. She has been my partner, my adviser, my gentle critic, and my best friend. The hundreds of hours I put into this book took away from our time together, but her only reaction was encouragement.
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