Making his first official public appearance since his thyroid cancer was diagnosed three months ago, Chief Justice William H. Rehnquist stood and, speaking in a damaged but clear voice, administered the presidential oath of office for the fifth and probably final time yesterday.
Rehnquist, 80, wearing a black cap, smiled and leaned on a cane as he walked slowly down a short flight of stairs to reach the platform where President Bush, Vice President Cheney and other dignitaries were waiting.
The time was 11:42, making Rehnquist the last important participant to arrive; he was also the first to leave, departing shortly after Bush took the oath at 11:56 but before Bush began his address.
These accommodations to his weakened condition did not diminish the impression of a proud man struggling, successfully, to fulfill a cherished duty on a grand stage.
At the Inauguration Day luncheon following the ceremony, Bush said, "I want you to know how touched I was that [the] chief justice came to administer the oath." It was "incredibly moving," he added.
Former senator Alan K. Simpson (R-Wyo.) said he could "tell that he was going to do that, if it took all the energy of his life."
Rehnquist's body clearly bore the signs of the battle he has been waging against cancer, a fight that has included aggressive radiation and chemotherapy treatments. His cheeks were hollow, and a white plastic device was visible at the base of his throat where surgeons performed a tracheotomy on Oct. 23 to help him breathe.
Normally, tracheotomy patients can speak only by covering the tube that lets air into their throats.
But Rehnquist was able to speak without doing that, suggesting that the device he was wearing contained a valve that opens to let air in, then closes automatically so that exhaled air is forced back up past the vocal cords, producing speech.
Such a device made by Passy-Muir Inc. of Irvine, Calif., was worn by the late actor Christopher Reeve and is widely used at the National Naval Medical Center in Bethesda, where Rehnquist received his tracheotomy.
"I can't confirm it for sure, but having a long-standing relationship with the hospital . . . and after hearing him, we're pretty sure it was one of ours," said Melissa Fontes, president of Passy-Muir.
Some spectators said they heard respiration as Rehnquist spoke, but Fontes said that is not characteristic of the device her company makes and may have been caused by cancer-related "anatomical abnormalities" in Rehnquist's throat.
Sen. Orrin G. Hatch (R-Utah) said Rehnquist's "voice was strong." He added: "I was very proud of him."
Rehnquist was accompanied at the ceremony by the eight other members of the Supreme Court, and escorted in and out by his administrative assistant, Sally M. Rider, who has been helping him conduct court business during his illness.
The court has not disclosed the precise nature of the chief justice's ailment. But outside medical experts, in reports that the court has not denied, have said that his symptoms are consistent with anaplastic thyroid cancer, which is usually fatal within a year of diagnosis.
Rehnquist has not been present for oral arguments at the court since Oct. 13, but has said that he will vote in all cases except some that were argued in November, the month in which he began treatment.
He was uncharacteristically absent from the court's annual Christmas party Dec. 17, but has come into the court to work on several occasions since then, court officials say. He was in his chambers on Wednesday, though he did not join the other justices for the two oral arguments that took place that day.