READING TIME: 7 minutes
SUMMARY: To his credit, Fetterman has not hidden his struggle with depression or the ways his stroke has affected him. However, both have changed him significantly, and he has missed A LOT of votes, committee meetings, and meeting with his constituents. He’s also behaving erratically and scaring people, especially with his driving. Maybe it is time to codify what should be done when an elected is significantly impaired either physically or mentally.
KEY WORDS: John Fetterman, Mitch McConnell, Senate, Elected, Joe Manchin, Kyrsten Sinema, Diagnosis, Stroke, Major Depression
COMMENT: How can we be fair to constituents, electeds, and our government when electeds fall ill? What should the “rules” be?
The Fetterman Conundrum
With someone finally having looked into the box they’ve been keeping McConnell in and found him to be whatever is passing for alive in the geriatric ward of the Senate, now we only have outraged demands for Pennsylvania Senator John Fetterman to do his job! Last week, Fetterman continued to flirt with the Republican party by introducing his Republican counterpart at Trump-a-palooza in Texas further fanning the flames of panic that Manenima has risen from the dead to haunt the hallowed halls of Congress once again.
Among Fetterman’s sins that have angered many Democrats are his votes supporting the Iranian and Gazan war crimes, approving of many of Trump’s deeply dubious Cabinet appointments and judges, and his open support of ICE, claiming that they are simply doing their job (of murdering US citizens and immigrants alike and, otherwise, terrorizing US communities). Perhaps his worst sin, though, has been voting for Trump’s agenda more than 26% of the time!
His record has the left furious with him and the right salivating over him. Everyone has laid their bets on the prediction markets about whether he’ll switch parties.
Fetterman’s History
The mishegas with Fetterman started long before Trump snuck in the rigged backdoor of the White House. His split with his progressive fanbase seems to have started after the 7 October Hamas attack on Israel in 2023. His enthusiastic support for Israel’s vengeful pursuit of genocide in Gaza led him to declare that he is a Democrat, not a progressive, even though, he seemed to run as a progressive, garnering support and praise from Bernie Sanders.
Fetterman rocketed onto the national stage as lieutenant governor of Pennsylvania when he colorfully and fiercely defended the integrity of the state’s vote in the 2020 election. In the aftermath of the 2020 election, I was happy to have him championing the Pennsylvania vote. When he ran for Senate, though, I remember thinking that he was narcissistic, but he was using it for good way, or at least in ways that aligned with my political goals, which is what we mean by good, right?
Diagnosis versus Clinical Impressions
I’m not diagnosing here; I’m just giving my impressions of the person I saw on the TV and social medias. Not having met him or had the opportunity to interact with him in a clinically significant way or have enough reliable information about him in the media, I can’t diagnose him. But I can use what we know about his behavior and health to develop an informed opinion.
Fetterman: Narcissistic Contrarian
For me, there was always a kind of red flag flapping in his wake. He seemed like he had a propensity for erratic, quarrelsome, contrarian behavior and attitudes. I thought his progressivism wasn’t so much as a genuine commitment to its ideals, but an expedient way to fly in the face of the establishment. I wanted him to win in much the same way as I wanted Manchin to win — it was better than the Republican alternative — but I had reservations. He was going to be trouble.
After arriving in the Senate and refusing to change his attire to something more suitable for the august body — echos of Sinema, no? — it reinforced my perception of him as a contrarian, so when he really started pushing back against the Democratic agenda and siding with Trump and Republicans, I figured it was more of his narcissistic search for the spotlight and contrarian need to piss people off.
I woulda left it there, except for his troubling health issues. Famously, two days before the primary vote in May 2022, Fetterman had a life-threatening major stroke. Even though, it left him impaired, and he covered up his status for several days, he won the primary. Luckily, he faced an even more impaired candidate in Mehmet Oz in the general.
Fetterman’s Medical History
The Stroke during the Campaign
The stroke had a significant impact on him. It damaged the auditory receptive language processing area of the brain. He describes hearing people talk as sounding like the teacher in Charlie Brown cartoons. He’s compensated for his impairment by using speech-to-text applications on his phone and tablet devices since he can still decode written language. While it slows his interactions, it does not leave him unable to communicate, which is so often the case after a major stroke, and a good reason to monitor your blood pressure and do everything you can to avoid having one. You won’t be as lucky as John Fetterman or have the medical and financial resources afforded to him by his position in the world.
In October, when he had to actually debate Oz, his impairments were apparent for all the world to see. Although, he acquitted himself well in the debate, he struggled at time with processing issues and repeating phrases. In their Jesus-like charitable way, the rightwing trolls jumped on that and roasted him on every media platform in the land. Just like Jesus would’ve been, they were merciless. Reading these unkind comments, Fetterman says, plunged him into a deep clinical depression.
Even though he handily beat Oz, he became depressed and withdrew from social contact. He had all the classic symptoms. He didn’t get out of bed for days at a time. He quit eating and lost significant amounts of weight. And, he had severe suicidal ideation. If you, or someone you know, is experiencing suicidal ideation or thoughts of self harm, you can use the US and Canada hotline of 988. Wikipedia maintains a surprisingly thorough list of suicide hotlines from around the world if you’re not in either of those countries.
Major Depression and Hospitalization
After he was sworn into office in January, he entered voluntary inpatient treatment at Walter Reed National Military Medical Center — remember what I was saying about you not having the same resources available to you as a sitting US senator? Post-stroke depression is a real thing, too. You don’t need to be dog-piled by rightwing trolls on social media to be depressed after a stroke. He was discharged in March 2023 after forty-four days of treatment. Hey, he didn’t miss as much time as Congress has as a whole or Mitch McConnell is.
His Concerning Behavior
The stroke also affected him in other ways. It probably weakened the link between his frontal lobe and his internal reward and language processing centers. The frontal lobe is home to impulse control, planning, and rational thought. Damaging links between this vital part of our brains and any other can severely affect the behaviors and mental processes the other areas control.
It has been widely reported that he has missed things like funerals for police officers — political suicide! (forgive the pun) — and a meeting with the Children’s Hospital of Philadelphia to discuss cuts to Medicaid funding as well as committee meetings, hearings, and votes. He even claimed poor health to miss a meeting with paralyzed military veterans only to show up on a Fox News show later in the day — more political suicide.
He’s had emotional verbal outbursts at meetings with constituents and other organizations as well as with staff. There have been reports that his staff is concerned that he is not taking his medication and has deviated from his safety plan, alienating the people around him that are helping him implement it. And, if all of this wasn’t concerning enough, supposedly, he has been driving erratically and dangerously.
What to Make of Fetterman
With the sour aftertaste the horrific Manenima days still lingering in our mouths, we all fear the turncoat Democratic senator. It has been easy for Democrats and progressives to criticize Fetterman for changing his policy positions and wanting to work across the aisle with the anti-democatic forces of Trump and the party of oligarchy, but I don’t know if it is fair or even right in this case. I’m not saying what Fetterman is doing is right or good, I’m just saying there is a greater more nuanced context for it.
While I am disheartened by these changes in Fetterman, I am inclined to extend a bit of grace to him. He’s going through physical and mental issues that few of us will ever face, and thankfully, so. Rearranging the wiring in your brain like happens when you have a major stroke can change your personality, especially when the parts of the brain that manage impulse control and motivation are damaged.
We can use what is known about post-stroke and depressive individuals and reverse engineer what has happened to Fetterman’s brain. Let’s face it, rearranging the neural connections can really eighty-six your entire personality, worse, it can leave you with little to no insight into what is happening, much less why.
He has a language processing issue. Responding to spoken questions and comments is difficult for him. He probably is a bit embarrassed by it still. I can understand not wanting to expose yourself unnecessarily to public scrutiny. But, he’s a senator. It is what he was elected to do.
Anyone who’s had a job that involves working with other people, knows how annoying other people can be sometimes. If your impulse control is malfunctioning, it is easy to have outbursts and shout at people. If your planning centers have been damaged, it can be easy to ramble. If your language processing centers are compromised, it’s easy to be repetitive.
All of Fetterman’s bad behavior can be traced back to his stroke and depression. He is to be commended for having been as open as he has been with his health struggles. It helps normalize mental health issues for all of us. Hopefully, it will help us all deal with our mental health struggles more openly and successfully. And, child, wouldn’t it be nice if we all could miss Fetterman’s forty-four days, McConnell’s ninety-two, or Keen’s one hundred forty-two and still get paid and have a job to return to.
Medically Unfit for Office
But, the Fetterman situation does buggar a much bigger question. What do we do when we have an elected official who is no longer able to fulfill the duties of their office. We’ve had an inordinate amount of this happening lately. Senator Feinstein’s very public cognitive decline and Schroedinger’s McConnell come to mind. But, there was the disappearing act of Representative Keen, too, where he was AWOL for over one hundred days, finally, returning to the House and explaining that he was receiving inpatient treatment for depression. Nothing wrong with that, but you gotta tell folks up front, right?
I don’t have a real concrete solution to the problem, but I got a couple of ideas. First, timely disclosure of what is really going on. I think that has to be a minimum. We don’t need more McConnells or Keens happening. It’s just not fair to their constituents or the processes in the Congress. Second, along with disclosure should be a good faith effort to guesstimate how long someone will be out of commission and if it is longer than thirty days, maybe a governor could appoint a temporary replacement? I don’t know, but in our fast-moving world, we shouldn’t leave an office hanging like that. We could stipulate qualifications or limitations or something.
I also know what I think isn’t needed. Term limits and capping age doesn’t solve the problem. That is tossing the proverbial baby out with the ubiquitous bath water. We need an informed electorate making informed decisions about who serves, both of those measures encourages disengagement, rather than engagement. For every Feinstein, you have a Grassley and Sanders. A more effective solution may be a review committee like the Congressional ethics committees that would review an individual’s situation and make recommendations for the Chamber to act on.
I know we complain about having an aging Congress, but we elected them. If we don’t like it, we can change it with our votes. One of the big lessons Trump has taught us is that the voter is ultimately responsible for the government. A failure in the Legislative or Executive Branch is on us. We need to fix it using our votes. That needs to be the message.
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