Public Spotlight: Lloyd Austin

Dragon Tamer and American Hero: Lloyd Austin

Most of Secretary of Defense Lloyd Austin’s heroic deeds have been of the archetypal American masculine mold. Things like valor in combat, being part of elite soldiering units like the Army Rangers, and distinguishing himself as an extraordinary political leader. Recently, his heroism has taken the form of public vulnerability in the face of battling and taming the dragon of prostate cancer.

On February 1, 2024, Secretary Austin delivered a formal statement about his prostate cancer diagnosis, the complications of his treatment, and his decision to keep his cancer battle private. This decision of privacy resulted in tremendous scrutiny and political critique, and Austin, a self-described private man, used the moment of political turmoil to acknowledge that he, as cabinet level official and leader, needed to set an example for destigmatizing prostate cancer for all men, and especially for Black men.

Austin, after routine screenings, received lab results in early December 2023, that indicated he had prostate cancer. On December 22, he had a prostatectomy, which is a minimally invasive procedure to treat and cure prostate cancer. During the procedure, functional duties of the Secretary of Defense were transferred to the Deputy Secretary of Defense Kathleen Hicks.

Many people were highly critical of how Austin communicated the information surrounding his diagnosis and recovery. During a February 1, 2024, Pentagon press conference, the overall feeling was one of discomfort as multiple reporters quickly rattled off recovery well-wishes before launching into probing questions about the very recent cancer diagnosis. These same reporters then did a hard pivot to a question or two about geo-political conflicts.

The optics of the situation were striking – a seventy-year-old, four star general, a West Point graduate, an Army Ranger, a pioneer of African American military leadership, and a cancer survivor who was still showing visible signs of pain from complications of his recent treatment – standing before a room of reporters apologizing for keeping a personal medical issue private. “The news shook me,” he said. “My first instinct was to keep it private … I never like burdening others with my problems.”

Arguably this is a prerogative anyone has when it comes to their personal health. In fact, health related issues are so universally considered to be of a private nature that medical professionals take an oath to keep their patient’s confidentiality. Yet, many would argue that the American public has the right to know the health of its leaders. Austin suggested, as Secretary of Defense, that he forfeited some of the privacy that nearly all Americans expect. He expressed that he did have an obligation to his boss, the President of the United States, to inform him of his diagnosis.

The question that should have been asked in that press conference was why would a leader and decision maker of Secretary Austin’s caliber and experience, a decorated general who has made countless life or death decisions, feel as if a cancer diagnosis would needlessly “burden” others? He was peppered with questions about the political and legal ramifications of his choice, but no one asked if he would have done anything differently as a human confronting a cancer diagnosis. Luckily, Secretary Austin stepped up and provided an answer to that question. He expressed that he “missed an opportunity to send a message on an important public health issue,” and that he wanted to “fix that right now.”

He further explained: “I’m here with a clear message to men, especially older men … I was diagnosed with a highly treatable form of cancer. 1 in 8 men will get prostate cancer. 1 in 6 Black men will get it. Get screened, get your regular checkups, prostate cancer has a glass jar, if your doctor can spot it, they can treat it and beat it.”

In this brief, but powerful statement, Austin took what some labeled as a mistake and turned it into an illustration of strong and vulnerable masculinity. Lloyd Austin is a warrior, a survivor taming the dragon of cancer, and a man setting the right example for millions of American men, especially Black men, who often feel a stigma around chronic illness.

Unfortunately, in American society, men are often lauded for “suffering in silence” or carrying their own burdens. Hiding any form of vulnerability (physical or emotional) is considered by many to be the “proper” masculine method of dealing with a problem. This is problematic on countless levels, but one of the most striking and harmful impacts is the reluctance of American men to participate in standard preventative medical care. This illogical and antiquated concept of masculinity is directly costing people their lives. Lloyd Austin is what so many consider to be the prototypical “American man’s man.” Even at the age of seventy you get the feeling that he could parachute into a valley and run up a mountain faster than most of us can drive to the grocery store. And he could stand up in front of a room of relative strangers, in front of the entire country while political opponents were calling for his resignation, and discuss his cancer, his treatment, and the need for more men to get screened.

Finally, the impact of implicit bias in healthcare is starting to be addressed and attention is being brought to the medical plight faced by Black men in America. Austin’s courageous statements shed light that, according to the National Institute of Health (NIH), there were “an estimated 268,490 projected [PCa] cases in the United States in 2022” and that “Black men are disproportionately affected by PCa; they have the highest PCa incidence in the United States” (Lillard JW Jr, Moses KA, Mahal BA, George DJ).

His example gave a strong, masculine, and human element to The American Cancer Society’s recommendation that “Black men begin discussing prostate‐specific antigen (PSA) testing with their physician at age 45 years to increase the chances of an early diagnosis” (Lillard JW Jr, Moses KA, Mahal BA, George DJ).

The NIH has determined that “factors accounting for low enrollment of Black men include an overall mistrust in the healthcare system and clinical research, a lack of awareness and access to prospective clinical trials, lack of representative diversity in clinical trial research teams, lack of education or bias of health care providers to recommend definitive therapies or access to clinical research, and reluctance to receive medical care.” NIH research has also found that “decisions on PCa and screening among Black men were heavily dependent on information from community members, family, and interpersonal sources, such as barbers and pastors” (Lillard JW Jr, Moses KA, Mahal BA, George DJ).

Who better than Lloyd Austin to be that trusted community leader to encourage men to get screened? Once again, Austin is saving lives and serving his country.

For battling prostate cancer, for battling the uncommon complications of his procedure, for having the human desire to keep medical issues private, for standing up in front of the country and acknowledging that he did have cancer, and for being an example to other strong men, Secretary Austin is a hero. He showed that a warrior, a leader, an accomplished and driven man can get cancer, can get an uncomfortable test, can be floored by a cancer diagnosis, and step up for the treatment needed to live, to serve, and to be with his family. He is a hero because men will see his actions, and instead of considering getting screened as a sign of weakness they will see it as a sign of strength, responsibility, and masculinity.

Sources
Austin, Lloyd. Pentagon Press Conference. February 1, 2024

Copp, Tara and Baldor, Lolita. The Associated Press. “A timeline of Defense Secretary Lloyd Austin’s prostate cancer diagnosis and treatment.” February 12, 2024.

Lillard JW Jr, Moses KA, Mahal BA, George DJ. “Racial disparities in Black men with prostate cancer: A literature review.” Cancer. 2022 Nov 1;128(21):3787-3795. doi: 10.1002/cncr.34433. Epub 2022 Sep 6. PMID: 36066378; PMCID: PMC9826514.