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  • Writer's pictureThe San Juan Daily Star

Surprised by new details about Austin’s health, White House orders review

Defense Secretary Lloyd J. Austin III during a Senate Armed Services hearing in Washington on March 28, 2023. The defense secretary remains in the hospital but is in “good condition” and conducting official business, the Pentagon spokesman said. (Valerie Plesch/The New York Times)

By Peter Baker

The White House was caught off guard once again earlier this week when it learned that Defense Secretary Lloyd Austin had been diagnosed with prostate cancer a month ago and had surgery to treat the disease under general anesthesia on Dec. 22 without notifying either President Joe Biden or his staff.

The new revelations exacerbated frustration in the West Wing, where officials were still dealing with the discovery that Austin, 70, had been secretly hospitalized last week for complications resulting from a condition that the Pentagon did not disclose even to the White House until Tuesday morning.

While aides to the president said he would not fire Austin, they acknowledged the breakdown in communications and moved to assert new discipline over the administration. Jeffrey Zients, the White House chief of staff, ordered a review of procedures and sent a directive to Cabinet secretaries making clear that they are to inform the White House when they are unable to perform their duties.

“Notify the Offices of Cabinet Affairs and White House Chief of Staff in the event of a delegation of authority or potential delegation,” Zients wrote in the memo, which was obtained by The New York Times. “This notification should occur when agencies anticipate or are preparing for a delegation of authority and again when the delegation occurs.” He added that he wanted any such notification in writing.

White House spokesperson John Kirby said Biden’s “first and foremost concern is the secretary’s health” and that the president still had “full faith and confidence” in Austin and would keep him until the end of his term.

But Kirby acknowledged concerns with the secrecy. “It’s not good,” he told reporters at a briefing. “It’s certainly not good, which is why we want to make sure it doesn’t happen again.”

Republicans remained dissatisfied. “The failure to notify Congress of his inability to perform his duties was a clear violation of the law,” said Sen. Roger Wicker of Mississippi, the ranking Republican on the Senate Armed Services Committee. “It remains unclear who decided to ignore federal law, but there must be accountability. An internal review — ordered by the same chief of staff who played a part in this crisis — is woefully inadequate.”

The president was not told until Thursday that Austin had been taken by ambulance to Walter Reed National Military Medical Center in Bethesda, Maryland, three days earlier, and the Pentagon did not make it public until Friday evening. Even then, the Pentagon said only that he was being treated for complications from “an elective medical procedure.” Austin did not even reveal the specifics of his condition in a telephone call with the president Saturday, according to White House officials.

The White House only learned Tuesday morning that Austin had been diagnosed with prostate cancer, at which point Zients informed Biden. Kirby confirmed that the White House likewise did not know that the Dec. 22 procedure involved surgery under general anesthesia, which normally would trigger the transfer of a defense secretary’s power to his deputy.

A statement released later Tuesday by Austin’s doctors at Walter Reed disclosed that he had been diagnosed in “early December” and did not describe the resulting surgery as “elective.” Austin was brought back to the hospital on Jan. 1 after experiencing nausea with “severe abdominal, hip and leg pain,” according to the doctors, who determined that he had developed a urinary tract infection. He remains hospitalized and the doctors said they “anticipate a full recovery although this can be a slow process.”

The White House memo to the Cabinet reflected the sense of consternation that the nation’s top defense official could be in the intensive care unit for so long without the president or other major national security officials being aware of it. Even Austin’s deputy secretary, who would be called upon to act in a crisis in his absence, was not told at first that he was in the hospital.

While Biden has been described as understanding, people close to the White House recounted a deep frustration and bafflement among some on the president’s team. Austin, a reserved retired general, does not have a particularly intimate relationship with Biden or his team, but he is well liked and deeply respected, making the situation all the more upsetting to them.

For days, White House officials pressed the Pentagon to disclose more about the medical issues and were flabbergasted that it took so long. Austin’s secrecy has unwittingly provided critics with ammunition to accuse Biden of not being in full control of his administration and raised questions about how the 81-year-old president would handle a health crisis of his own.

The Defense Department has initiated a 30-day review of what happened and how its procedures should be changed if necessary. In a memo, Kelly Magsamen, Austin’s chief of staff, on Monday ordered Jennifer Walsh, the department’s administration and management director, “to identify the relevant facts and circumstances during this period and evaluate the processes and procedures through which the deputy secretary of defense was notified that she should carry out the functions and duties of the secretary of defense.”

In his memo Tuesday, Zients told all Cabinet departments to send him their current procedures by Friday so he can evaluate them to determine if they need adjustment. He made clear that power should be transferred “when a cabinet member is traveling to areas with limited or no access to communication, undergoing hospitalization or a medical procedure requiring general anesthesia, or otherwise in a circumstance when he or she may be unreachable.”

Austin participated in a secure conference call on the morning of New Year’s Day with Biden, Secretary of State Antony Blinken, National Security Adviser Jake Sullivan and other officials about operations in the Middle East, according to the White House. At some point later that day, Austin experienced what a spokesman said was “severe pain” and was taken to Walter Reed.

Austin has acknowledged the lack of transparency. “I recognize I could have done a better job ensuring the public was appropriately informed,” he said in a statement on Saturday. “I commit to doing better.”

White House press secretary Karine Jean-Pierre pointed to that as an acceptance of accountability in explaining why the president has remained supportive of his defense chief. “Secretary Austin was very clear,” she said, “and we appreciate that he had taken responsibility for this.”

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