Watching John Fetterman during Tuesday night’s Pennsylvania Senate debate left Judy Gage of Jamesville, New York, feeling heartbroken.
“Because I know that he knows what he wanted to say,” said Gage, 71, who experienced a stroke in 2017. “He speaks differently now. That doesn’t mean that what’s up in his brain is any different than it was before, it’s just short circuiting when it comes out.”
Pennsylvania Lt. Gov. Fetterman had a stroke five months ago that has compromised his speech processing capabilities. During the debate in Harrisburg, Pennsylvania, against Republican Mehmet Oz, Democratic nominee Fetterman stumbled at times.
For stroke survivors interviewed by NBC News, the test Fetterman faced was not just political, but deeply personal.
In him, they saw an avatar of their own struggles following a stroke: to recuperate physically, to communicate fluently and to coax from others an empathetic understanding that while some of their faculties may have been compromised, their intellects often remain unscathed.
The intense scrutiny, criticism and even outright mockery directed at Fetterman following his debate performance has felt like searing judgment of their own post-stroke issues.
Ben Marritt, 39, had a stroke when he was 32, which has left him with neurological fatigue and a stutter. He said he sees Fetterman as a role model of what’s possible, and also a kindred spirit.
“This John Fetterman story hits me particularly close to home,” said Marritt, who lives in Meaford, Ontario, and is currently on medical leave from his job as a warehouse checker for The Beer Store.
Holding back tears as he described how his young children never got to know him as he was before his stroke, Marritt spoke of his reaction to the intense judgment Fetterman has received.
“It feels terrible. It makes real all of the negative thoughts that you have in the back of your mind whenever you’re dealing with people, said Marritt. "They think I can’t do it, they think I’m not good enough.”
Marritt has friends in Pennsylvania and has been pushing them to support Fetterman.
It is a common misconception that someone who struggles to speak following a stroke is necessarily compromised cognitively, said Dr. Kevin Sheth, chief of the Division of Neurocritical Care and Emergency Neurology at the Yale School of Medicine. Sheth differentiated between the intellectual and cognitive capacities of stroke survivors and their ability to process language and communicate.
Fetterman sustained an ischemic stroke, which occurs when a blood clot impedes the flow of oxygen and other vital nutrients to the brain. Consequently, certain brain cells can incur damage that results in the post-stroke difficulties that someone like Fetterman faces. But there is generally ripe opportunity for progressive healing.
Sheth said it is reasonable to expect that the Democratic Senate candidate will continue to improve over the coming months.
Since Gen. Michael Hayden, 77, a retired four-star general and former director of the Central Intelligence Agency, had a stroke in 2018, he has struggled with aphasia, a disorder resulting from damage to the areas of the brain that govern language.
During a telephone interview, Hayden said that his speech has improved over time and that even a year ago, communicating over the phone would have been much more difficult.
“Maybe in another year it’ll be very different for me as well,” said Hayden, who lives in northern Virginia, of the prospect that his brain will continue to heal and adapt.
More than two million Americans have aphasia, most commonly due to stroke, according to Darlene Williamson, president of the National Aphasia Association and a speech and language pathologist.
Fetterman’s campaign reports that he does not have definitive aphasia, rather an auditory processing disorder, which makes it difficult for him to process speech.
To aid him during the debate, he had access to closed captioning on two 70-inch screens placed above the moderators.
Some stroke survivors said the debate rules should have allotted Fetterman longer periods to speak.
Brianne Williams, 51, who lives outside Orlando, Florida, and had a stroke in 2010, broke into tears as she recalled the debate.
“That man was sitting there reading two monitors,” Williams said of Fetterman. She was frustrated that the candidate was “not being given the grace that we give people with disabilities.”
“I know what it’s like to have the words in my head and to try to get them out of my mouth and just not be able to quick enough,” Williams said.
Gage has little patience for people looking down on Fetterman in the wake of the debate.
“Those who say they are turned off by someone who isn’t perfect or can’t perform perfectly, then to hell with them," Gage said. "Shame on you.”
Physical and mental exhaustion is a hallmark post-stroke condition. Accordingly, some stroke survivors said that at the end of the hourlong debate, Fetterman seemed worn out.
Makana Vincent-Harvest, 67, of Wahiawa, Oahu, had a stroke in 2011. Now retired, at the time she had a demanding job as an executive assistant and then was out of work on medical leave for a year as she recuperated.
“I just wanted to give him a hug after awhile and say, ‘I know how you feel,” Vincent-Harvest said of watching Fetterman.
Not all stroke survivors have appraised Fetterman so generously.
Tom Mannel, 76, who had a stroke three years ago and lives in Kernersville, North Carolina, said he is a registered Democrat but often votes for Republicans, including for Donald Trump. He said he believes that Fetterman is too compromised by his stroke to serve as a senator and that if he lived in Pennsylvania he would vote for Oz, whom he prefers for being a political outsider.
“I am in my current condition far more equipped to speak and think and function, interacting with others on a daily and spontaneous basis than I think Fetterman is. And that’s unfortunate,” said Mannel, who is retired from his work as a national account manager in marketing with AT&T.
Others said they hoped that the attention focused on Fetterman’s recovery might inspire greater empathy and understanding of what stroke survivors go through.
They said that the closed captioning Fetterman currently requires is, in the words of disability law, a reasonable accommodation — one akin to those provided to members of Congress, such as Reps. Tammy Duckworth, D-Illinois and Madison Cawthorn, R-N.C., who use wheelchairs.
Multiple members of Congress have had strokes and continued in their positions, including Sens. Chris Van Hollen, D-Md., and Ben Ray Luján, D-N.M.
“Yeah, I stutter, I limp occasionally,” said Williams. “I still go camping. I got my degree after my stroke. This is not an intellect thing, this is a signal crossing that’s trying to resolve itself.”
Stroke, Sheth noted, is the fifth leading cause of death in the United States and a leading cause of disability.
“Why are we treating it like it’s some rare, mysterious thing?” Sheth said. “Eight hundred thousand people have a stroke in the U.S. every year. Do we really think that the message is that those 800,000 people who have a stroke every year can no longer contribute to society or hold a job?”
“What we should do is evaluate people based on their ability, not their disability,” said Sheth.