Pennsylvania Voters Have No Good Options

A fluke medical crisis has thrown one of the most consequential elections into disarray—with serious consequences for the entire country.

A photograph of John Fetterman in profile standing in front of a microphone
Matt Rourke / AP

No one knows quite how the stroke that Pennsylvania’s John Fetterman suffered in May might affect his performance as a U.S. senator if he wins an election next month. But his halting, sometimes painful performance last night in the sole debate in his race against Republican Mehmet Oz showed that he’s not outwardly the candidate who won the Democratic nomination earlier this year.

The answers here are simply unavailable. His campaign insists that he is cognitively healthy but struggles with processing speech aurally and orally, a judgment no ordinary voter would be able to make from watching the debate alone. (As Fetterman recovers, he has sometimes performed better on the campaign trail and in one-on-one situations.) The campaign has declined to release full medical results, but although more transparency from public officials is important and doctors can assess Fetterman’s current health and make educated forecasts about his recovery, they aren’t seers, either.

Yet the peculiarities of the American electoral system—and this election—mean assessing the race purely from the perspective of Fetterman’s ability is impossible. The choice is not between Fetterman and another Democrat or a candidate with similar policy positions; it’s between Fetterman and Oz, an exponent of Trumpism and other quack cures. Moreover, the result in Pennsylvania could determine which party controls the Senate, with huge implications not only for the next two years of policy but even for the future of democracy in the United States.

That such a weighty matter could come down to the randomness of a blood clot in one man’s brain feels unthinkable: For want of a nail, the kingdom was lost; for want of a clear blood vessel, no one knows what might happen. A cynical, and not incorrect, view is that many sitting senators don’t seem all that sharp or well equipped even without questions about their health; and some who did have health problems kept getting reelected to the chamber in their dotages. The question before Pennsylvanians, however, is whether to elect Fetterman in the first place.

There are few obvious analogues to a situation where the health of the republic might rest so directly on the health of a single politician. Perhaps Richard Nixon would never have been president had Robert Kennedy not been assassinated. Had Senator Paul Wellstone not died in a plane crash shortly before the 2002 election, perhaps he would have defeated Republican Norm Coleman and tipped the balance in the chamber. Ted Kennedy’s death from cancer in 2009 gave Republican Scott Brown an opening to win a Senate seat and in doing so shrank Democratic policy possibilities. Then-President Donald Trump’s serious bout with COVID in fall 2020 also threatened to be a pivotal moment.

By the time Fetterman had his stroke in May, just before the Democratic primary, he had come to seem like a juggernaut, and not merely because of his oversize stature. He blew through the Democratic field, including the putatively very electable Representative Conor Lamb, and held a commanding lead over the Republican contenders. No one knew immediately how serious the stroke was, and no Democrats wanted to take the chance of replacing an apparently viable candidate with a weaker one—not when the stakes were so high. So they waited, and hoped Fetterman would be able to bounce back quickly.

Through the summer, that seemed to work. A clever social-media strategy and Oz’s own gaffes allowed Fetterman to maintain a lead while staying out of sight. Fetterman gradually returned to the trail, but polls have tightened—how much because of natural sorting of voters, national currents shifting toward Republicans, or voter hesitations about Fetterman’s health is impossible to say with certainty.

Fetterman agreed to a single debate with Oz and tried to set expectations very low. Even so, he seems to have missed them. Perhaps refusing to debate would have raised even more questions, but Democrats are now questioning whether he should have simply declined to appear. Underlying all this is a bigger, usually unspoken anxiety: Is Fetterman really capable of closing out the campaign? The question is somewhat idle, though, because there’s no replacing him now.

This leaves Fetterman asking voters to take it on faith that only his speaking, and not his thinking, is impaired. Candidates ask voters to take any number of things on faith, but Fetterman’s speech troubles are more overt, and yet also much harder for an ordinary person to assess, than a pledge not to vote to raise taxes.

Most Pennsylvania voters have long since decided for whom to vote, and the debate and even Fetterman’s stroke may not make much difference. But voters who were never Fetterman diehards may simply stay home now, hesitant to elect someone they may believe is not up to the job. That may mean the state elects Oz instead, a brazen carpetbagger who spent years peddling snake oil, is barely willing to do the minimum to hold the gig, and supports an insurrectionist former president.

The nationalization of politics, the sorting of the parties into homogeneous caucuses, and the threat posed by the MAGA movement mean that assessing candidates as individuals, rather than as avatars of parties, is harder and harder to do. Those choices are made at the primary level: You decide whether you want Oz or David McCormick, or whether you want Fetterman or Lamb. Come November, you’re voting for a party. The narrow margins in the Senate and tight partisan alignment mean that however bleak this feels, it’s probably rational. An individual senator is unlikely to make much impact, so an eccentric senator who is a reliable partisan voter is the best one can hope for.

Earlier this month, I wrote about a similar dynamic in the Georgia race for U.S. Senate, where Republican Herschel Walker is trying to unseat Democratic Senator Raphael Warnock. As in Pennsylvania, the outcome could determine control of the Senate. The reasons why voters might have hesitations about Walker are very different from the ones they might have about Fetterman. The GOP candidate has no business in any elected office, has lied and misrepresented his family life, and appears to have very little hold on the stuff of politics.

But both elections illustrate what happens when voters are locked into a candidate chosen months ago in a primary, in a deeply divided country where voters regularly subjugate their feelings about a candidate to their feelings toward a party—or, in many cases, their antipathy to the other party. This is not a functional system, but voters in Pennsylvania have no alternative, and much rests on their decision.