Standing in the Gap

Standing in the Gap

Making hospital rounds in the days of COVID was a problem unlike anything I had ever experienced. Never in my career was it so difficult going from one room to the next, never knowing if a patient would still be there the next day, constantly trying to anticipate the next disaster waiting to happen.

I still remember the crushing shortness of breath, the look of fatigued despair, and the families asking if there was anything—anything—that would change or improve their loved one's outcome. The ICU beds were completely full. Transfers to higher levels of care were impossible because the urban hospitals were maxed out, too. It was the brutal reality of the COVID world.

Honestly, if you had told me at the start of my primary care career that a major occupational hazard of mine would involve public anger over wearing a mask, taking a vaccine, or washing hands thoroughly, I would have laughed in your face. Yet I spent countless hours trying to explain why these basic public health measures were crucial to limiting the spread of a deadly disease.

Which brings me to Dr. Anthony Fauci.

This was the second time in my career that I depended on Dr. Fauci to walk me through uncharted clinical territory. I am an old enough physician to have taken care of my fair share of HIV/AIDS patients. Neither COVID nor HIV/AIDS was understood—or even named—when I was a student, resident, or young faculty member at the University of Oklahoma College of Medicine. Yet the teacher who guided my understanding of clinical care for both of these terrifying diseases was this one man.

Watching him take the witness stand recently was deeply anxiety-provoking. I listened to the disingenuous questions from Senators who lacked even a faint clue about the basic science that had kept them safe. I saw conservative journalists strategically placed in the background so the camera would catch their mocking facial expressions and eye-rolling.

As I watched, a stark reality dawned on me: part of the public disdain for those of us who served as bearers of difficult news is that someone has to stand in the gap. Someone has to absorb the heat, fire, and anger generated by everyone’s fear, confusion, and missteps. We demand perfection, yet none of us is perfect. And despite our best efforts and growing understanding, people lost their lives, their livelihoods, and their sanity.

Make no mistake: Fauci made mistakes. He should have been vastly better at communicating uncertainty, maintaining transparency, and addressing people’s real-world fears rather than brushing them off. He failed to integrate the whole human experience into public policy, opting instead to treat complex, messily human societal issues like pure laboratory science. 

Though, given the bad-faith circus surrounding him, I’m not sure he could engage honestly … so he pleaded the fifth.

Here is the inconvenient truth: we all messed up.

We desperately need to figure out why things went sideways so we don't repeat this nightmare during the next crisis. But launching unhinged personal attacks and engaging in disingenuous pandemic revisionism isn't going to fix our public health infrastructure, which has always been underfunded and treated like an orphan stepchild by traditional medicine. 

Pandemics are messy, awful, and packed with impossible tradeoffs. As a country, we’ve completely avoided having a real reckoning about how terrified we were and how much we lost. Scientists and bedside clinicians did their absolute best with broken systems in an insanely polarized landscape. 

And through it all, most of us didn't run away.

The anger people feel is real, and in many ways, it was earned. But at some point, the political theater and point-scoring have to stop. We have to stop using one man as a lightning rod and start turning that energy toward fixing what is actually broken.

J.Michael Pontious M.D.

August 8, 2026