The White House was caught off guard once again Tuesday 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.

White House spokesperson John Kirby said Biden 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.

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.”

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 New York Times News Service