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In "View From the East Wing" (to be published Tuesday by Gallery Books), former first lady Jill Biden writes of her four years in the White House, her husband's debate performance, her advocacy, and the challenges facing the Biden presidency, from the COVID pandemic and the January 6 insurrection to the president's health.  

Read an excerpt below, and don't miss Rita Braver's interview with Jill Biden on "CBS Sunday Morning" May 31!

"View From the East Wing" by Jill Biden

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In the year before we left the White House, Joe began waking up repeatedly at night. This symptom, I knew, was common in men his age, and almost always caused by something benign. Joe never missed his annual physical—at his February 28, 2024, exam at Walter Reed Medical Center, his doctor proclaimed him "a healthy, active, robust 81-year-old male, who remains fit to successfully execute the duties of the Presidency"—and he had access to the best medical care available. Right there in the residence, there's a fully staffed twenty-four-hour doctor's office. You stop in because you have a headache, because your throat is sore, because you need your flu shot or COVID booster.

Knowing that Joe would prefer to speak about any urological issues with his male doctors rather than with his wife, I alerted one of them to make sure they knew. "He was up seven times last night," I said. "I'm worried about him."

Now that the doctors had been made aware of the issue, I trusted that Joe would be examined and treated. But as far as I could tell, the issue persisted. Even knowing this, I never imagined that the cause of this very common symptom of age would turn out to be cancer.

While it surely sounds old-fashioned that I spoke about the issue to the doctors rather than to Joe directly, it's always been the nature of our relationship that we've maintained a veil of discretion around personal health. When I went through menopause, I never spoke about it with him, even though I experienced two years of horrible insomnia, and when I did manage to fall asleep I was jolted awake by night sweats.

Back in Wilmington, I realized that Joe's symptoms had gotten worse, and I encouraged him to make an appointment with a urologist.

Joe went up to Thomas Jefferson University Hospital in Philadelphia for the appointment. At the very first examination, the doctor said, "There's something here. We need to find out what it is." He sent Joe for a biopsy May 15.

We got a call later that same day. The urologist told us that Joe had cancer, and he ordered various other tests to find out if the cancer had spread.

One of the questions we've been asked is why Joe hadn't had a recent prostate exam. That was a question I had, too. I've since learned that the American Urological Association doesn't recommend routine prostate-specific antigen (PSA) screening for men older than seventy. The thinking is that prostate cancer usually spreads more slowly in older men. Cancer at that age doesn't tend to affect life expectancy, which for men in the US is about seventy-six. Sometimes the risk of performing a biopsy in an older man can outweigh the benefits.

Due to a high PSA, Joe's cancer appeared to be advanced. We still had hope, though, that the cancer was localized to his prostate. Joe went for a PET scan, also at Jefferson Hospital, on May 16. We waited for the scan results in an exam room that was the size of a closet. It had a curtain, not a door. Joe was in the exam chair, and I was sitting on a chair they'd brought in for me.

The results didn't take long, about half an hour. The doctor opened the curtain. As soon as I saw her face, I knew.

"I'm sorry," she said. "Oh, I'm so sorry." She wouldn't stop saying "I'm sorry."

Stage IV. It had spread to his bones.

Prostate cancer is very common—one in eight men receive the diagnosis in their lifetime, and it is highly treatable when found early. So many men have notably had it and treated it successfully—John Kerry, Robert De Niro, Ben Stiller, Colin Powell, Warren Buffett ... Yet, in all the cases I knew about, they'd caught it earlier; it hadn't spread to their bones.

I walked out of that closet of a room, past the Secret Service.

Breathe, I kept repeating to myself as I headed to the ladies' room to compose myself before I faced anyone.

Then the questions began—starting with what course of treatment would be best. We had to act fast. We needed a plan. Joe could do radiation and hormone therapy. Thanks to that regimen, he would have every hope of many more years left. His doctors said that it was unlikely the cancer would kill him; he would likely live out his natural life.

Breathe.

The press statement went out May 18. Joe's staff, the younger staffers in particular, were devastated. But we couldn't dwell in the grief because we were put immediately on the defensive, accused of having hidden his illness. The question became: How was it possible that the president of the United States, the most powerful man in the world, a man who has a medical team—not just a doctor, a medical team—around him twenty-four hours a day could wind up with cancer so advanced? Joe couldn't stub his toe without ten people wanting to run at him waving bales of gauze. You put the president in bubble wrap, and he ends up with stage IV prostate cancer? It made no sense.

Truly, I did not know what to say to people who were baffled like that doctor on the beach. I felt the same way. I was stunned. And yet, I didn't want to waste too much energy looking back and asking how this could have happened. We had no time to lose. He had to get started on treatment. Joe went in for a bone density test on May 21, and the next day he began hormone therapy. The hormone pills can cause serious side effects, particularly fatigue and moodiness. That has been true for Joe.

As anyone who's ever loved someone through a major illness knows—and I went through it with both my parents, and both Joe's parents, and, most excruciatingly, with Beau—you live in a world of questions: What time is the physical therapist coming? Did he take his medicine? What did he have for breakfast? How much water is he drinking? He didn't sleep well last night—do I need to call the doctor?

Worry becomes your constant companion     

Excerpted from "View From the East Wing" by Jill Biden. Copyright © by Jill Biden. Reprinted by permission of Gallery Books, a division of Simon & Schuster, LLC. 

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"View From the East Wing" by Jill Biden

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For more info:

• "View from the East Wing: A Memoir" by Jill Biden (Gallery Books), in Hardcover, eBook and Audio formats, available June 2