Ask More: The Power of Questions to Open Doors, Uncover Solutions, and Spark Change pdfdrive com

What’s going on here?
The autoimmune system had been Fauci’s specialty in medical school.
Trained in immunology and infectious disease, he was absorbed by the question
of why the human immune system sometimes turned on itself, robbing the body
of its ability to fight off illness and infection. In his early work as a young
researcher at NIH, Fauci had been researching an autoimmune disorder known
as Wegener’s granulomatosis. The disease inflames the blood vessels in the
lungs, kidneys, and upper airway. Symptoms include nosebleeds, sinus pain,
coughing up blood, skin sores, and fever.

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In a laboratory two floors above him, cancer researchers were conducting
groundbreaking research into Hodgkin’s disease. Fauci regularly ran into his
colleagues in the hallways or over a meal. They compared notes, shared
observations, and told stories as doctors do. One thing his colleagues told him in
particular caught his attention. It seemed cancer patients were prone to infectious
diseases as a result of their chemotherapy. The chemo not only suppressed the
cancerous tumors, but also the patients’ own immune systems. So Fauci
wondered:
Could you turn off the immune system without killing the patient in
order to cure a disease?
Fauci hypothesized that a delicate balance of low-dose, anticancer drugs
could suppress the immune system in Wegener’s patients. He knew Wegener’s
had no cure; treatments had so far been ineffective. Doctors had tried corticoid
steroids and prednisone, but patients remained dangerously prone to bacterial
infection or the flu.
To test his hypothesis, Fauci’s research team began experimenting with low
levels of chemo drugs in control groups. They conducted clinical trials and pitted
the new drugs against placebos. They tracked their patients over months and
kept meticulous records about their health, age, condition, and progress.
“To my incredible gratification and I think a little luck,” Fauci told me, “it
turned out that the drugs that we picked were just right.” The drugs also proved
effective for other autoimmune diseases, and Fauci quickly made a name for
himself. He appeared to be on track for an extraordinary career in the field of
immunology. Then something unforeseen happened that changed Fauci’s life.
It began in his office on a Saturday morning early in June 1981. Fauci was
scanning the Morbidity and Mortality Weekly Report, put out by the Centers for
Disease Control (CDC). He read an item about five gay men in Los Angeles who
had died as a result of a pneumocystis pneumonia. Caused by a fungus
commonly found in the lungs of healthy people, this form of pneumonia can
become deadly in those with weakened immune systems. Fauci did a double take
and asked himself:
What is going on?
Why all gay men?
Why pneumocystis pneumonia in otherwise healthy gay men?

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At first, Fauci thought recreational drugs might be the problem. That wasn’t
his field of expertise, however, and he was busy with Wegener’s research.
“What the hell,” he figured. “Forget it.”
A month later, another CDC morbidity report hit Fauci’s desk. It featured
another alert about the same mysterious illness. Now it reported that twenty-six
men had died, and not just in Los Angeles. Victims were in New York City and
San Francisco as well. All were gay. All had seemed in perfect health before
coming down with deadly pneumonia. Fauci was alarmed.
“This is going to be huge,” he said to himself.
Cultures Clash
Science, medicine, and experience drove Fauci to conclude that we were on the
verge of a full-blown health crisis, a new and frighteningly unpredictable illness
whose dimensions were completely unknown. He responded as a scientist and as
a doctor, thinking in terms of public health. He had been trained to observe a
problem and ask about it in a methodical way, putting impulse and judgment to
the side.
Outside the gates of science and the NIH, however, there was an altogether
different response. I was the White House correspondent for Associated Press
Radio. I had recently returned from London, where I’d been based as a foreign
correspondent. Now I was assigned to a noisy, cramped, show-offy place where
reporters strutted their stuff to show how tough or influential they were, and the
press secretary played power politics, leaking stories to those he liked and
freezing out those he thought were unfair, unfriendly, or overly hostile.
Welcome to the White House Briefing Room. We were just a few miles from
NIH but we were in another universe.
On this day, in October 1982, someone in the press corps asked about this
new and deadly illness that few others wanted to talk about. The reporter, Lester
Kinsolving, was with WorldNetDaily, a conservative news organization
committed to “exposing wrongdoing, corruption, and abuse of power.” His
questions to Reagan’s press secretary, Larry Speakes, produced a surreal
moment.
KINSOLVING: Larry, does the president have any reaction to the