Before Maryland Lt. Gov. Boyd K. Rutherford (R) chaired a Board of Public Works meeting in Gov. Larry Hogan’s absence Tuesday, the two met in the governor’s mansion to discuss hundreds of millions of dollars in contracts that were up for review.

Rutherford had spent the morning at a long budget meeting. Hogan (R), who is preparing to begin chemotherapy for advanced, aggressive non-Hodgkin’s lymphoma, sandwiched the session with Rutherford between medical visits.

It was the beginning of a new normal for Hogan and Rutherford and the first day of a new governing reality in Annapolis, one in which Hogan must balance running the state with the effects of a life-threatening illness and brutal treatment regimen, either of which could render him incapable of governing.

Hogan disclosed his diagnosis Monday in an emotional news conference. He made clear his desire to remain fully engaged in the job he won against the odds but also reluctantly acknowledged that he would not always be able to do so.

Maryland Gov. Larry Hogan (R), with his young granddaughter and Lt. Gov. Boyd K. Rutherford at the Inaugural Gala on Jan. 21. (Jahi Chikwendiu/The Washington Post)

“There’s probably two, three days every month, or every three weeks, where I’m not going to be feeling so well, probably. And we’ll see how that goes,” Hogan said. “But the rest of the time, I’ll be working.”

He said he will rely on Rutherford — a lawyer who is as ­buttoned-down as Hogan is gregarious — to fill in when he is ill or incapacitated, or if his cancer gets worse. When that happens, he will sign a letter directing Rutherford to act as governor as needed. He signed such a letter on June 16 before a procedure that required anesthesia.

Patients with Hogan’s condition generally go through six chemotherapy treatments, one session every three weeks for 18 weeks. Kevin Cullen, director of the University of Maryland’s Marlene and Stewart Greenebaum Cancer Center, said the first treatment is often done as an inpatient procedure, requiring a few days of hospitalization. Hogan said he likely will be in the intensive care unit for four days for the first round of chemotherapy, which he said would begin as soon as possible.

Hogan will likely feel fatigued after each chemotherapy session but should be able to maintain a moderate work schedule that includes meetings and leading discussions, according to Cullen. His travel will likely be limited.

“When we have people getting these kinds of treatments, they’re typically on their phones and laptops and having normal conversations,” Cullen said. “I think he’d be able to do that.”

At the Board of Public Works meeting Tuesday, people wore green “non-Hodgkin’s lymphoma awareness” ribbons to show support for the governor. Rutherford relayed to the audience Hogan’s concerns about wasteful government spending, then slashed a multi-year contract request from the Department of Juvenile Services for nearly $300 million to just a single year worth $60 million.

Maryland Gov. Larry Hogan (R) announced he has "very advanced and very aggressive" non-Hodgkin's lymphoma. Here's what you need to know about this type of cancer, its survival rate and treatment options. (McKenna Ewen and Gillian Brockell/The Washington Post)

“The substitute teacher is back — and with a new lesson plan,” Rutherford said, referring to a time before Hogan’s diagnosis when he had filled in at a meeting.

Rutherford, who like Hogan had never held elected office before being sworn in on Jan. 21, promised to “keep moving forward.”

“His request of us was to continue to do our jobs,” Rutherford said, “which we will.”

Chief operating officer

Traditionally, relationships between governors and lieutenant governors have “almost been a marriage of convenience” — two politicians who form a ticket to complement one another regionally or otherwise, said Paul D. Ellington, who was chief of staff to then-Lt. Gov. Michael Steele (R) in the 2000s. Once they get into office, Ellington said, they typically have their own staffs and operates in “silos.”

But Hogan and Rutherford are different. Hogan said from the start that Rutherford would have a more hands-on role than previous deputies. Rutherford said he would serve, in effect, as Hogan’s chief operating officer, refraining from hiring his own staff and largely focusing on making government more efficient.

Hogan put Rutherford in charge of efforts to address heroin deaths in the state and also named him as a liaison to city officials in Baltimore when riots broke out following the death of Freddie Gray.

“Boyd has been involved in more of the decision-making than Michael Steele was in the beginning,” Ellington said. “Boyd has been at the table from the start.”

Hogan spokesman Doug Mayer said his boss will continue to govern as his treatment begins. For example, Mayer said, he will make a long-awaited decision on the future of the Purple Line light-rail project by the end of this month.

Hogan said state troopers have been bringing him paperwork to tend to while he is at doctor appointments, and he described “getting things done” even when he is not at the State House. But he also conceded that he would not always be able to do so.

“They also tell me it’s gonna beat the hell out of me. They tell me, ‘You’re going to go through hell and back again, but . . . the results are gonna be good,’ ” Hogan said Monday. “I know I won’t just beat this disease but that I’ll be a stronger and better person and governor when I get to the other side of it.”

Earl Adams Jr., chief of staff to then-Lt. Gov. Anthony Brown (D), said Brown temporarily assumed Gov. Martin O’Malley’s duties a couple of times, including once when O’Malley (D) was out of the country.

But “we always knew when the governor was coming back,” Adams said.

‘No victim’

Rutherford, 58, was the secretary of Maryland’s Department of General Services under former Maryland governor Robert L. Ehrlich Jr. (R). He was also an assistant secretary at the U.S. Department of Agriculture under President George W. Bush. Rutherford and his wife live in Columbia, Md., and they have three grown children.

Rutherford grew up in the Michigan Park area of Northeast Washington, the son of a postal worker who drove a cab part time and an office worker at the National Institutes of Health. A political independent as a young adult, Rutherford said he registered as a Democrat while living in the District, essentially so he could vote in the party primaries where city elections are often decided.

He is a fiscal conservative who believes in business development as a way to empowerment, in line with the teachings of Marcus Garvey and the black nationalist movement. In an interview before taking office, he said he became a Republican about 20 years ago because the Democratic Party “didn’t speak for me.”

“The Democratic Party treats black people as victims, and I’m not a victim,” Rutherford said.

Ellington said Rutherford “is very task-oriented and always has been. He’s almost apolitical. He has his core beliefs, but he doesn’t wear them on his sleeve.”

Still, he added, there will be challenges to his new role. “Larry’s going to have his good days and his bad days,” Ellington said. “Boyd will probably be left wondering some days, ‘Is the governor feeling good today or not? Do I do this today or not?’ ”

Josh Hicks and John Wagner contributed to this report.