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Fetterman vs Oz, One year later [1]

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Date: 2023-10-25  

A year ago today a courageous John Fetterman stepped up to debate Dr. Mehmet Oz. He was still a patient recovering from a life-threatening stroke, and Oz was a physician. Oz insisted on a debate, and in fact a spokeswoman for his campaign called Fetterman a “liar, a liberal, and a coward” and agreed to a list of mock debate concessions, including a promise “not to intentionally hurt John’s feelings” and to pay for additional medical staff on standby.

As the debate unfolded many people were shocked to hear just how badly the stroke had affected Fetterman’s ability to communicate, and how much recovery he still needed. The headlines were often nasty, alarmist, and politically motivated. As a family doctor in Pennsylvania I was certainly concerned, but I did not feel like the debate performance disqualified him. Rather, I felt like it solidified my support. Here is what I wrote a year ago:

I watched most of the debate tonight between John Fetterman and Mehmet Oz. I live in Philadelphia, Pennsylvania, and I will be voting. I’m going to keep most of my political views out of this brief post. Instead I want to simply comment on John Fetterman’s “performance.” Frequently I see people in the office who have suffered from strokes. Some have lost strength on one side of the body, or have been partially paralyzed. Others have lost the ability to form words and sentences. Some strokes can be terribly cruel, while other events can be mild and recoverable. It takes real courage, toughness, and patience to endure what may come, and what may not come back. John Fetterman’s pattern of speaking sounded very familiar to me. I can think of at least 5-10 of my current patients who speak in a similar manner - halting, stumbling at times, but with an unmistakable preservation of deeper cognitive processes. If I listen, and allow for the choppiness, it sounds fluent to me. I had no trouble understanding the gist of each of Fetterman’s answers, and where he stands on the political, ideological, and moral issues of the day. The parts of his brain that handle auditory processing are not up and running to full capacity. The usual back and forth of an argument between two people felt syncopated instead of on the beat. To accommodate for his auditory problems, the debate format allowed him to read the moderators’ questions (and presumably Mehmet Oz’s responses and challenges) off a teleprompter in real time. But like most crappy debates in the modern era, candidates were given strict 10, 15, and 60 second time budgets to respond before being cut off, or dinged by a buzzer that must have been disorienting, especially for Fetterman. His disability was partially accommodated, and partially exploited by this multimedia, interruptive format. In a lot of ways I understood Fetterman’s answers better than I understood Oz’s. Stripped of eloquence, he was forced to answer with imperfect simplicity. Debates are theater and manipulation, and there he stood under the bright lights without the usual verbal make-up and costume, delivering as best he could. Anyone watching who has had a stroke, or has had a family member or friend suffer a stroke, probably felt a good mix of cringing anxiety and proud determination. It can take a year plus for the brain to recover what it will after a stroke, and with a good team around him to help with communication, Fetterman looked fine to me in terms of cognitive abilities and the intact status of his core personality and beliefs. From this distance, I agree with his physicians. He could do the job. Mehmet Oz was able to communicate effectively, but his cognitive competence was not in question. I did not recognize him as a physician. As a doc, I have interacted with other docs, constantly, for more than 20 years. Oz continues on a journey from cardiothoracic surgeon (the skills and rigorous training of any surgeon command instant respect from me), to a kind of pseudo-primary-care-celebrity doctor, to a purveyor of products and endorsements and media that have made him incredibly rich… to this stage of running for Senate toting a gun in advertisements, and debating about how “local political leaders” should insert themselves in a decision huddle between a pregnant woman and her doctor. Politically fair game. But as a doctor? Current PA Senator Pat Toomey (R) tweeted after the debate: Anyone watching today could tell there was only one person on that stage who can represent Pennsylvania in the U.S. Senate: @droz. It’s sad to see John Fetterman struggling so much. He should take more time to allow himself to fully recover. I was watching. As a physician I can tell that both Fetterman and Oz could competently represent Pennsylvania in the Senate. It’s not “sad” to see John Fetterman struggling so much. To me, and most other people who have seen a loved one struggle, it’s instead inspiring to see him up there on a national stage debating a former surgeon only 5 months into his recovery. It’s terrifying to think a stroke can happen to any of us, and Covid is making that risk go up actually. Fetterman’s journey, like many other patients’, is not about simply “taking more time to allow himself to fully recover.” He will probably always have some residual difficulty with auditory processing and his patterns of speaking. For most people who have had a heart attack, stroke, car accident, cancer, neurodegenerative disease, or other serious medical illness, waiting around for a “full recovery” is not a viable part of the healing process. The most courageous of us get up and keep going with whatever we have left, and with whatever productive time we are given.

(* This post was originally published on a medical Substack I write called EXAMINED. Stop by sometime and visit.)

John Fetterman did win, and helped tip the balance of the U.S. Senate to the Democrats. This has made an incredible difference in the direction of our country.

Shortly after being sworn in, Fetterman announced publicly that he would need treatment for major depression. This is very common after a stroke, and certainly understandable given his ongoing struggles with hostile detractors and personal recalibration of speaking abilities. Yet lately Fetterman has been emerging stronger, speaking up in the wake of the Israel terror attacks. He has been voting and sponsoring important bills, and recently appeared on The Late Show with Stephen Colbert. He looked great to me. His auditory processing and speech have certainly improved, and you can tell his brain has been healing and forging new connections around those areas that were damaged. His depression is in remission. Fetterman joins other public figures like Simone Biles, Bruce Springsteen, Michael Phelps, Buzz Aldrin, and J.K.Rowling in the crucial effort to destigmatize depression and mental health care, encouraging and inspiring others to seek help.

Fetterman has not accomplished as much as a legislator as he would have without the stroke and major depression. Right wing media and personalities hammer away at this. But I think it is important to point out that John has five more years left in his term. By way of comparison, MAGA leader Jim Jordan has not introduced a single bill in 16 years of service that passed both houses of Congress. The Center for Effective Lawmaking has ranked him in the bottom five (or worse) among House Republicans in the last four Congresses.

And so as I look back on my public statements after the Fetterman vs. Oz debate a year ago, I stand by my initial capacity assessment from afar. John has struggled, but his disability was not disqualifying. He is emerging stronger, casts a mean vote, and stays true to the core beliefs that defined him as a small town Pennsylvania mayor, Lieutenant Governor, and current United States Senator. I don’t care if he wears a hoodie as long as it is a symbol of whom he is serving, and not a sign of disrespect for the institution of the Senate. It isn’t.

Congratulations, John.

I voted for you.

Thanks for not letting us down.

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