When John Fetterman was released from Walter Reed hospital in March 2023, Adam Jentleson, then his chief of staff, was proud of his boss for seeking help for what the senator’s office and his doctor had said was a case of clinical depression. His six weeks of inpatient care had been the latest medical setback for the Pennsylvania Democrat, who had had a stroke mere months before being elected to the U.S. Senate in 2022, nearly derailing his campaign against Republican Mehmet Oz. But a year after his release from the hospital, Fetterman’s behavior had so alarmed Jentleson that he resigned his position. In May 2024, he wrote an urgent letter to David Williamson, the medical director of the traumatic-brain-injury and neuropsychiatry unit at Walter Reed, who had overseen Fetterman’s care at the hospital. “I think John is on a bad trajectory and I’m really worried about him,” the email began. If things didn’t change, Jentleson continued, he was concerned Fetterman “won’t be with us for much longer.”

His 1,600-word email came with the subject line “concerns,” and it contained a list of them, from the seemingly mundane (“He eats fast food multiple times a day”) to the scary (“We do not know if he is taking his meds and his behavior frequently suggests he is not”). “We often see the kind of warning signs we discussed,” Jentleson wrote. “Conspiratorial thinking; megalomania (for example, he claims to be the most knowledgeable source on Israel and Gaza around but his sources are just what he reads in the news — he declines most briefings and never reads memos); high highs and low lows; long, rambling, repetitive and self centered monologues; lying in ways that are painfully, awkwardly obvious to everyone in the room.”

Fetterman was, according to Jentleson, avoiding the regular checkups advised by his doctors. He was preoccupied with the social-media platform X, which he’d previously admitted had been a major “accelerant” of his depression. He drove his car so “recklessly,” Jentleson said, that staff refused to ride with him. He had also bought a gun. “He says he has a biometric safe and takes all the necessary precautions, and living where he does I understand the desire for personal protection,” Jentleson wrote, referring to Fetterman’s rough-and-tumble town of Braddock, Pennsylvania. “But this is one of the things you said to flag, so I am flagging.”

Another red flag, Jentleson added: “Every person who was supposed to help him stay on his recovery plan has been pushed out.” Fetterman was isolated, had “damaged personal relationships,” and was shedding staff. The turmoil in his office continued over the following year. Since winning election in 2022, he has lost his closest advisers, including three of his top spokespeople, his legislative director, and Jentleson. His circle of trust has shrunk, and people I spoke with made it clear that they expect more staffers to depart.

When Fetterman first caught the attention of the national press, journalists wrote about him like he was a benevolent ogre crossed with a folk hero. More specifically, that’s how I wrote about him. “This is the tale of Big John Fetterman, the giant who lives in an abandoned car dealership beside a steel mill,” my 2018 profile in the Washington Post began. “He’s six-eight, arms covered in ink, head as bald as a wrecking ball.” At the time, Fetterman was mayor of Braddock, which looked a lot like the left-behind corners of the country that had flocked to Donald Trump. He was running for lieutenant governor of the state, and it was easy to see his appeal: He was a bit introverted and curmudgeonly, but funny, smart, and passionate about the fate of communities like Braddock, tattooing the date of each murder that occurred in the town during his tenure on his arm. Endorsed by Bernie Sanders, but also sympathetic to fracking and other positions that cut against the progressive grain, he cruised to victory that year.

The stroke in 2022 made it difficult for Fetterman to communicate, which was painfully evident in his one televised debate with Oz. As Republicans piled on with claims that Fetterman was incapable of doing the job, Democrats rallied to his defense and confidently predicted he would still be fit to serve. Now, even though he requires the help of captioning on an iPhone to deal with an auditory-processing impediment, he remains a promising politician, at least to casual observers. He still exudes an elusive sense of authenticity, someone who can chop it up with manosphere chieftains like Joe Rogan while maintaining his strong stance on trans rights. A recent poll from Morning Consult found that his overall popularity is on the rise, with 50 percent of respondents approving of the job he is doing, against just 35 percent who don’t. With the Democratic Party out of power and fighting with itself about how to move forward, it would be easy to imagine a “Fetterman 2028” machine kicking into gear.

Instead, many of his former staffers are hoping it never happens. “Part of the tragedy here is that this is a man who could be leading Democrats out of the wilderness,” Jentleson said. “But I also think he’s struggling in a way that shouldn’t be hidden from the public.”

Jentleson is a longtime Washington operator. He’s worked for a liberal think tank and written a book about the filibuster. He and I first met back when he worked for Harry Reid, then the Democratic leader of the Senate, and later we became friends. Jentleson continues to believe, broadly, in the Fetterman project: that Democrats would benefit from punching left more often and that voters crave a heterodox candidate willing to stick a thumb in the eye of his own party. He says his disagreements with Fetterman are, by and large, not political but rather an expression of genuine worry for Fetterman’s well-being. He told me he hadn’t gone public with his concerns earlier because he had hoped Fetterman could correct course.

“I believed in John’s ability to work through struggles that lots of Americans share,” he said. “He’s not locked into a downward trajectory; he could get back in treatment at any time, and for a long time I held out hope that he would. But it’s just been too long now, and things keep getting worse.”

He’s not the only one who is uneasy. Former and current staffers paint a picture of an erratic senator who has become almost impossible to work for and whose mental-health situation is more serious and complicated than previously reported. No one is saying every controversial position (for example, his respectful relationship with Trump) stems from his mental health — but it’s become harder for them to tell which ones do. When I spoke with Fetterman in April and shared those concerns, he denied anything was amiss. He told me that he felt like the “best version” of himself and later texted that the staff turnover at his office was typical of Washington. “Why is this a story?” he asked.

Many of the staffers I spoke with are angry. They are troubled. And they are sad. These were some of Fetterman’s truest believers, and they now question his fitness to be a senator. They worry he may present a risk to the Democratic Party and maybe even to himself.

Almost immediately after winning his 2022 race, Fetterman began to fear that everything would unravel. It started, according to two of his former staffers, when Kenneth P. Vogel of the New York Times reached out to Fetterman’s team about a donation the campaign had received from a super-PAC associated with FTX, the now-bankrupt cryptocurrency company started by Sam Bankman-Fried. The Times reported that the PAC had spent $212,000 supporting Fetterman — a sizable amount, but in the context of the most expensive Senate race in the country, which surpassed $300 million in total spending, it was barely a blip. The staff knew it was not great optics to be linked to a crypto scammer, but as far as scandals went, it was pretty minor.

Fetterman, however, fretted it would end his career. In long meetings and phone calls, he was unable to shake the idea he might never even get sworn in. “Every call would be like an hour with him, trying to convince him, to talk him out of some crazy fantasy,” a former staffer said. (Fetterman denies these claims.)

Members of his team told me this was an early warning sign that something was off with their boss. In early February 2023 — after Fetterman had indeed been sworn in — members of the Senate gathered at the Library of Congress for a caucus retreat. Fetterman, fresh off a hard-fought victory in the cycle’s marquee race, should have been riding high. Only he wasn’t. A staffer recalled getting a text from a person at the retreat asking if their boss was okay. Fetterman was sitting at a table by himself, slowly sipping a Coke and refusing to talk with anybody. Later that day, another staffer heard an alarming report from a journalist: Fetterman had just walked, obliviously, into the road and was nearly struck by a car.

An aide found Fetterman wandering on Capitol Hill a short time later. Worried that he had suffered another stroke, the staffer whisked him to George Washington University Hospital. Doctors there determined there had been no new stroke and that the “dizziness and confusion” he’d experienced was partly owed to severe dehydration. Fetterman also consulted with a psychiatrist there and, according to someone briefed by doctors, was prescribed medications for depression. Doctors discharged Fetterman, and his team told the press that he had been briefly hospitalized after “feeling lightheaded while attending a Democratic retreat.”

A week later, Democratic Ohio senator Sherrod Brown came to pay Fetterman a visit in his new Capitol Hill office. They seemed destined to get along: Each hailed from purplish-red states and exuded an Everyman energy more likely to be found in union halls than in the halls of Congress. But their meeting went awry. Brown tried his best to get a conversation going, but according to two people present, Fetterman was virtually “catatonic.” He could barely string two sentences together, talking so quietly that everyone in the room had to strain to hear him. Fetterman then stood up and began walking around the office in tight loops, a move the two staffers described as doing “figure eights.” After Brown left, Fetterman paced from one room inside his office complex to another and back again. At one point, one of his aides said, he walked into the hallway peering over his shoulder, as if he were being followed by shadowy figures.

The staff got in touch with a Senate physician, and everyone agreed: Fetterman needed to get to Walter Reed. He was admitted on February 15.

Those first days in the hospital were rough. Fetterman was experiencing delusions. He thought that if he took a bed at the hospital, he would be arrested. He told doctors that he believed members of his family were wearing wires to secretly record him. In one chaotic moment, Fetterman grew convinced that a political rally was being held in the hospital’s lobby and that he needed to break out of his room to attend. David Williamson, Fetterman’s doctor, told me that the main causes of the delusions were the lingering effects of the stroke, dehydration, and depression and that the original medication for the depression could also have been a factor. According to paperwork from Walter Reed, doctors then stopped all antidepressants and put him on other drugs. (Williamson declined to comment on the specifics of the medication plan.)

The new medication worked, and over the next few weeks, Fetterman’s “mood steadily improved,” according to a public discharge briefing from Williamson. He started sleeping and eating better. He was staying hydrated. He’d come into the hospital burdened by thoughts of self-harm and an indifference about whether he lived or died. “If the doctor said, ‘Oh, by the way, you have six months left,’ I would have been like, ‘Okay, whatever,’” he later told Time magazine. Now, with the new treatment plan, Williamson said Fetterman quickly “evidenced better mood, brighter affect, and improved motivation, self-attitude and engagement with others.”

He started welcoming visitors. In a photograph from the time released by his office, Fetterman sits in a hospital conference room in front of a treadmill, as if to evince an image of health, reviewing documents with Jentleson. Democratic Vermont senator Peter Welch, one of the few colleagues in Congress invited to visit Fetterman in the hospital, told me that seeing him at Walter Reed “was like seeing a friend who was in really rough shape suddenly being his old self.”

After six weeks in the hospital, the doctors determined his mental-health issues were in remission. Williamson said, “He expressed a firm commitment to treatment over the long term.”

Doctors provided Fetterman with a multi-faceted treatment approach. He needed to stay on his medication and to get his blood checked regularly. It was also important that he stay hydrated, so staff made sure his office fridge remained stocked with Gatorade. He needed to eat healthy and get regular exercise (this was both for his mental health and for the underlying heart problems that had led to his stroke). It was also strongly suggested that he stay off social media, which exacerbated his mental-health challenges. “I’ve never noticed anyone to believe that their mental health has been supported by spending any kind of time on social media,” he said in 2023.

Fetterman seemed to be a changed man, and he was changing Congress, too. The sergeant at arms installed monitors on Fetterman’s Senate-floor desk and on the dais to facilitate the audio-to-text transcription he needed to follow proceedings. He wore his hoodie and shorts to work, later saying it was difficult to find any suits that could fit his “chopstick legs” and accommodate the fact that he had “no ass.” Fetterman’s willingness to be open about his issues seemed to mark a new era in how the public discussed the mental health of politicians. “The benighted days of secrets and shaming are gone,” Jennifer Senior wrote in The Atlantic.

Fetterman threw himself into the work. He chaired his first subcommittee meeting, which focused on the benefits of food stamps. He flew out to western Pennsylvania to meet with farmers dealing with the toxic effects of a train derailment in nearby East Palestine, Ohio. He co-sponsored a bill to ban stock trading in Congress. And in September, after federal prosecutors accused New Jersey senator Bob Menendez of taking bribes, Fetterman became the first senator to call for him to resign.

A few other Democrats joined the chorus calling for Menendez to step down, but Fetterman was disappointed at how many kept their mouths shut. There was an issue, however, on which Congress moved swiftly and in unison: Fetterman’s sartorial choices. The resolution came from Democratic West Virginia senator Joe Manchin and Utah Republican Mitt Romney. They called it the Show Our Respect to the Senate Act — SHORTS for short. It required male senators to wear a coat, tie, and slacks (or other long pants) whenever they were on the Senate floor, and it passed by unanimous consent.

Outwardly, Fetterman played it cool, offering as his official statement a photograph of actor Kevin James smiling sheepishly. But behind the scenes, he stewed. “He was absolutely irate,” said a former staffer. “I think it’s what soured him on the Democratic caucus.” (Fetterman denies this.) It was, perhaps, a trivial matter for the Senate to spend its time on. But there was hardly a moment to dwell on it. A few weeks later, Hamas staged a large-scale terrorist attack against Israel, killing more than a thousand people and kidnapping 250 others.

In the days after the October 7 attack, Israel declared war and retaliated with brute force, killing Hamas forces as well as thousands of civilians. In the U.S., progressives began calling for a cease-fire to at least pause the carnage. Fetterman felt differently. “Now is not the time to talk about a cease-fire,” he posted on October 18. “We must support Israel in efforts to eliminate the Hamas terrorists who slaughtered innocent men, women, and children.”

If his base was surprised by this, perhaps they hadn’t been paying enough attention. While Israel had not been a prominent issue in his various campaigns, Fetterman had been talking about his support for the country for years. “I’m not really a progressive in that sense,” he said while campaigning in 2022. “There is no daylight between myself and these kinds of unwavering commitments to Israel’s security.” Still, it wasn’t until October 7 that it became clear Fetterman was the most outspoken Israel hawk in his party, offering constant and unconditional support for the military action in Gaza. Early on in the conflict, 16 of his former campaign staffers wrote a letter — anonymously — saying they found his full-throated support for Israel to be a “gutting betrayal.” Jentleson had taken to defending Fetterman on X from such criticisms, posting, “The thing about being a staffer is that no one elected you to represent them.”

But it wasn’t just staffers who were upset. There was also Fetterman’s wife, Gisele, who had become something of a political celebrity in her own right: She is a kindhearted philanthropist (the proprietor of a “free store” in Braddock that gave away goods and clothing), a formerly undocumented immigrant from Brazil, and a vocal progressive. In early November, just weeks after the attack, Gisele arrived at her husband’s Senate office and, according to a staffer present, they got into a heated argument.

“They are bombing refugee camps. How can you support this?” the staffer recalled her saying with tears in her eyes.

“That’s all propaganda,” Fetterman replied.

Later, a still visibly upset Gisele pulled the staffer aside. She asked him if members of Fetterman’s team were pushing him to take these stances for political reasons. The staffer told her that the opposite was true: Many of them were as upset as she was. “If you’re pushing back on this, there’s no hope,” the staffer recalled her saying. “This is horrible news.”

A few days later, Gisele texted a different staffer: “I am at breaking point and I can’t co-sign this any longer. Id love some help in language to separate myself from this. Can anyone help me?”

Gisele might have disliked what her husband was up to, but his father loved it. Karl Fetterman, an insurance executive, was way more conservative than his son. He used to have a magnet on his refrigerator that warned that his dog bites Democrats, and he watched Fox News constantly. When Fox would air segments about Fetterman’s strong stances on Israel or invite him on as a guest, the senator’s father would, according to former staff, almost always call to say how proud he was.

The war in Gaza was also luring Fetterman back to X. He had handed over his social-media passwords to his staff as part of his recovery plan, but when he saw in December that Pennsylvania protesters had stuck BOYCOTT ISRAELI GOODS stickers on hummus containers, he approved a post for staff to send. The message adhered to a classic meme format featuring two photos of Drake: one in which the rapper appeared disgusted by text that read PROTEST THE RAPE OF ISRAELI WOMEN + GIRLS and another in which he nodded approvingly to PROTEST HUMMUS.

The post roiled his staff. According to one former aide, a group of women who worked in the office argued that the message could be read as hurtful to sexual-assault survivors. Members of Fetterman’s senior team spent hours urging him to take the post down. The point he was trying to make — that protesters didn’t care about the atrocities committed by Hamas — was being lost in the controversy. According to one of them, Fetterman’s response was that he didn’t want to give in to the “woke mob” and that anyone upset was welcome to resign. Eventually he took it down.

The endless fights over Israel, which saw Fetterman draw further into himself, coincided with setbacks in his recovery regimen. At that point, Fetterman hadn’t gotten his blood drawn for months, despite bloodwork being a crucial component of the plan. In the final weeks of 2023, a Senate physician called the office, according to a staffer, to say that he had seen Fetterman “acting bizarrely” near the underground trolleys that shuttle people between the Capitol and nearby office buildings. He had witnessed Fetterman, seemingly unaware of his surroundings, walk directly into a group of people, nearly bowling them over.

“I just got off with the docs,” a staffer wrote to Gisele in a text. “They said they’d call you to debrief.” The staffer went on to say that others shared his worries about Fetterman’s behavior and that at least two top aides were likely to quit soon because of it: “I don’t want to sound defensive, but I want to be clear that this isn’t just me. Everyone here is feeling alarmed.”

“I don’t think for a second that it’s you,” Gisele responded. “Will he find out tonight that they are leaving? My fear is something is off and it won’t register.”

Gisele then texted that she had told her husband that his staff and doctor were worried about him but that he told her “that’s not true and I guess I am not talking to you today” before hanging up. The doctor had also “said that he was fighting to get access of the Twitter account,” she went on. “Please promise me that he’ll never have access.”

The staffer said that Fetterman was asking for the passwords but that he would not give them up.

“I told him I don’t want to talk to him until his blood is tested,” Gisele wrote.

One former staffer recalled overhearing Gisele on speakerphone that December saying to Fetterman, “Who did I marry? Where is the man I married?”

In our conversation, Fetterman downplayed any supposed arguments with Gisele, telling me that she “has her own voice” and that he would never try to change her views, even if they differed from his. “I think that’s very common in political marriage,” he said. In a statement, Gisele suggested Jentleson was part of a conspiracy to damage her husband’s reputation, saying Jentleson fed her “scary, untrue stories about John’s health.” She added, “I would talk to John’s doctors about what Adam was telling me and they would be confused. Those doctors would tell me that their concerns were not with John, but with Adam. Any alleged ‘concerns’ heard from me came straight from those lies, not from John’s doctors or my own eyes.” In response, Jentleson said, “I stand by everything I said, and I hope Senator Fetterman gets the help he needs.”

Fetterman did have his blood drawn in mid-January 2024. But by mid-March, his aides were again worried that he hadn’t been getting regular checkups. No one I spoke to for this article could be sure about whether Fetterman stayed on his medication during this period, but five different people said they heard comments from the senator that suggested he was not. Going off meds is a common temptation for people with mental-health diagnoses once they start to believe they are well, and it often results in regression. Two aides told me they frequently heard him talk about how he felt so great that he didn’t “need” medication. One person told me Fetterman said he “didn’t like the way” his medication “made” him feel — made, past tense.

Fetterman was not acting like himself, though it could be hard to pinpoint exactly what was off. “I do feel like, you know, at a certain point, some of the folks in the senior staff just started taking too many liberties around trying to figure out his mental-health state,” one staffer said. “It’s like, obviously I could see him having a bad day, and I would try to avoid him myself, but we maybe had no way of knowing, and I want to make sure that it’s not just the blanket explanation. Because we don’t know, right?”

There was also the possibility that Fetterman’s illness had drawn out or intensified his existing predilections. In some ways, Fetterman was being the guy voters sent to Congress. He keeps to himself? He cancels fundraising events last minute? He thinks a lot of his colleagues are morons? Make him president already! He was never a particularly easy person to work with — he’d had that reputation throughout his entire political career. So sometimes the staff would debate whether a fundamental change had occurred or they were just imagining things, particularly since there were stretches of time when he was lucid and together. “It got hard to know which way was up,” Jentleson told me. “Was he acting crazy, or were we overreacting? I asked myself that a lot.”

Still, in group texts including senior staff from March 2024, staffers used terms like manic to describe his behavior. They pointed out that he was canceling medical appointments despite the blood tests being “pillars of the recovery plan.” “I imagine an ‘intervention’ would backfire,” Eric Stern, a Fetterman consultant at the time, texted. “But is there any universe in which Gisele could convince him to get his levels checked? I’m honestly just worried for him and don’t know who else could get through to him.” “The way he talked to me today was different,” texted Rebecca Katz, Fetterman’s longtime consultant and confidante. “Meaner.” (Katz would quit within weeks).

One staffer told me there would be entire days when they couldn’t let anyone outside the office be around him because he was in “some sort of state” and might say “really fucked-up shit to constituents.” Sometimes he would just “shut down,” according to one former staffer. He was saying “unhinged shit,” according to one text, and spending more time on social media. Stern wrote to the group that it seemed to him like Fetterman was “spiraling” and that his constant “doomscrolling” — “I think he’s on essentially all day now?” — would only make things worse. “It’s self sabotage,” Katz texted. “Him against the world is his comfortable place.” Another staffer chimed in to say the boss had picked a fight in the Senate cloakroom when an attendant wouldn’t let him bring a friend in. “He said something to the effect of, ‘you let all these imbeciles in here but you won’t let me bring in my friend?’”

Bobby Maggio, a longtime aide who often defended his boss, thought that people might be overreacting to the cloakroom incident. He replied that this could just be an example of Fetterman being “gruff” and frustrated by a “stupid rule.”

In February 2024, Jentleson announced he was stepping down as chief of staff while remaining on the payroll as an adviser. For months afterward, he debated whether to contact Fetterman’s doctor. When he was still working for Fetterman, he had been explicitly told not to, and when he did so anyway, there were massive fights. According to Fetterman, “In December 2023, Adam Jentleson took action that jeopardized the privacy/sanctity of my confidential medical records. I subsequently directed my doctors to sever any access Adam could have to my medical information.”

In May 2024, Jentleson decided it would be best to lay everything out there. “I wanted to do what I could think of to try and get him help,” he said. “That’s why I sent the letter.” He also said he worried that Fetterman could end up inadvertently hurting someone else. “He engages in risky behavior,” he wrote in the letter. “He drives recklessly: he FaceTimes, texts and reads entire news articles while driving — and I don’t mean while stopped at a light or something, he reads and FaceTimes while driving at high speeds.”

Less than a month later, Fetterman caught a red-eye flight back from Los Angeles after taping an episode of Bill Maher’s show. His staff urged him to have someone pick him up from the airport and drive him home, but he refused. Just before 8 a.m., according to a police report, Fetterman was traveling at “well over” the 70-mph speed limit on I-70 when he smashed his Chevy Traverse into the back of a 62-year-old woman’s Impala, totaling both cars. Gisele, who had been in the back seat, suffered a pulmonary contusion and spinal fractures. Fetterman, calling from the side of the road, told a staffer he had fallen asleep at the wheel and handed the phone to a police officer.

“It’s a miracle no one died,” the officer said.

After Donald Trump won the election, Fetterman did something no other Democratic senator dared to do: He went to Mar-a-Lago. “I didn’t bend any knee; they reached out and invited me,” Fetterman told me. “And if you’re a senator from a critical state and the president would like to have a conversation, that’s part of our responsibility.” Gisele, however, wasn’t so keen on traveling with him. “It was a whole saga,” said a former staffer. “She wasn’t going to go, and they had fights about it.” To convince her, Fetterman told her to think of this as an opportunity to showcase what a model Dreamer looked like in an effort to get the president-elect to soften his views on illegal immigration. If she didn’t go, Fetterman said, she’d lose the right to complain about whatever he did as president. “He said in a small group with senior staff, ‘I told her to put up or shut up,’” the staffer recalled. “‘If she doesn’t go, I don’t want to hear about it.’”

Fetterman described the interaction slightly differently. “It’s not so much convincing her,” he told me. “It’s the upside.”

Ultimately, Gisele did go, and by all accounts the meeting went smoothly. According to Fetterman, the conversation lasted about 75 minutes and the president was charming, “fully engaged,” and different from the persona you may see on television. “His faculties haven’t slipped at all,” Fetterman told me. “It’s not that I admire it — I acknowledge it, and if you don’t, you do it at your own peril politically.”

While many Democrats were shell-shocked by Trump’s victory, Fetterman seemed unfazed. He understood the Trump phenomenon better than most of his party and, having won a state that went for Trump in 2024, shared more voters with him, too. And so it made sense, in his mind, that he could find ways to work with the incoming president. The Mar-a-Lago pilgrimage was a start, but Fetterman went further. He was the only Democrat to vote for Trump’s pick for attorney general, Pam Bondi. He posed for a thumbs-up photo with Elise Stefanik, then the nominee for U.S. ambassador to the United Nations. And he came close to supporting Pete Hegseth, the nominee for secretary of Defense who had been dogged by reports of excessive drinking, financial mismanagement, and sexual misconduct.

“We are going to have massive issues internally when he votes for Hegseth,” a staffer texted in mid-January. Fetterman had been the only Democrat to meet with Hegseth late last year as the former Fox News host made the rounds on Capitol Hill trying to earn Senate support for his confirmation. Fetterman had left his meeting with Hegseth unimpressed, according to former staff, but as the decision neared, it seemed like he might actually vote for him. It would be a bad look, he told staff, if all the Democrats turned their backs on the person who would be leading the armed forces. It would make them appear weak and partisan.

Fetterman became so torn by the decision that, on the day of a procedural vote that would move Hegseth’s nomination closer to completion, he floated the idea of not voting at all. “What if I left?” he asked his staff. Instead of voting, he said, maybe he should just sneak out of Washington and hole up at his parents’ place in York, Pennsylvania. “I felt like I was looking at a six-eight 8-year-old,” the staffer said.

The back-and-forth led to what one person in his office at the time called a full-blown meltdown. According to a contemporaneous text message from this staffer sent to a colleague, Fetterman had become so distraught about the Hegseth vote, as well as chatter in the media that he might switch parties and become a Republican, that he spent part of the day locked in his office, fighting with Gisele and crying while FaceTiming with staff. “He says that they are trying to cancel him again but we don’t know who ‘they’ are,” a staffer said in a text. Fetterman ultimately voted against Hegseth’s nomination. In a statement, Fetterman said, “My no vote on Pete Hegseth speaks for itself. The rest is pure conjecture.”

Fetterman’s struggles seemed to be occurring in a vacuum of his own making. He was friends with Welch of Vermont and Republican senator Katie Britt of Alabama. The three of them dined on occasion and swapped stories about their families. But beyond that, he was isolated. He deleted himself from the Democratic-caucus group chat. He rarely, if ever, attended hearings. During the first quarter of this year he missed more votes than any other senator.

In my conversations with various Democratic Senate staffers, the view of Fetterman essentially boiled down to: He can be difficult to work with, but we’re lucky to have him in the Senate. In recent months, Senators Patty Murray of Washington and Jeanne Shaheen of New Hampshire had what staff referred to as verbal altercations with Fetterman. But, like former senator Joe Manchin, Fetterman provides a mostly reliable vote from an unreliable state. He has what baseball statisticians might refer to as a high WAR (wins above replacement).

“One of the biggest challenges we have is to get trust from working-class Americans,” Welch said. “And I think John has a unique ability and sensibility to connect and be trusted.” Welch said he thinks Fetterman is doing well emotionally and appears to be “quite engaged with the job.” When asked if she had observed Fetterman struggling, Britt told me, “Not at all.”

Still, some of Fetterman’s behavior was leaking out into public. Last year, the Sunrise Movement posted a video of Fetterman mocking and filming one of his constituents, a climate activist who was calmly trying to ask him about his stance on pipelines. Earlier this year, a passenger on a flight to Pittsburgh filmed a video of Fetterman getting into an argument with the pilot about wearing his seat belt in a way that was visible to the crew. “If you want to go to Pittsburgh, it’s simple,” the pilot explains. “You’re going to have to follow our instructions or be asked to get off the airplane.”

Moments like these were becoming increasingly difficult for staff to explain. And behind the scenes, things were worse. In March, Fetterman suddenly took an early-morning trip to Hartford, Connecticut, without telling his team why — leaving them at a loss for what to tell Gisele when she demanded to know why he was missing one of their kids’ birthdays. Fetterman objected to this characterization, saying to me, “I took a weekend trip in March to visit the grave site of my friend from grad school who died in 1993 — a trip my staff and family knew about.”

When he was in Washington, there were entire days in which his schedule was cleared because he seemed like he was in no mood to be around others. And when he did have meetings, they sometimes went south. In early February, Fetterman met with Jeremy Ben-Ami, the leader of the progressive Jewish organization J Street. Over the course of Israel’s campaign against Gaza, J Street has walked a difficult line, calling itself “pro-peace” and “pro-Israel,” a Zionist institution that isn’t afraid to take shots at Prime Minister Benjamin Netanyahu. The organization lives in a gray area, but during the meeting, it became clear that Fetterman saw things in black and white.

“You can’t reform a carton of sour milk,” Fetterman told Ben-Ami, according to notes from the meeting, referring to the Palestinians. Fetterman said he did not believe in a two-state solution and claimed he had never met an Arab person who would condemn Hamas. “Correction,” the notes from the meeting stated. “Only a single Arab he has met with that staff was present for wouldn’t outright condemn Hamas.”

Fetterman went on to make statements that shocked people. In opposing a cease-fire, he said, “Let’s get back to killing.” A person who heard the conversation told me, “He said, ‘Kill them all.’” In a statement, Fetterman denied the account, adding, “Any reference to killing was solely about Hamas, and I do support the destruction of that organization, down to its last member.”

When I met with Fetterman in mid-April, it was the first time I had interviewed him since we drove around western Pennsylvania in 2018. The lobby of his Capitol Hill office contains a wall covered by red posters commemorating the Israelis who have been held hostage by Hamas since the October 7 attack, the word KIDNAPPED appearing atop each one. In his personal office, Fetterman sat with his legs spread wide in a leather chair. He wore his customary Carhartt hoodie but no shoes, occasionally scratching at his feet through his socks. He looked a bit like a ’90s-sitcom husband lounging comfortably in his man cave. Fetterman’s staff, past and present, had cautioned me that there are good days and bad days. I was told this was a good day.

Years after the stroke, Fetterman continues to struggle with auditory processing. To chat with me, he had put an iPhone on the table that transcribed my questions to him in real time. Sometimes Fetterman wouldn’t finish reading a question before answering, and other times his sentences could come out a bit garbled. After a podcast taping earlier this year with The Bulwark, the interviewer Tim Miller came away feeling like Fetterman might not be all there. “He’s struggling,” Miller said in a separate podcast taping. “He’s, like, really struggling. And I just think coming off of the Biden thing, we should not be hiding the ball on this sort of stuff.”

But in my conversation with Fetterman, I didn’t find any indication that the stroke had left him cognitively impaired. Our interview lasted just over an hour, during the first half of which he seemed excited to discuss just about anything I threw at him. He had problems with the way Democrats had estranged themselves from the public, he said, but still had no intention of leaving the party to become a Republican or even an independent: “Same chance I’m going to end up with a beautiful head of hair.”

We talked about family, about the toll a life in the public eye can put on them (“It’s shitty,” he said), about Gisele’s hatred for politics (“It’s only intensified”), and about how near-death experiences can bring loved ones together (“I’ll never miss an opportunity to have dinner with him and talk to him now,” Fetterman said about his father, who had suffered a heart attack that nearly killed him).

As for Fetterman’s own health, he said it was better than ever. A day earlier, he had published an op-ed in the New York Times about his experience with the anti-obesity medication Mounjaro, which he said helped save his life. And it wasn’t just his physical health. “For someone that suffered from depression — to me it’s just bright,” he said. “It feels crisp, and not on anything, I just feel like my best version.”

Feels crisp and not on anything. This seemed as good an opening as any to ask him the hard questions about his mental health. “It’s been two years since Walter Reed,” I began. “I know mental health is a lifetime struggle.”

“I wouldn’t even describe it as a lifelong one,” he said, cutting me off. He explained that before his stroke he wasn’t “joy, joy, joy” all the time but that the actual mental-health break only happened after “everything kind of collided at the same time.”

“Do you ever worry about slipping?” I asked.

“No, no, no,” he said. “It’s freeing … And really appreciate things that I would never have been able to do if I never recovered from that stroke.”

“I’ve talked to a number of former staffers of yours who say they are worried about you,” I said. “Who say that they are worried that you are not on your recovery plan. That you might not be taking your meds. That they’ve heard you make comments about how you didn’t need them anymore or that you didn’t like the way they made you feel. Do you care to comment on that?”

“No, I won’t,” he said, his eyes casting between his feet and the two press staffers sitting at a back table. He said that no one in his staff would know about his personal health situation and that anyone who told me otherwise was simply misinformed. “There’s not really anything to respond when that’s just not accurate,” he said.

“What they say,” I pressed on, “is that they’ve witnessed ups and downs that could be associated with kind of a relapse. And they also worry that the medication that you’re on is not just for depression, but more serious drugs that if you’re not on them would be a problem. Is there truth to that?”

“I don’t have any comment on that,” he said. “I’m going to go off record. Go off record. Go off record.”

I cannot report what Fetterman said over the course of the next four minutes, but I can say that after he was done talking, I found myself in the hallway outside his office making awkward small talk with one of his press aides. Five minutes later, the door opened and I was ushered back in. The office felt different now. Quiet and tense. Fetterman was still in the same chair but slumped into himself, like a deflated parade float. His shoes were now on, and he avoided looking at me. Finally, I broke the silence. “Anything to say about that?” I asked, hoping to pick up our conversation where we had left off.

“There’s not anyone that you’re referencing who would be privy to my medical history,” he said.

“Do you care to comment whether they are right or wrong?” I asked.

“I’m just going to say that it’s disgruntled employees saying things that are either untrue or, so, that’s kind of the business that we are in,” he said.

I asked him why these staffers might be disgruntled.

“For whatever reason,” he said. “There’s a lot of people who just hide behind unnamed sources in articles.”

I tried to move the conversation to Trump’s tariffs and other issues before leaving, but it was plainly clear that his mind was elsewhere. His voice was low. He barely bothered to look up. His sentences were clipped. “I feel like there’s been kind of a tone shift here,” I said, trying to catch his eye. “Can you tell me what you’re feeling? What you’re thinking?”

For the first time since I had returned to his office, he looked right at me. “No, everything’s great,” he said, deadpan. “Everything’s great. I don’t know what you’re referencing.”

Thank you for subscribing and supporting our journalism. If you prefer to read in print, you can also find this article in the May 5, 2025, issue of New York Magazine. Want more stories like this one? Subscribe now to support our journalism and get unlimited access to our coverage. If you prefer to read in print, you can also find this article in the May 5, 2025, issue of New York Magazine.