Tuesday's State of the Union address delivered by President Donald Trump was notable for several reasons, and it was of particular consequence for Cape Girardeau native Rush Limbaugh.

During the speech, Trump awarded the Presidential Medal of Freedom, the nation's highest civilian honor, to the conservative commentator.

"Rush Limbaugh, thank you for your decades of tireless devotion to our country," the president said, with a showman's knack for capturing a moment. "And, Rush, in recognition of all that you have done for our nation, the millions of people a day that you speak to and that you inspire, and all of the incredible work that you have done for charity, I am proud to announce tonight that you will be receiving our country's highest civilian honor, the Presidential Medal of Freedom."

The award came a day after Limbaugh announced on his radio show he has "advanced" lung cancer.

Limbaugh returned to his broadcast Friday, during which he spoke about the honor. Limbaugh said the presentation in the House chamber was a surprise. He had known he would be receiving the award but expected an Oval Office ceremony later this month. He noted he wondered about accepting such an honor and recalled a wounded servicemember telling him at a previous event "we all have our role" to play in society and civilians, too, deserve recognition for their efforts.

Rush Limbaugh reacts as first Lady Melania Trump prepares to present him with the the Presidential Medal of Freedom as President Donald Trump delivers his State of the Union address to a joint session of Congress on Capitol Hill in Washington, with second lady Karen Pence, second left, and Kathryn Limbaugh, third left.Alex Brandon ~ Associated Press

"I decided, 'OK, drop this business. The president wants to give it to you. That's all that matters. You've gotta do it,'" he said.

When he arrived in the House chamber Tuesday, a calmness came over him, he said.

"If you can imagine an envelope or like a wave of warmth that just swept over me sitting there," he noted. "You have no idea what this is like. Of all the things you think might happen to you in life, this is not one of them."

Eighth District Rep. Jason Smith congratulated Limbaugh on the award.

"It is the highest civilian honor for one of our nation's greatest voices. For more than three decades, Rush has used his radio show to defend individual liberty and champion the Constitution, not only earning him millions of devoted listeners but becoming perhaps the most famous conservative voice in America," he said in an emailed statement. "I had the honor of speaking with Rush ahead of the President's speech and it was a great conversation. I told him that I was praying for him and his family and that I was glad he could be there because it was going to be a very special night. One of the last times I had seen Rush was when we were together for the President's visit to Cape Girardeau. He's a real fighter, and he'll continue to be in my prayers as he battles his most recent diagnosis."

Throughout the nation's history, presidents have awarded the medal to recipients from a wide spectrum of fields -- politics, business, science, art and sports. The citation notes the award for "especially meritorious contribution to (1) the security or national interests of the United States, or (2) world peace, or (3) cultural or other significant public or private endeavors." Past winners include Norman Rockwell, Walt Disney, Tennessee Williams, Duke Ellington, Elvis Presley, Sam Walton, Warren Buffett, Edward R. Murrow, Johnny Carson, Jonas Salk, Bill Gates, Martin Luther King Jr., Rosa Parks, the Rev. Billy Graham, Mother Teresa, Neil Armstrong, Muhammad Ali and Babe Ruth.

Limbaugh's selection was seen by some as controversial and was not Trump's first eyebrow-raising pick for the medal. He awarded the medal to Miriam Adelson, who had given more than $100 million to political candidates and organizations. Several other winners were not universally acclaimed. President Barack Obama awarded the medal to democratic activists Barbra Streisand and Oprah Winfrey, for example.