In his evaluation of Fetterman, Clifford Chen, MD, concluded that “he has no work restrictions and can work full duty in public office.” Fetterman is currently lieutenant governor.
But Chen also noted that the Senate candidate has exhibited symptoms of an auditory processing disorder that can cause hearing difficulties. While this means that Fetterman does not always properly process words spoken aloud, his communication skills have reportedly improved significantly since his first speech therapy appointment.
Fetterman had what is known as an ischemic stroke, the most common type. Almost 87% of all strokes are ischemic, meaning there is an artery blockage that prevents blood flow to the brain.
Although we don’t have many more details about his stroke, Lee Schwamm, MD, a vascular neurologist at Massachusetts General Hospital in Boston says that, given his symptoms, it’s likely that Fetterman experienced a blockage in his middle cerebral artery. And if Fetterman is right-handed, Schwamm says, his language systems live in the left side of his brain, so the stroke would have been in the left-middle cerebral artery in particular.
For recent interviews, Fetterman has relied on visual aids like a teleprompter and closed captioning, and plans to do the same for an upcoming debate against his opponent, Republican Mehmet Oz, who is a board-certified heart surgeon. Oz has been particularly vocal about Fetterman’s health in the wake of his stroke, going so far as to suggest that the candidate’s wife might have to serve as Senator in his place.
But experts see that as a likely exaggeration.
“In general, patients who have a mild receptive language difficulty don’t have any change in IQ – their cognitive abilities are not altered,” says Gregory Albers, MD, neurologist and director of Stanford University’s Stroke Center. He added that, after a stroke, patients can have a recovery that lasts over a long period of time.
“Although the most rapid recovery happens in the first few months, continued recovery is expected over many months,” Albers says.
Schwamm says that a political debate – or any forum that requires more on-the-fly thinking and communication – will be the best measure of his abilities. But he doesn’t expect that Fetterman will function at his highest level of performance during a debate setting, which can be stressful for anyone, stroke or not.
Also, Schwamm, says, we have many senators and representatives who need assistive devices like canes or wheelchairs, are on medication for heart disease, or have some degree of dementia – but we don’t block them from political life or remove them for office for their health conditions.
“Accommodation is not weakness, accommodation is a mechanism for leveling the playing field so that people can perform at their highest levels,” says Schwamm. “We have to embrace the fact that people process information differently, even if you’ve never had a stroke. What matters is the product of their work, not the method of their work.”