Anthony Fauci (Photo by Alex Wong/Getty Images)

What is it with today's octogenarians and big government jobs? Time was when a public servant approached his ninth decade, he had long since given up trying to remake the world. He was happy merely to be still alive, happily sitting back enjoying the fruits of his life and work and planning nothing more ambitious than a night's sleep.

No longer. One 81-year-old has just had to have his hands prised from the reins of the Democratic Party's presidential nomination. Another on the threshold of that age barrier is campaigning for a fresh stint so that he'd turn 80 in the Oval Office.

Perhaps in their minds the years of wisdom they have accumulated equip them to be productive leaders. More likely it's simple vanity, an inability to let go, a conviction almost no one else shares that they still have good years ahead of them. Whatever it is, it's a delusion that rarely ends well. There are few examples of men (or women) in public office whose insistence on working into their ninth decade turned out well for them or the rest of us.

Anthony Fauci was due to turn 80 in 2020. If the good doctor had hung up his white coat as the calendar ticked over into that fateful year, he would have spent the rest of his days basking in a well-earned reputation for virtuous public service. For more than three decades his work as the head of the National Institute of Allergy and Infectious Diseases had placed him at the forefront of the battle against some of the most serious health challenges of modern times: AIDS, especially, but also brief and terrifying encounters with Ebola, Zika, and other diseases from which diligent work by public health officials kept us mercifully mostly safe.

He wouldn't be as famous as he is today. His name wouldn't be a household one. But it wouldn't be a curse either, a name loathed by those on one side of our hyper-partisan political and cultural divide. This is Dr. Fauci's tragedy—and unfortunately his legacy—an accomplished doctor and public servant who will be remembered by half his compatriots as a modern hero and by the other half as a megalomaniac villain. For many, his name has become synonymous with that arrogant insistence by elites that only they knew what was best for us and then made decisions rooted in uncertain science that had devastating consequences.

Fauci has written a memoir, which is only in part a defense of his controversial last few years in office. It's a testimony to the unbalanced nature of the effect on his reputation of COVID that in a 464-page book, the pandemic episode does not start until page 345.

We can acknowledge that the first 90 percent of his career was in many ways a classic American success story—the child of an Italian immigrant family, brought up in modest circumstances in Brooklyn; the bright kid who went to Catholic schools, and through talent, hard work, and luck quickly ascended the rungs of his profession—public health administration.

There were, it's true, early signs of the God complex some doctors succumb to and which may explain Fauci's ultimate fate. One moment of revelation—for him and us—comes in the early stages of the AIDS epidemic when he wrote a piece in a medical journal boldly prophesying prevailing opinion at the time—that the disease would be a major public health issue. In language that prefigures his outpourings during COVID, he describes it as an "apologia pro vita sua," self-consciously comparing it, as he says, "to the article of the same name written by (Cardinal) John Henry Newman in defense of his religious opinions" in 1864.

The work Fauci helped lead contributed to identifying AIDS, its precursor virus, HIV, and ultimately to the development of treatments that reduced it from a death sentence to the manageable condition it mostly is now. Fauci deserves credit too for the work he and others did under President George W. Bush to help bring desperately needed AIDS relief to Africa—and for the official response to the Ebola and Zika outbreaks during Barack Obama's presidency.

Which brings us inevitably to the Trump years and COVID. Fauci tells of his initial alarm at the onset of the virus, but the savior-doctor self-image is never far below the surface: "I became an instant hero to the millions of Americans who see me as a physician bravely standing up for science, truth and rational decision-making."

An honest critic now is obliged to acknowledge that, as Fauci recounts, no one had a clear idea how serious COVID might be in those early days—and an abundance of caution in official and private responses was understandable. The problem that Fauci faces is that, as the pandemic wore on and the draconian public safety measures to tackle it hit harder, he and other officials were promulgating actions based on a science that was never as settled as they claimed.

Mask-wearing, initially discouraged, later became essential, we were told, for saving lives. The strict imposition of social distancing that closed schools, workplaces, restaurants, and ruined the livelihoods, education, and mental health of so many, wasn't rooted in hard medical evidence but "sort of just appeared," as he later told a congressional hearing.

Mindful of how ruinous some of these measures were, and even as he likes to claim credit for saving lives, Fauci is quick to insist he wasn't the decision-maker. There was a "gross misperception," he says, "that I was in charge of most or even all of the federal government's response."

And he tries to further dodge responsibility by belatedly acknowledging the limits of the scientific evidence he had for his advice: "People associate science with absolutes that are immutable when in fact science is a process that continually uncovers new information. … What we know continues to evolve and uncertainty is common."

And where would people get this idea that science was an absolute truth? Perhaps from the man who responded to his critics by saying, "They're really criticizing science—because I represent science. That's dangerous."

Fauci largely avoids dealing with some of the most egregious examples of how this mindset worked—the active suppression of serious and well-credentialed critics who challenged him. He takes issue with the case made by the authors of the Great Barrington Declaration—a group of highly regarded epidemiologists and others who warned that broad lockdowns were ruinous and unnecessary—but he is silent on what we now know were efforts by top officials in the public health establishment to actively discredit their well-intended efforts.

He forcefully denies that his institution was in any way responsible for helping fund the research in the Wuhan laboratory in China that may have produced the COVID virus in the first place. But he says nothing about the campaign he and others led to suppress—and denounce—those who argued on strong scientific evidence for the lab-leak theory.

Fauci's many critics must always acknowledge the uncertain, unpredictable, and genuinely alarming nature of the challenge we all faced in those early days of the crisis—and accept that in those conditions policy mistakes are inevitable.

But Fauci himself must take a sizable share of responsibility for actions taken that continue to cause great economic and social harm to this day, actions that were too often based on claims of scientific certainty where there was none and the suppression of valid dissent where it might have been of critical help. In the end he played a key role in the resulting loss of trust in the public health establishment that, the next time we face a crisis on the COVID scale, will likely prove catastrophic.

On Call: A Doctor's Journey in Public Service
by Anthony Fauci
Viking, 464 pp., $36

Gerard Baker is editor at large of the Wall Street Journal and author of American Breakdown: Why We No Longer Trust Our Leaders and Institutions and How We Can Rebuild Confidence (Twelve).

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