HARRISBURG, Pa. — After getting their first long look at John Fetterman in Tuesday night’s Pennsylvania Senate debate, fellow Democrats are second-guessing his decision to appear on stage five months after a stroke — and some question whether he should have remained on the ballot at all.

“He should not have debated. Anyone on his team who agreed to a debate should be fired, or never work again, because that debate may have tanked his campaign,” said Chris Kofinis, a veteran Democratic campaign strategist. “This race was trending toward victory. Now, it’s anyone’s guess what happens.”

Several Democrats who spoke to NBC News, some on the condition of anonymity, said they were shocked by the degree to which Fetterman struggled to communicate clearly, even though he has acknowledged ongoing difficulty in processing what he hears and speaking without dropping words.

Oz himself seemed to poke at Fetterman’s struggles on the debate stage, wondering aloud at one point if he “wasn’t clear enough” for his opponent to “understand” him. Fetterman’s allies have accused critics of boosting “ableist” rhetoric about the candidate, insisting that he is moving along in his recovery just fine and noting that two current Democratic senators have recovered from recent strokes with little concern about their ability to perform the job.

But by Wednesday morning, many Democrats were in a panic over his performance. And there were fresh questions about how transparent Fetterman has been through a months-long recovery that continues to present communication challenges less than two weeks before Election Day.

“Folks are pretty much freaking out on the Dem side,” Khari Mosley, a Pittsburgh-based Democratic consultant and grassroots activist, said via text message. “I think there was false hope he’d thread the needle last night so some wind was taken out of the sails. In many ways that’s the first time many [people] got to see the phenomenon known as John Fetterman, not the best timing for the biggest stage of his life.”

One Democrat who has been in touch with the Fetterman campaign said it erred in not having him do more events and interviews sooner, to better acclimate voters to the challenges he was facing and to make the incremental improvements in his recovery more visible in real time. Fetterman, after spending much of the summer off the campaign trail, began ramping up his activity in the weeks leading up to the debate.

“Their team has been ignoring what tons of strategists and insiders have been saying for months: we’ve expressed our concerns many, many times about being more transparent,” the source said. “It’s OK to have a medical issue — you just have to be transparent about it.”

The alarm is also acute in Democratic circles beyond Pennsylvania.

“It was startling,” said a senior Senate Democratic aide who has worked on political campaigns. “I really question the judgment that he continued with this race.”

But with partisan control of the 50-50 Senate hanging in the balance, Democrats have little choice but to hope that Fetterman’s platform matters more to voters than his performance. He has little room for error: the FiveThirtyEight of recent polls suggests he holds a 2.3 percentage point lead over Republican Mehmet Oz, a margin that has narrowed appreciably since Labor Day.

That puts Democrats in a bind: they don’t want to criticize him because they believe victory is within his grasp. And Fetterman’s campaign, eager to project strength, said Wednesday that it had raised $2 million since the debate ended

“There’s always second-guessing,” Sen. Bob Casey, D-Pa., said on MSNBC Wednesday. “And I know Democrats sometimes invent things to worry about at the end of a campaign. … I think it was the right decision to have both candidates appear together and answer questions.”

But questions about Fetterman’s transparency date back to the primary. His campaign waited two days to disclose his hospitalization after the stroke. Fetterman easily won the Democratic primary days later, and his campaign insisted he would recover and resume regular campaign activity. Early on, Republicans and even some Democrats were critical about the lack of updates from Fetterman’s team. Under pressure, the lieutenant governor released a letter from his cardiologist disclosing a previously unreported heart condition and acknowledged that he “almost died.” The concerns within Fetterman’s own party quieted down after the window for replacing him on the ballot closed this summer.

Still, Fetterman has declined multiple requests from NBC News and other media outlets to release his full medical records. Last week, his campaign put out a letter from his doctor — who is also a campaign contributor — that concluded he is fit to serve in the Senate and said that Fetterman’s main problem was in processing words he heard.

“He spoke intelligently without cognitive deficits,” Dr. Clifford Chen wrote in his evaluation of Fetterman. Chen did not return a call for comment.

Mustafa Rashed, a Democratic consultant from Philadelphia, said he didn’t want to armchair-quarterback the decision to put Fetterman on stage because there would be blowback either way: criticism for his performance or for ducking a debate. But with hindsight’s benefit, Rashed said, he wouldn’t have risked exposing Fetterman’s difficulty communicating.

“It’s easy for me to say this today,” Rashed said. “Ultimately, I don’t think the debate is going to make that much of a difference. It probably didn’t change any minds.”

Brooke Hatfield, associate director for the American Speech-Language-Hearing Association, said Fetterman’s performance should not surprise anyone familiar with stroke recovery, but she stressed that his struggles with words is not indicative of cognitive impairment

“What we see with stroke survivors is the speech and language system is separate from the way we think and our cognitive skills,” she said, noting she has not individually examined Fetterman and so she had to speak in generalities.

Hatfield said people recovering from a stroke can become deeply frustrated because they know what they want to say, but they just have trouble saying it and, she speculated, the high-pressure “format of a live debate intensifies those communication challenges.” 

Fetterman spokesperson Joe Calvello was pressed by reporters in the post-debate spin room about the candidate’s decision to take the stage and his performance on it.

Calvello asserted that Fetterman did “pretty damn well” for someone who was “in a hospital bed just several months ago.” When one reporter asked why they agreed to a rapid-fire format, given Fetterman’s recovery struggles, Calvello replied: “The people of Pennsylvania deserved a debate and we weren’t gonna complain like Dr. Oz did the whole time.”

Fetterman’s campaign sought to reframe the post-debate conversation around abortion, pointing to Oz’s on-stage remark that “women, doctors, [and] local political leaders” should be making decisions regarding whether or not an abortion takes place. Hours after the debate, Fetterman released an ad that seized on Oz’s comment and tied him to GOP gubernatorial candidate Doug Mastriano, who has equated abortion with murder and would be able to sign new abortion restrictions if elected this fall.

“Oz would let politicians like Doug Mastriano ban abortion without exceptions, even in cases of rape, incest or life of the mother,” the narrator says. “Oz is too extreme for Pennsylvania.”

But it’s going to be hard for Fetterman to change the subject to abortion, said Terry Madonna, a longtime Pennsylvania pollster who is now a political science professor in residence at Millersville University.

“Everybody in Pennsylvania this morning has been writing and talking about how he got confused, how he couldn’t complete sentences, how he used wrong words. It was clear he should not have been onstage at the debate,” Madonna said. “The campaign probably thought there would be empathy for him, but the fact of the matter is his performance was obviously very questionable and it’s just dominated the news.”

Madonna said he’s never seen a debate performance this bad, but he said it remains to be seen how it affects the race overall.

Fetterman’s debate performance took some Republicans by surprise, too. David La Torre, who advised Republican Jake Corman’s gubernatorial bid before his primary loss to Mastriano, said one “could easily argue that had [Fetterman] dropped out and Democrats gone with [Rep.] Conor Lamb, that Conor Lamb would win this race.”

Lamb, a Democrat representing a swing district in the Pittsburgh suburbs, finished a distant second to Fetterman in the primary.

“Somewhere along the way, their decision was made to keep pushing through this stroke,” La Torre, who is backing Oz but supporting Democrat Josh Shapiro in the gubernatorial race, said. “And they did a great job hiding him for a long time. I just think they finally ran out of time last night. So much pressure has been put on them for transparency and to do debates. And their polling numbers are slipping. I don’t blame him one bit for doing this debate. I blame them for continuing to have John Fetterman as a candidate.”

Regardless of Fetterman’s condition, he was at a natural disadvantage in a televised debate with a celebrity TV doctor who is comfortable with cameras, said Chris Borick, a pollster with Muhlenberg College in Pennsylvania whose September poll showed Fetterman with a 5-point lead over Oz.

But for all of Oz’s advantages, Fetterman didn’t look ready for the stage, said Borick.

“You would have to ask the question, given his situation, would it have been better to simply say we’re not going to debate this cycle and just take the hits there and not put him out in a very challenging environment for him?" Borick said. "I think, in retrospect, the answer was not to put him out there."

Oz has his own troubles. He has never led Fetterman in a major public poll, and early voting has been under way for weeks — with more than 630,000 Pennsylvanians already having cast ballots. Moreover, Oz has limited ties to a state where he only recently became a resident, and he has dealt with high unfavorability ratings throughout the campaign.

“If nobody had voted early, and this was the old days, I would say Fetterman is pretty much done after last night. But a lot of people have voted already and I’m guessing he banked a big lead already. We’ll know more soon,” said David Palelologos, Suffolk University pollster who is surveying the race next week and conducted one in September that showed Fetterman with a 6 percentage point lead.

Similarly, some Democrats maintained optimism.

“I think this was always a format that was going to be tough for John, but I think the fact that he went and took questions for an hour and had some key moments that were favorable is good,” state Rep. Malcolm Kenyatta, who ran against Fetterman in the Democratic primary, said Wednesday morning.

Kenyatta, echoing the post-debate messaging of the Fetterman campaign, said Oz hurt himself when he said abortion decisions should be made by doctors, women and “local political leaders” elected by their communities. That’s at odds with Fetterman’s position that the government has no place in the doctor’s office.

But another top Pennsylvania Democrat, who believes Fetterman’s debate performance was devastating and requested anonymity to offer candid thoughts on the party’s nominee, fears the race is over.

“If I’m the Democrats,” this person said, “I’m putting my money in Ohio.”

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