Defense Secretary Lloyd Austin is expected to resume his duties on Tuesday after being hospitalized over the weekend for the third time in as many months, doctors at Walter Reed National Military Center said. Austin, 70, has temporarily transferred the duties and functions of his office to Deputy Defense Secretary Kathleen Hicks, though his absences over the past few months have drawn scrutiny to the defense secretary’s role in advising the president on the use of nuclear weapons.
Counter to some public perception, Austin — like all secretaries of defense — has no direct role in ordering the use (or canceling an order to use) any part of the nation’s nuclear arsenal. Only President Joe Biden can authorize a nuclear strike.
“We remain confident in the nuclear command and control system, which is designed to operate under any circumstances to maintain Presidential control of nuclear weapons,” a defense official told Task & Purpose on Monday. “The President is the sole authority for employment of U.S. nuclear weapons. The Secretary of Defense, in conjunction with the Chairman of the Joint Chiefs of Staff, are the President’s primary military advisors. While he was in the hospital, either Secretary Austin, or the Deputy Secretary, were always fully prepared to support the President as Commander-in-Chief. At no time during the Secretary’s hospitalization was there ever a gap in authorities, and there was never a risk to command and control.”
While Biden has the sole authority to authorize the use of nuclear weapons as commander in chief, he also seeks counsel from his civilian and military advisors, including the defense secretary, chairman of the Joint Chiefs of Staff, and commander of U.S. Strategic Command, a National Security Council spokesperson told Task & Purpose on Monday.
“In this situation, Deputy Secretary of Defense Dr. Kathleen Hicks is performing the duties of Secretary of Defense and able to provide advice to the President,” the spokesperson said.
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The president would likely want to consult with both his defense secretary and chairman of the Joint Chiefs of Staff if intelligence indicated that a nuclear attack on the United States was imminent, said Chuck Hagel, who served as defense secretary from February 2013 to February 2015.
The Pentagon has a clear chain of command so someone can backfill the defense secretary if needed, Hagel told Task & Purpose.
“You’re never left uncovered,” Hagel said. “Just because the secretary is out of the loop, that doesn’t mean the Pentagon is out of the loop. No, you go to the next person.”
Should U.S. military intelligence sensors detect that the United States has come under a nuclear attack, the president would rely on the defense secretary and chairman of the Joint Chiefs of Staff about what options were available to respond, Hagel said.
“Those two individuals know more about the realities of what’s going on than the president does, simply because that’s their job,” Hagel said.
The president would also depend on the Defense Department to confirm the accuracy of any information indicating that the United States was under a nuclear attack, he said.
“A president – if he’s obviously thinking right, and he’s not mentally impaired – would certainly never contemplate using nuclear weapons without talking to the secretary of defense, or without talking to the chairman of the Joint Chiefs of Staff,” Hagel said. “That would make no sense. That would be crazy.”
Still, the defense secretary is not in the chain of command when it comes to actually ordering a nuclear strike, said Hans M. Kristensen, director of the Nuclear Information Project for the Federation of American Scientists.
A launch order goes directly from the president – who would use the “football” device carried by a nearby aide – to the Pentagon’s National Military Command Center, which would authenticate the order and distribute it to launch units, Kristensen told Task & Purpose.
That system was designed during the Cold War so that an enemy could not prevent a U.S. nuclear response by disrupting the nuclear chain of command through a massive first strike, Kristensen said.
But the world has changed considerably since the Cold War, he said.
“In the real world, most nuclear scenarios would most likely involve at first some limited nuclear use, and sort of gradual increase of intensity,” Kristensen said. “It’s very unlikely that you would see sort of a large-scale nuclear first strike coming out of the blue.”
Instead, it is more plausible that events would escalate to the point at which a U.S. military commander would request authorization from the president to use nuclear weapons, he said.
In that scenario, the president could choose to have a briefing with his defense secretary, chairman of the Joint Chiefs of Staff, and commander of U.S. Strategic Command before deciding on the matter, Kristensen said.
“But this is something the president can choose to do,” Kristensen said. “He’s not required by law to follow that procedure.”
Austin is currently in critical care at Walter Reed, where he is being treated for an “emergent bladder issue,” according to the Defense Department. This is the latest hospital stay for Austin, who was treated at Walter Reed for prostate cancer in December.
On Monday, Austin underwent a non-surgical procedure under general anesthesia for his bladder issues, Dr. John Maddox and Dr. Gregory Chesnut said in a statement. The two doctors anticipate that Austin will make a full recovery, and he will be closely monitored overnight.
“A prolonged hospital stay is not anticipated,” the doctors said. “We anticipate the Secretary will be able to resume his normal duties tomorrow. The current bladder issue is not expected to change his anticipated full recovery. His cancer prognosis remains excellent.”
Austin, who is sixth in the presidential order of succession, is listed in good condition and “continues to be eager to perform his duties,” Air Force Maj. Gen. Pat Ryder, a Pentagon spokesman, told reporters on Monday.
“We’ll keep you updated on whether that includes from the hospital or if that is from home,” Ryder said at a Pentagon news briefing.
Ryder was unable to say definitively on Monday whether Austin’s bladder issue was a complication from his prostate surgery or a completely new medical challenge.
Austin was taken to the hospital by his security detail at about 2:20 p.m. on Sunday, Ryder said. The White House was notified on Sunday of Austin’s health issue before he left for the hospital.
At roughly 4:55 p.m. Austin transferred the functions and duties of his office to Hicks, who is acting as defense secretary while Austin recuperates, Ryder said.
Austin has been hospitalized three times since Dec. 22, when he was treated for prostate cancer. He underwent a surgical procedure known as a “prostatectomy,” which was uneventful.
But on Jan. 1, Austin was admitted to Walter Reed due to complications from the surgery, and he was transferred to the intensive care unit after being diagnosed with a urinary tract infection. He transferred certain authorities to Hicks the following day.
For reasons that are still unclear, neither Hicks nor the White House were immediately notified that Austin had been hospitalized until Jan. 4. Congress, the military service secretaries, Joint Chiefs of Staff, and the public were all made aware of the situation on Jan. 5.
Austin was released from Walter Reed on Jan. 15 and worked from home until Jan. 29, when he retired to the Pentagon.
At a Feb. 1 Pentagon news conference, Austin said that he did not handle his health situation the prior month properly, and that he should have informed President Joe Biden in December that he had been diagnosed with cancer.
Austin also said that it was a “gut punch” when he first learned he had prostate cancer, and his initial instinct was to keep the issue private to not burden others with his problems.
“But I’ve learned from this experience. Taking this kind of job means losing some of the privacy that most of us expect,” Austin told reporters “The American people have a right to know if their leaders are facing health challenges that might affect their ability to perform their duties, even temporarily. So, a wider circle should have been notified, especially the President.”
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