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Nine days after surgery for thyroid cancer, ailing Chief Justice William Rehnquist was not on the bench when the Supreme Court convened Monday, one of several signs that his illness is more serious than first indicated. “According to my doctors, my plan to return to the office today was too optimistic,” Rehnquist said in a statement released by the Court shortly before the Court’s regular argument session began. Rehnquist’s statement Monday also offered the first details about his course of treatment. “I am continuing to take radiation and chemotherapy treatments on an outpatient basis,” said Rehnquist, 80. When the Court first announced on Oct. 25 that Rehnquist underwent a tracheotomy at Bethesda Naval Hospital Oct. 23 in connection with his thyroid cancer, outside experts tempered any gloomy analyses of the disease because the Court went on to say Rehnquist “is expected” back on the bench Nov. 1. But Rehnquist’s absence Monday, along with the description of his treatment, underscores the severity of his disease and his difficult road ahead. The combination of chemotherapy and radiation, according to University of Chicago oncologist Dr. Ezra Cohen, suggests that Rehnquist has the “anaplastic” type of thyroid cancer, “which is notoriously aggressive and difficult to cure. That’s the bad news.” But Cohen, who emphasized he was talking about typical cases, added that this course of treatment also indicates that while the cancer may have spread to surrounding lymph nodes, it has probably not metastasized throughout his body, “so it is curable. That’s the good news.” Cohen also said that the treatment, which typically lasts five to seven weeks, has a cumulative toxic effect that may weaken Rehnquist and make it temporarily difficult for him to swallow and talk. During that period, Cohen said, “I doubt he’d be able to work.” According to the American Cancer Society Web site, “Chemotherapy is not very effective against thyroid cancer although it is sometimes used if thyroid cancers no longer respond to the other preferred treatments.” The site indicates that some combinations of drugs and radiation have had limited success. Neither Rehnquist’s communiqu� nor Court officials indicated when he might return to the bench, but his statement that he was “continuing to recuperate at home” seemed to suggest that he will miss at least this week’s oral arguments, which run through Wednesday. “While at home, I am working on Court matters, including opinions for cases already argued,” Rehnquist also stated. “I am, and will continue to be, in close contact with my colleagues, my law clerks, and members of the Supreme Court staff.” In Rehnquist’s absence, Justice John Paul Stevens, the Court’s senior associate justice, presided over the Court session. Stevens remained in his usual position, to the right of Rehnquist’s now empty middle chair. As the session began, Stevens announced that the chief justice “has reserved the right to participate” in cases the Court hears during his absence. The Court has no firm rule about whether justices may vote on a case in which they were not present for oral argument, but the general practice is that they do if they are able, with the aid of transcripts, audiotapes, and written briefs. In theory, that option would afford Rehnquist the opportunity to participate in a presidential election controversy, should one reach the high court. Four years ago, Bush v. Gore ultimately was decided by the Court five weeks after Election Day.

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