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WASHINGTON—For four days in January, most of Washington, including President Biden, didn’t know who was running the Pentagon.
Defense Secretary Lloyd Austin was secretly rushed to Walter Reed Military Medical Center on New Year’s Day, suffering from nausea and severe pain. It would be eight days before
the president learned why.
So began a series of events without modern precedent. Austin—sixth in the line of presidential succession and second in the line of military command after the president—was hospitalized and his deputy required to step in from a beach in Puerto Rico where she was on vacation,
days before Biden was informed.
Only a small cadre of aides was aware that Austin was hospitalized. Most others in the Pentagon, including Deputy Defense Secretary Kathleen Hicks, who was carrying out his duties, were kept in the dark, according to the Pentagon’s current version of events. Sasha Baker, the Defense Department’s top policy official and the most senior official present at the Pentagon during that time, attended a meeting at the White House on Jan. 3, unaware that Austin was hospitalized.
The improbable episode involving one of Biden’s most loyal and
low-profile cabinet members reflects the culture of secrecy that has been a hallmark of Austin’s tenure since he arrived at the Pentagon in January 2021. It also raises questions about how that secrecy may have inadvertently subverted the careful plans government agencies make for ensuring continuity of operations when a leader is incapacitated or unavailable to make decisions.
On Thursday, the Pentagon’s inspector general—its internal watchdog—said it was launching a review of the “roles, processes, procedures, responsibilities, and actions” related to Austin’s hospitalization.
Defense Secretary Lloyd Austin Has Prostate Cancer, Pentagon Says
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Defense Secretary Lloyd Austin Has Prostate Cancer, Pentagon SaysPlay video: Defense Secretary Lloyd Austin Has Prostate Cancer, Pentagon Says
Defense Secretary Lloyd Austin is being treated for complications due to prostate cancer, according to the Pentagon. The condition wasn’t disclosed to President Biden until days after Austin was rushed to the hospital, officials said. Photo: Violeta Santos Moura/Reuters
While Austin was in the hospital—and White House and senior officials at the Pentagon were unaware who was in charge—the U.S. carried out
a deadly drone strike against an Iranian-backed militia leader in Baghdad, and
issued an ultimatum to Yemen’s Houthi rebel group to cease
its attacks on international shipping in the Red Sea or face the consequences.
When news of Austin’s hospitalization eventually got out, the public backlash was swift. Lawmakers, including some Democrats, expressed outrage at the unprecedented lack of information. White House and Pentagon officials privately fumed at the absurdity of the lack of transparency surrounding Austin’s condition.
Many questions remain about the series of events related to Austin’s stay in the hospital, including who was in charge, when, and why there wasn’t better disclosure.
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When the president was finally informed about details of the defense secretary’s medical condition, it had been more than a week since Austin, 70, had been hospitalized for complications from an earlier surgery to treat prostate cancer, and more than three weeks since his first hospital stay just before Christmas.
Austin first entered Walter Reed Military Medical Center on Dec. 22, for a prostatectomy, which required he go under general anesthesia. Many of his top aides had no idea he was receiving a medical procedure that would require him to stay overnight, defense officials said, but there was a transfer of power to Hicks to run the Pentagon during the surgery.
On the evening of Monday, Jan. 1, Austin experienced severe abdominal pain and was rushed via ambulance to Walter Reed, where he was put in the intensive care unit, the Pentagon said. Once there, doctors identified a urinary tract infection and abdominal fluid collections in Austin, and he remained in the ICU for several days.
On the day Austin returned to the hospital, Kelly Magsamen, his chief of staff, was sick with the flu, and her deputy was out, U.S. officials said, a factor that contributed to the delayed communications.
The following day, Jan. 2, Hicks, who was on a beach in Puerto Rico with her family, was informed by the Pentagon that she needed to assume some of Austin’s duties. The request was a surprise since Hicks had planned her vacation well in advance and normally, if she was to assume the defense chief’s duties, she should be in Washington to perform them.
She wasn’t told why she would have to step in, and, according to what military officials have said in a shifting narrative of the last few weeks, didn’t ask why.
Deputy Defense Secretary Kathleen Hicks was on vacation when she was informed that she needed to assume some of Lloyd Austin’s duties. PHOTO: ALEX BRANDON/ASSOCIATED PRESS
The communications team which routinely travels with her, even while on leave, prepared for an elevated role while at the hotel, which required her to stick close to her communications suite, forgoing walks on the beach. She began to make some routine operational and management decisions in Austin’s stead, and was “fully authorized and ready to support the president on other military matters, should the need have arisen,” a Pentagon official said.
That same day, news of Austin’s hospitalization went to a few officials, including Air Force Gen. CQ Brown, Jr., the chairman of the Joint Chiefs of Staff, but no details were shared about why he was there or his condition, according to Pentagon officials.
For two more days, information about Austin’s condition was kept to the small group of aides.
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In the meantime, the U.S. conducted a strike in Baghdad targeting a leader of an Iranian-backed Iraqi militia, which Austin had approved earlier. Air Force Maj. Gen. Pat Ryder briefed reporters on Thursday, Jan. 4, and made no mention of the secretary’s whereabouts.
Hicks continued carrying out some duties while she stayed in Puerto Rico, and the White House remained in the dark for most of the day.
Also Thursday, Magsamen told national security adviser Jake Sullivan, who shared the information that got to Biden. She also told the military service secretaries and their top assistants that Austin had a medical issue. Hicks and Magsamen began to craft a public statement, though Hicks apparently didn’t know that Austin was battling complications from his surgery, the Pentagon said.
At 5:03 p.m. Friday, at the end of the week when government agencies typically drop bad news, the Pentagon announced that Austin had been hospitalized for an “elective medical procedure,” but provided no details. The statement said Austin had resumed full responsibilities, though no announcement had been made earlier that Hicks had taken on some of his duties.
The congressional oversight committees learned about the hospitalization just minutes before the Pentagon released its statement At that point, Austin had been at Walter Reed for nearly five days as part of his second hospital stay.
Walter Reed National Military Medical Center in Bethesda, Md. PHOTO: SAMUEL CORUM/GETTY IMAGES
The following day, Austin released a second statement and committed to “doing better” when it came to transparency. Yet in a conversation Biden had with his defense chief on Saturday, the sixth day of his hospital stay, Austin didn’t share the nature of his medical situation, and apparently the president didn’t ask.
John Kirby, a spokesman for the National Security Council said on Wednesday that White House officials attempted to get the Pentagon to provide answers.
“I would just tell you that that effort to try to get more information was overt,” Kirby told reporters.
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Top Pentagon officials also didn’t know, even as some were pressing for more answers.
“This is important to say: this was my medical procedure, and I take full responsibility for my decisions about disclosure,” Austin said Saturday.
On Sunday, Ryder released a statement that Austin had spoken to Hicks and top military commanders and that the defense chief was recovering, but still provided no details about the reasons for Austin’s surgery, or his second stay at the hospital.
Kelly Magsamen is the defense secretary’s chief of staff. PHOTO: CHAD J. MCNEELEY/U.S. DEPARTMENT OF DEFENSE
On Monday, the Pentagon promised internal reviews and Magsamen issued a memo on how the notification system should work going forward, about the same time White House officials issued a reminder of how notifications for all departments should proceed. But Austin’s ailment remained a mystery a full week after he was admitted to Walter Reed. The Pentagon repeatedly said there were “no excuses” for the confusion all while offering several, including Austin’s penchant for privacy, Magsamen’s illness and internal misunderstandings.
Minutes before a scheduled 2:30 p.m. Tuesday briefing, the Pentagon issued a 395-word statement explaining Austin’s diagnosis of prostate cancer, the surgery to treat the cancer, and the complication that led him to return to the hospital. As Ryder briefed at the Pentagon, Kirby told White House reporters that Biden learned about the cancer diagnosis earlier Tuesday—and not from Austin directly.
On Wednesday, Austin marked his 10th day of his postsurgery return to the hospital. He remains in charge of the Pentagon.
Write to Gordon Lubold at
gordon.lubold@wsj.com and Nancy A. Youssef at
nancy.youssef@wsj.com
www.wsj.com
