PHILADELPHIA (KYW Newsradio) — There’s been a lot of hand-wringing over Pennsylvania U.S. Senate candidate John Fetterman’s fitness for office following his debate with Republican opponent Mehmet Oz last month.
Fetterman has auditory processing disorder as a result of his stroke in May, which he suffered days before the Democratic primary. During the debate on Oct. 25, he struggled to complete sentences and stumbled over words, as he warned he would.
Some voters — and certainly his opponents — have concluded that this is a sign of cognitive issues, but Jefferson Health neurologist Dr. Pascal Jabbour said that’s not actually the case.
Jabbour, who leads the neurovascular division at Thomas Jefferson University Hospital, said auditory processing disorder, also known as aphasia, is caused by damage to the part of the brain that controls language and expression.
“It is very frustrating for the patient because those patients have all their mental abilities. They don’t have any cognitive problems. They have everything in their head, but they have trouble expressing themselves, forming words,” he explained. “They have trouble interpreting what they are hearing, but … the cognition is there. So the patient can think clearly, but it’s the communication ability that’s affected.”
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Many of Fetterman’s adversaries point to a moment in the debate when he was asked about fracking. He stumbled in his response: “I do support fracking. And I don’t, I don’t, I support fracking.”
Some people have interpreted the flub to mean that there’s some kind of a cognitive problem and that he doesn’t have a grasp of the issues.
“This is typical expressive aphasia,” Jabbour continued. “They can repeat themselves and they can seem to be confused, but in reality, they are not. It’s their way. So their ideas are clear in their head, but they are having a problem expressing the idea.”
Jabbour said he can understand how people who don’t have a medical background could misinterpret what they’re seeing as confusion. But, he said, it’s an interruption of the communication skills, not of the thinking skills. And, he said the stress of the debate likely made Fetterman’s auditory processing problems much more acute.
As for the idea that Fetterman needs to be at home recovering and not on the campaign trail, Jabbour said it’s actually important for stroke patients to go back to normal life as quickly as possible.
“We always encourage the patient to go back to doing what they like to do,” he said. “Go back to their hobbies, try to interact with the people within society. … I would never tell a stroke patient, ‘Oh, go stay home, you need to focus on your recovery,’ because recovery is practically doing what you like to do.
“If you’re having trouble walking, you need to walk more. If you’re having trouble speaking, you need to try to speak more and interact more.”
The disorder is treated with speech therapy. Jabbour said most people who have had a small stroke like Fetterman’s will continue to see improvement between a year and a year and a half after the medical incident.
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