OBJECTIVES: This article describes the challenges faced by the National Library of Medicine with the rise of artificial intelligence (AI) and access to human knowledge through large language models (LLMs). BACKGROUND AND SIGNIFICANCE: The rise of AI as a tool for the acceleration and falsification of science is impacting every aspect of the transformation of data to information, knowledge, and wisdom through the scientific processes. APPROACH: This perspective discusses the philosophical foundations, threats, and opportunities of the AI revolution with a proposal for restructuring the mission of the National Library of Medicine (NLM), part of the National Institutes of Health, with a central role as the guardian of the integrity of scientific knowledge in an era of AI-driven science. RESULTS: The NLM can rise to new challenges posed by AI by working from its foundations in theories of Information Science and embracing new roles. Three paths for the NLM are proposed: (1) Become an Authentication Authority For Data, Information, and Knowledge through Systems of Scientific Provenance
(2) Become An Observatory of the State of Human Health Science supporting living systematic reviews
and (3) Become A hub for Culturally Appropriate Bespoke Translation, Transformation, and Summarization for different users (patients, the public, as well as scientists and clinicians) using AI technologies. DISCUSSION: Adapting the NLM to the challenges of the Internet revolution by developing worldwide-web-accessible resources allowed the NLM to rise to new heights. Bold moves are needed to adapt the Library to the AI revolution but offer similar prospects of more significant impacts on the advancement of science and human health.