WASHINGTON – The revelation that Defense Secretary Lloyd Austin had prostate cancer surgery and was later hospitalized in intensive care due to complications from that operation without President Joe Biden, Cabinet members or even his deputy knowing has put an intense spotlight on what staff knew when and why they did not inform government or military leaders or the public.
Austin has since returned to work, but was hospitalized again Feb. 11 “for symptoms suggesting an emergent bladder issue.” While his doctors have said his prognosis is excellent, Austin's mobility has been noticeably affected, sometimes using a cane or motorized cart to get around the Pentagon.
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Austin finally addressed questions surrounding his hospitalization in a press conference earlier this month where he said he never told anyone on his staff to keep his hospitalization a secret. That has left unanswered questions as to why some members of his staff chose not to inform Biden or the public about it.
Although doctors say he is recovering well, there are many unanswered questions about the lack of disclosure and what impact the diagnosis will have on his ability to do his job, which entails an aggressive travel and public schedule, including a trip to Brussels that is scheduled to depart Feb. 13 to meet with other defense chiefs to discuss military assistance for Ukraine and then meet with NATO defense ministers.
Here's a look at the timeline:
Early December: During regular medical screenings, Austin's lab results identify prostate cancer which requires treatment. He does not disclose that news to staff or the White House.
Dec. 22: Austin undergoes what doctors have now described as a “minimally invasive surgical procedure called a prostatectomy to treat and cure prostate cancer." Austin is under general anesthesia during this procedure at Walter Reed. He does not inform the White House or senior staff that he is undergoing the procedure, but he does temporarily transfer some of his authorities to Deputy Secretary of Defense Kathleen Hicks. Hicks is not told the reason for the transfer, which is not unusual.
Dec. 23: Austin is discharged from Walter Reed.
Dec. 24-31: Austin is working from home. On Dec. 25, in response to militia attacks in Iraq and Syria that injured several U.S. service members, U.S. Central Command strikes multiple facilities used by Kataib Hezbollah and affiliated groups in Iraq.
Jan. 1: By the evening, Austin is in severe pain, but conscious, and is taken by ambulance back to Walter Reed. He is admitted to the intensive care unit. His personal security detail is with him, but no call is made to an operations center or to key staff to alert them of the hospitalization. He is evaluated throughout the evening. Neither his staff nor the White House are informed of the development.
Jan. 2: Austin is visited by a junior aide. Following the guidance of his physicians, he again transfers “certain operational responsibilities that require constant secure communications capabilities” to Hicks, who is on vacation in Puerto Rico. She again is not told why.
Also that day, Austin's senior staff, including chief of staff Kelly Magsamen, his senior military assistant, Lt. Gen. Ron Clark, the assistant defense secretary for public affairs, Chris Meagher, and Pentagon press secretary Maj. Gen. Pat Ryder, say they are informed of Austin's hospitalization. Chairman of the Joint Chiefs of Staff Gen. CQ Brown is also told. None of those officials notifies the White House, National Security Council or Hicks. Austin remains in the intensive care unit.
Jan. 4: The U.S. conducts strikes against a militia target in Baghdad. Hicks is still assuming the authorities Austin transferred to her, but the Pentagon says Austin had pre-approved the strike before his hospitalization. Hicks is finally told Austin is in the hospital, and she and Magsamen begin working on a statement to notify Congress and others. White House national security adviser Jake Sullivan is notified and he notifies Biden.
Also that day, Ryder briefs the media and never mentions Austin's hospitalization.
Jan. 5: The congressional notifications begin that evening, just minutes before the Pentagon issues its first public statement about Austin’s status. The three-sentence statement says only that he was admitted to Walter Reed on Jan. 1 because of complications from a “recent elective medical procedure” and is recovering. It does not state his condition or if he is still in the hospital. The Pentagon Press Association issues an immediate statement underscoring the seriousness of the lapse: “The public has a right to know when U.S. Cabinet members are hospitalized, under anesthesia or when duties are delegated as the result of any medical procedure.”
Jan. 6: Austin issues a statement saying: “I could have done a better job ensuring the public was appropriately informed. I commit to doing better.” He still does not divulge what medical issues he is addressing. And Defense Department officials still will not say publicly when the White House and others were notified. Austin also speaks to Biden, but does not tell the president he has prostate cancer.
Jan 7: Congressional leaders on both sides of the aisle say they will be looking further into the matter. Ryder for the first time reveals publicly that Austin went to Walter Reed for the medical procedure on Dec. 22 and that he was admitted to the ICU on Jan. 1 due to severe pain, but provides no other details about the procedure.
Jan. 8: The White House and Pentagon begin separate reviews of policies on notification when there is a transfer of power and how the public will be informed. Several Republicans call for Austin to resign. National Security Council spokesman John Kirby says Biden still supports Austin, and Ryder says Austin has no plans to resign. Ryder, in his first public briefing to reporters on the matter, provides a more detailed timeline of events and says Austin is still hospitalized but out of the ICU. He does not disclose the ailment. The Pentagon does not know when he will be discharged.
Jan. 9: The Defense Department releases a statement from Austin's doctors revealing he was diagnosed with prostate cancer and that the procedure on Dec. 22 was prostate surgery. The doctors' statement says Austin was taken back to Walter Reed on Jan. 1 after he developed a urinary tract infection related to that surgery and was admitted to the ICU. They say he is expected to fully recover.
Also on Jan. 9, the White House says Biden had not been informed until that day that his defense chief had cancer.
Jan. 11: The Pentagon inspector general announces it will review the "roles, processes, procedures, responsibilities, and actions” surrounding Austin's hospitalization to ensure they are sufficient to ensure timely and appropriate notifications and transition of authorities if needed.
Jan. 12: Biden says he still has confidence in Austin.
Jan. 15: Austin is released from the hospital. He works from home as he recovers, including undergoing physical therapy.
Jan. 26: Austin’s doctors at Walter Reed say his prostate cancer prognosis is excellent and no further treatments will be needed after seeing him for a follow-up appointment.
Jan. 29: Austin r eturns to work at the Pentagon.
Feb. 1: In a Pentagon press conference, Austin says the cancer diagnosis was a shock to him, and that he should have handled the situation differently. He says he never instructed anyone on his staff not to tell the president.
Feb. 8: The Pentagon finishes its internal review of Austin's hospitalization and failure to inform the President of others, but no other details are provided.
Feb. 11: Austin is taken back to Walter Reed for an “emergent bladder issue.” After a series of tests and evaluations, Austin is admitted into the intensive care unit “for supportive care and close monitoring" and he again transfers his authorities to Hicks. The Pentagon announces the hospitalization within hours.
Feb. 12: Austin cancels a trip to address the Ukraine Defense Contact Group in Brussels and undergoes another procedure under general anesthesia to address the bladder issue. His doctors issue a statement saying his hospitalization is not expected to be long and that his cancer prognosis remains “excellent.”