Behind Gen. Austin’s controversially quiet ICU stay

A public firestorm continues to swirl around the failure of Defense Secretary Lloyd Austin to inform President Biden or Congressional leaders upon accepting admission into an intensive care unit.

But at least word is out on the elective procedure that started the secretive medical episode in the first place: minimally invasive surgery for prostate cancer.

Austin’s physicians in the episode of care, trauma surgeon John Maddox and urologic oncologist Gregory Chestnut, told the press Jan. 9 that Austin underwent prostatectomy Dec. 22.

The site of care was Walter Reed National Military Medical Center, at which Chestnut is director of prostate disease research. Clinicians there had discovered the cancer in early December during a routine screening.

Because the surgery involved general anesthesia, 70-year-old Austin stayed overnight before being sent home the next day.

All seemed well until Jan. 1, a week and a day post-discharge, when the hospital readmitted Austin with nausea and severe pain from the abdomen down, according to multiple accounts.

When he turned up positive for a urinary tract infection, his doctors transferred him to the ICU.

It’s not clear whether Austin directed the care team to maintain silence about the cancer diagnosis, the rehospitalization and/or the ICU transfer.

In any case, “further evaluation revealed abdominal fluid collections impairing the function of his small intestines,” Maddox and Chestnut reported in remarks released by the Pentagon.

Austin’s physicians drained the fluids from his stomach non-surgically. His UTI cleared and the team noted the early detection of the cancer, stating his prognosis for full recovery is “excellent.”

That said, Austin remains an inpatient at Walter Reed.

In a press briefing broadcast online and on cable TV Jan. 9, Pentagon press secretary Maj. Gen. Pat Ryder said Austin “continues to recover well and is in good spirits.”

Ryder advised attendees and viewers to watch for daily updates on Austin’s condition from the DoD.

As for the fallout over the communications failure, the fray has so far followed partisan lines.

Republican Rep. Elise Stefanik of New York has called for Austin’s firing or resignation. “This concerning lack of transparency exemplifies a shocking lack of judgment and a significant national security threat,” she said in a statement.

Democratic Sen. Dick Durbin of Illinois said Austin “has all but confessed that he didn’t follow the procedure and accepted responsibility—but we need to know more.”

And Gen. Ryder, the Pentagon spokesman, said Austin has no plans to resign. “He remains focused on conducting his duties as Secretary of Defense in defense of our nation,” Ryder said, adding that Austin tends to be intensely private about what he sees as personal matters.  

At the same time, Ryder said, Pentagon lawyers are looking into the possibility that Austin faces legal exposure for failing to inform the country’s top civilian leaders about his period of incapacitation.

The story continues to develop in the consumer press.