Narrator: On the evening of November 8, 2020, Dr. Anthony Fauci was sitting around a fire pit with friends, trying to find a moment of normalcy in a world ravaged by the COVID-19 pandemic. The United States was seeing 150,000 new infections a day, and the death toll had surpassed 230,000. Suddenly, his phone rang. It was Albert Bourla, the CEO of Pfizer. He asked a single, ominous question: "Tony, are you sitting down?" Fauci’s heart sank, fearing the worst. But the news was the opposite of what he expected. The initial data from the Phase 3 vaccine trial was in, and it showed an efficacy of over 90 percent—a result so stunningly successful it brought tears to his eyes.

This moment of triumph, however, was not the beginning of the story, but the culmination of a five-decade career spent on the front lines of the world's most devastating public health crises. In his memoir, Expect the Unexpected: Ten Lessons on Navigating Life, Science, and Leadership, Dr. Anthony Fauci provides an intimate self-portrait, revealing the principles and experiences that shaped his journey from a Brooklyn boyhood to becoming the nation's top infectious disease expert.

Narrator: Dr. Fauci's path was forged long before he became a household name. His upbringing in a close-knit, first-generation Italian-American family in Brooklyn instilled in him a deep sense of community and duty. His father, a pharmacist, often extended credit to families who couldn't afford medicine, teaching a young Tony that service to others was a core responsibility. This value was reinforced at Regis High School, a prestigious Jesuit institution in Manhattan, where the guiding motto was "Men for Others."

This principle of service, combined with a rigorous education in the classics and sciences, led him to Cornell Medical College. It was there, during his first patient encounter, that he truly understood the fusion of science and compassion. He was taught that a patient is not just a collection of symptoms, but a human being who needs care and comfort. After a successful residency, he joined the National Institutes of Health (NIH), making a name for himself by developing a life-saving treatment for a rare and fatal inflammatory disease called vasculitis. By the age of forty, he was a celebrated academic physician. Yet, he felt a sense of unfulfillment, a feeling that his work, while important, was becoming incremental and lacked a broad public health impact. He was at a crossroads, searching for a bigger challenge.

Narrator: In the summer of 1981, that challenge arrived in the form of a small, cryptic report from the CDC. It described five cases of a rare pneumonia in otherwise healthy gay men in Los Angeles. A month later, another report detailed a cluster of a rare cancer, Kaposi's sarcoma, in the same population. While many in the scientific community dismissed these as curiosities, Fauci saw something different. He recognized the signs of a brand-new, transmissible disease that was destroying the immune system.

Despite the warnings of his mentors, who told him he was throwing away a brilliant career, Fauci made a momentous decision. He pivoted his entire research program, which had been focused on the regulation of the human immune response, to study this mysterious new illness. He felt it was his destiny. His expertise in immunology and infectious diseases placed him in a unique position to tackle the emerging crisis. This decision would define the next two decades of his life, plunging him into the heart of the AIDS epidemic and setting the stage for his role as a national leader in public health.

Narrator: As the AIDS crisis exploded, so did the anger and desperation of the communities it devastated. The government's response was seen as slow and indifferent, and Fauci, as the face of that response, became a primary target. Activist groups like ACT UP, led by the fiery playwright Larry Kramer, staged dramatic protests. Kramer famously penned an open letter calling Fauci an "incompetent idiot" and a "murderer."

Instead of retreating, Fauci chose to listen. He began to meet with activists, recognizing that their anger was born of fear and a desperate will to live. A pivotal moment came when activists proposed a "parallel track" system. This would allow patients who didn't qualify for rigid clinical trials to access experimental drugs, while still collecting valuable safety data. Fauci was moved by the story of a young teacher in San Francisco who was forced to choose between a drug that might save his life and another that could prevent his blindness. Realizing the system was failing patients, Fauci publicly endorsed the parallel track initiative, a move that stunned the scientific establishment but earned him the respect of his harshest critics. This shift from an adversarial to a collaborative relationship proved that listening to the community was not a distraction from science, but an essential part of it.

Narrator: For fifteen years, Fauci and his colleagues fought a losing battle against AIDS, providing comfort but having little to offer in the way of effective treatment. That all changed in 1996 with the development of protease inhibitors. When used in combination with other drugs, this new therapy had a near-miraculous effect. Patients on the brink of death were, in Fauci's words, rising from their deathbeds. This "Lazarus effect" transformed AIDS from a death sentence into a manageable chronic illness.

However, this miracle was confined to the wealthy world. The drugs, costing up to $18,000 a year, were completely out of reach for the millions suffering in sub-Saharan Africa. Haunted by this inequity, Fauci used his influence to advocate for a global response. This work culminated in the creation of the President's Emergency Plan for AIDS Relief, or PEPFAR, under President George W. Bush. The program, which Fauci helped design, was a monumental success, providing life-saving treatment to millions and proving that complex healthcare could be delivered effectively in resource-poor settings. It remains one of the most significant global health initiatives in history.

Narrator: Fauci’s career was a series of lessons in expecting the unexpected. After the 9/11 attacks, his focus was abruptly shifted from HIV to bioterrorism, as he was tasked with preparing the nation for threats like anthrax and smallpox. Then came a succession of viral outbreaks, each with its own unique challenges. The 2009 H1N1 swine flu pandemic tested the nation's vaccine production capabilities and forced officials to learn from the mistakes of a botched 1976 flu response.

In 2014, the Ebola outbreak in West Africa ignited a global panic, fueled by fear and a 24-hour news cycle. Fauci found himself not only leading the scientific response but also calming public anxiety, famously hugging a recovered nurse to combat the stigma surrounding the disease. Just two years later, the Zika virus emerged, presenting a new kind of terror with its link to devastating birth defects. Through each crisis, Fauci honed his ability to respond to rapidly evolving threats, balancing scientific rigor with urgent public health needs and navigating the complex political landscape that accompanied each new emergency.

Narrator: No previous crisis could fully prepare Fauci for the COVID-19 pandemic. The scientific challenge was immense, but it was compounded by a second, equally dangerous threat: a crisis of truth. As the public face of the government's response, Fauci was tasked with communicating complex, evolving science to a frightened and polarized nation.

He found himself in direct conflict with President Donald Trump, who publicly promoted unproven treatments like hydroxychloroquine and downplayed the severity of the virus. Fauci made a conscious decision to be the "truth-teller," viewing the American public as his patient and believing they deserved unvarnished facts, even if it meant contradicting the President. This stance turned him into a political lightning rod, a hero to some and a villain to others. He and his family faced death threats, requiring a full-time security detail. The experience underscored a frightening new reality: in an era of extreme divisiveness and rampant misinformation, a public health crisis can become as much a political and cultural battle as a scientific one.

Narrator: Ultimately, Expect the Unexpected is a testament to a life dedicated to public service, guided by an unwavering commitment to scientific truth. Dr. Fauci's story is not just about the viruses he fought, but about the principles he fought for: integrity, perseverance, and the moral responsibility to speak truth to power, especially when the health of the nation is at stake.

The book's most challenging idea is not about the next pandemic, which Fauci assures us is inevitable. It is about the erosion of truth and civility in our society. The greatest threat we face may not be a novel virus, but our inability to unite against it, fractured by misinformation and political division. The book leaves us with a critical question: How can we rebuild the trust in science and in each other that is essential to surviving the unexpected challenges that lie ahead?