Austin was hospitalized for complications following treatment for prostate cancer

Defense Secretary Lloyd Austin was treated for prostate cancer, which was identified last month, Walter Reed National Military Medical Center said in a statement, and complications from that procedure led to his hospitalization on New Year’s Day.

The statement — from Dr. John Maddox, trauma medical director, and Dr. Gregory Chesnut, center for prostate disease research of the Murtha Cancer Center Director, at Walter Reed — is the first indication of why Austin was hospitalized on New Year’s Day. It still does not answer questions, however, of why no one — not the president, nor Congress or indeed Austin’s own deputy — was kept in the dark about where he was or his condition.

New rules for Cabinet members

The secrecy surrounding Austin’s hospitalization prompted the White House to take a hard look at rules for Cabinet members, according to a memo obtained by NPR.

President Biden’s chief of staff Jeff Zients on Tuesday told Cabinet secretaries in the memo that he was reviewing the rules for how Cabinet members delegate their authority when they are hospitalized, under anesthesia, traveling to places with limited access to communication, or are otherwise unable to be reached.

Zients ordered Cabinet members to submit their current protocols in writing for his review by Friday – and also emphasized that they need to keep the White House informed about potential cases where they need to delegate authority.

Timeline of events

The Walter Reed statement provided a timeline of the events that led to Austin’s hospitalization. It said Austin has undergone regular prostate specific antigen (PSA) surveillance as part of his routinely recommended health screening. Prostate cancer, the most common cause of cancer among American men, affects 1 in every 8 men – and 1 in every 6 Black men during their lifetime.

“Changes in his laboratory evaluation in early December 2023 identified prostate cancer which required treatment,” the statement said. “On December 22, 2023, after consultation with his medical team, he was admitted to Walter Reed National Military Medical Center and underwent a minimally invasive surgical procedure called a prostatectomy to treat and cure prostate cancer.”

Austin was under general anesthesia during this procedure. He recovered from his surgery and returned home the next morning, the statement said, adding: “His prostate cancer was detected early, and his prognosis is excellent.”

But on Jan. 1, Austin was admitted to Walter Reed with complications from the Dec. 22 procedure, including nausea with severe abdominal, hip, and leg pain. Initial evaluation revealed a urinary tract infection, the statement said.

The following day, Austin was transferred to the ICU where he was found to have abdominal fluid collections that impaired the function of his small intestines, according to the statement.

“This resulted in the back up of his intestinal contents which was treated by placing a tube through his nose to drain his stomach. The abdominal fluid collections were drained by non-surgical drain placement,” the statement said. “He has progressed steadily throughout his stay. His infection has cleared. He continues to make progress and we anticipate a full recovery although this can be a slow process. During this stay, Secretary Austin never lost consciousness and never underwent general anesthesia.”

Austin remains in hospital, though he has returned to his full duties.

Secrecy surrounding the hospitalization

Kathleen Hicks, the deputy secretary of defense, assumed the top role on Tuesday, Jan. 2, a not unusual transfer of power that sometimes occurs purely for operational reasons. She did not learn of Austin’s hospitalization until that Thursday, said the official, who was not authorized to speak publicly. Hicks was on vacation in Puerto Rico at the time.

When Hicks learned of Austin’s hospitalization, she “immediately engaged staff on the drafting of a public statement and congressional outreach. She also began to make contingency plans to return to Washington, D.C., on Friday. However, she was informed that afternoon that the secretary was preparing to resume full communications capability and the associated operational responsibilities on Friday,” the official said.

Pentagon officials did not make a public announcement about Austin’s hospitalization until last Friday. The secrecy is in contrast to the usual practice among the president and Cabinet members, who will generally provide notice of when they are stepping away from their official duties.

Austin said in a statement released Saturday evening: “I am very glad to be on the mend and look forward to returning to the Pentagon soon. I also understand the media concerns about transparency and I recognize I could have done a better job ensuring the public was appropriately informed. I commit to doing better. But this is important to say: this was my medical procedure, and I take full responsibility for my decisions about disclosure.”

White House press secretary Karine Jean-Pierre said Monday that President Biden continues to have “complete confidence” in Austin’s leadership despite some Republican calls for him to resign over the lack of communication.

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