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secret. The name on the biopsy report was Tracy Malone, who was actually a sixty-two-year-old female military nurse. The first lady insisted that the statement the White House put out about it on August 1 contain neither the word cancer nor biopsy. By then, however, the media had figured out that something was up—it was, quite literally, as clear as the nose on the president’s face—and in a news conference on August 5, Ronnie admitted the truth. The whole episode damaged the White House’s credibility, but it also taught a lesson that transparency is a better policy on matters of presidential health. Ronnie told Speakes that he was never again to withhold medical information about him from the public.

A little over two years later, the situation would arise again, only this time it was Nancy who faced a cancer diagnosis. On October 5, 1987, she and White House physician Hutton went to Bethesda for her annual mammogram. Nancy’s stomach tightened when the nurse said they wanted to take a couple of images over again. Afterward, Hutton entered the examination room and asked the nurse to leave. He told Nancy that there were three flecks of calcium in her left breast, which were signs of cancer, though only a biopsy could tell them for sure.

“What do we do next?” she asked.

He and the first lady discussed her options. She wanted a team from the Mayo Clinic to be in charge, supervised by her longtime friend Dr. Oliver Beahrs. He was a former top surgeon at Mayo and had been a student of her father’s at Northwestern University Medical School. When Nancy was still in her teens, Beahrs was a frequent guest at the Davis apartment and performed magic tricks at Edie’s parties. Hutton called Beahrs, who said he would be on the next plane.

The trip back to the White House on the George Washington Parkway felt interminable to Hutton. He and Nancy were silent for much of it. She told the White House physician that he would have to deliver the news to her husband. When they arrived at the south entrance, Nancy straightened her posture and greeted the awaiting staff as though nothing was amiss. She headed for the family quarters to lie down in the bedroom, and Hutton turned toward the Oval Office. “I need to see the president right now,” he told assistant Jim Kuhn, who was sitting at his desk outside.

When Hutton walked in, Ronnie was writing on a yellow pad. Hutton felt so overwhelmed that, for a moment, he couldn’t find his voice. “Sir,” he said finally, “we’ve just returned from the Naval Hospital, as you know, and I’m afraid we’ve made an early discovery that will necessarily require surgical removal and macroscopic examination on Mrs. Reagan’s left breast. We won’t know if it is definitely malignant until the area in question is removed, and if it is positive, we will have various options of treatment, depending on her wishes. The best news is that it is an early discovery, which is very much in her favor.”

Ronnie was dumbstruck. “I’ve seen him taken aback, but he was stunned. He absolutely couldn’t digest this information,” Hutton recalled. “It was totally, totally out of character. It was just more than he could really understand.”

The president finally spoke, slowly and in a frail voice that Hutton had never heard before: “I know you doctors will take care of it.”

Hutton was astonished at the president’s odd and detached reaction, though he would later realize that there was an explanation for it. For the first time, Ronnie was being forced to imagine the unthinkable: a life without Nancy. The doctor left, figuring Ronnie wanted to be alone for a bit. Hutton assumed that, once Ronnie had a few moments to recover from the initial shock, he would summon the doctor back to provide more information and advice. No call came. So, Hutton went to the family quarters to see how Nancy was doing.

He was still there when Ronnie arrived home that day, a little earlier than usual. “Well, how are you?” Ronnie asked his wife matter-of-factly and gave her a hug. “It was as if there was no issue at all. It was the ultimate in denial for these two wonderful people,” Hutton recalled later. The doctor excused himself and departed.

The next morning, the buzzer went off in Hutton’s office. The president wanted to see him. Ronnie told Hutton that he wished the physician had stayed with them that night.

“Why, sir?” Hutton asked.

“Because I needed a good kick in the rear end,” Ronnie said. He admitted he had avoided any conversation with his wife that evening about the diagnosis and upcoming surgery. “We never discussed it. We never discussed it.”

The next morning, Ronnie apologized to Nancy for his insensitivity, but Hutton said the whole episode didn’t seem to bother her. “He’ll come around,” Nancy said. “It will be all right.” The couple carried on with their schedule that day, greeting the crown prince and princess of Japan upon their arrival in Washington and hosting a state dinner for them in the evening.

After conferring with doctors, Nancy decided that if it turned out to be cancer, she wanted to have a mastectomy rather than the less drastic lumpectomy that was becoming more common in cases like hers. Nancy knew that, given her anxious nature, she’d be constantly worrying about a recurrence. She wanted the extra assurance that the malignancy was out, even if it meant losing a breast. A mastectomy would also spare her the radiation therapy that would be required if surgeons preserved her breast.

“Listen, I know a little bit about cancer,” she told Hutton. “What do I need a breast for, number one. Number two, I know about multicentricity. If you have a lump here, you may have a lump there in two or three years. Why not just take all the breast tissue away?”

“Perfectly logical,” Hutton told her. “I think if it were my wife, that’s what I

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