On Oct. 30 last year, just nine days before the 2022 midterm elections, Democratic Senate nominee John Fetterman told a crowd gathered here for a rally to pay no mind to his debate performance — just elect him, and he would be their 51st vote.
“Come January, when a new Congress is sworn in, I’ll be much better, but Dr. Oz will still be a fraud,” Fetterman said.
At the same time, Sen. Bob Casey (D-PA) went on MSNBC with Andrea Mitchell, offering a word salad to the effect that Fetterman was fine, just missing a word or two, and that he and his team had been virtuous in their transparency every step of the way.
Except that they had not. The challenge reporters and his constituents have faced has never been the illnesses from which the father of three suffers, whether it be the stroke, the heart condition, or the current mental health crisis. Rather, it has always been the lack of transparency coming from the personal and political team that orchestrates Fetterman’s every move. From the get-go, they have conducted a case study on how not to be forthright.
When Fetterman suffered his stroke, it took days for anyone to know it had even happened. When he had a pacemaker installed, reporters found out only as the procedure was beginning. It then took several more weeks for them to admit the heart condition that had caused the stroke, cardiomyopathy, had actually been diagnosed five years earlier and that Fetterman failed to take his medication or follow up with treatment after that diagnosis.
Fetterman ran for lieutenant governor in 2018 and then filed to run in the primary for U.S. Senate last year, all without revealing his medical condition. When all of this unfolded last year, multiple news organizations, including the Washington Post, called on him to be transparent about his health status. His team did the opposite.
Since the revelation of his heart condition, no doctor has spoken publicly about the status of his cardiomyopathy, outside of the letter released in June by the cardiologist who had seen him five years ago. No one knows whether he or any other heart doctor is still treating Fetterman. Repeated questions to his team as to whether he is being treated by a heart doctor have gone unanswered, meaning the extent of his current heart condition is also unknown to the public.
According to the Yale School of Medicine, cardiomyopathy can weaken the heart, leading to more serious conditions, including lessened blood flow, arrhythmia, problems with the heart's valves, and heart failure. Cardiomyopathies require the management of any present symptoms and the prevention of further complications. But for five years, Fetterman apparently failed to take preventive measures or follow doctors' recommendations.
The best prognosis for cardiomyopathy begins with medication, followed by a defibrillator to control heart rhythms. If that fails, the standard of care involves a surgical procedure to remove damaged areas of the heart. In rare circumstances, a heart transplant could be performed, depending on the severity of the case and the success or failure of other treatments.
When Fetterman checked himself into Walter Reed National Military Medical Center in mid-February for clinical depression, his aides told the New York Times they did not anticipate it would be longer than a few days. When a month passed with no news on his condition, his staff posted a photo of him with his chief of staff at Walter Reed.
On Friday, three weeks after that photo was posted, Senate staffer Joe Calvello told the Philadelphia Inquirer that “John will be out soon. Over a week, but soon.”
When there is a vacuum of information, as has been the case from the very beginning with Fetterman, people find information, good and bad, with which to fill it. This is why you can find a plethora of conspiracy theories on social media filling those holes on an hourly basis.
That vacuum has also created what-if scenarios for if Fetterman resigns. And no one has authoritatively filled the vacuum as to what is going on, and not for the first time since he suffered his stroke.
Outside of social media trolls, most people in this state, whether they voted for him or not, have offered their prayers for his full recovery, not just from the effects of the stroke but also from his heart condition and mental health crisis. But any questioning of his prognosis has become taboo, which flies in the face of transparency that Democrats claim to be stewards of.
Twenty-six years ago, T.J. Rooney, then a powerful Democratic state representative from Bethlehem, decided his problem with alcohol had brought him to the brink of personal and professional destruction. He let the press and his constituents know upfront despite how it might affect his electability. Rooney explained he submitted a letter to then-Democratic House Minority Leader Bill DeWeese asking for leave to deal with "a problem that will only get worse if left untreated" and then told reporters he was on his way to check himself into a three-week alcohol rehabilitation program in Arizona.
“I was upfront about it before I left," he told me. "One of the fundamental reasons was, first, I thought that it was important for my constituents to know why I was gone, but I didn’t want anyone having to be making excuses for where I am when I'm not someplace I'm supposed to be.” He added that although his circumstances were very different from Fetterman’s, the fundamental need for transparency is exactly the same.
Rooney found that transparency, as difficult as it was, was the best pill.
“I received unbelievably thoughtful and caring responses, not at all dissimilar but on a much smaller scale than John received," he said. "By and large, being upfront supersedes politics when you expose a vulnerability like that. The response transcends that which you are most fearful of talking about and discussing. So it becomes an affirmation,” he said.
“Even people who just don't at all care for your politics will respect your transparency,” he said.
Rooney, who went on after his personal crisis to get elected several more times to the state House and then to serve as the powerful chairman of the Pennsylvania Democratic Party, said the Fetterman team's decision to tight-lip each crisis isn’t just causing questions with his detractors. His supporters also want to understand what is going on.
Many of his voters have said bluntly that had they known all of his conditions were worse than presented or that he was suffering from depression, they still would have voted for him. They also believe they should know the overall state of his health.
“Those are two concerns I've absolutely heard expressed by people who are supportive,” Rooney said. “But again, it speaks to the notion that a candidate-protective mode is a lot smaller lane than what voters give you when you're open and honest.”
Rooney said there is a line when you give too much information, “but there's a lot more room before we bump up against the line of too much information.”
Pennsylvania elected officials have had a long tradition of being upfront when medical crises have affected their lives. When then-Gov. Bob Casey Sr. (D-PA) had a heart and liver transplant, there were constant briefings on his condition. When it was questioned why he was moved up on the transplant list, that, too, was immediately addressed. Sen. Arlen Specter (R-PA) experienced a multitude of health challenges while in office, including bouts with benign brain tumors in 1993 and 1996 and then cancer in the form of Hodgkin’s disease in 2005 and 2008, as well as heart bypass surgery. And with each crisis, there were doctors answering the media's questions.
G. Terry Madonna, a political science professor at Millersville University, said that since the very beginning, there should have been much more transparency about Fetterman's health. “An explanation of what he could and could not do would've been helpful," he said. "Although his staff has been sending out stuff repeatedly, we really don’t know much. He hasn't been able, not just to serve in Congress, in the Senate, but he's not been able to travel around the state and visit with constituents, which is a pretty important requirement for officeholders, and particularly statewide officers. ... I thought in the case of Sen. Casey, who had prostate cancer, there was much more transparency for the simple reason that he went in, had the surgery. The doctor said he's 100% recovery, he'll be back in action, and within two weeks, he was back serving in the Senate,” he said.
Given that Fetterman is a statewide officeholder, Madonna reasoned that the public needs to have full awareness and appreciation of his health situation. “They need a full explanation in order to understand the status of his health," he said. "That doesn't mean he should quit. That doesn't mean he should resign. But it is very difficult to make a judgment about the status of John Fetterman's health because of a paucity of information that has been publicly made available."
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