After April’s Congressional recess and six weeks on medical leave for depression and an array of mental health issues, Pennsylvania Senator John Fetterman has completed his first full week back in the chamber. 

Fetterman has had an outpouring of support from both sides of the aisle during his treatment. 

Minnesota Democratic Senator Tina Smith, Pennsylvania Democratic Senator Bob Casey and Alabama Republican Katie Britt paid visits to his treatment room at Walter Reed National Military Medical Center. 

In the past month and a half, Fetterman’s struggles have brought mental health in politics to the forefront, and his experience has helped other members of Congress to realize the gravity of his situation. 

While many members of Congress have worked around disabilities in the past, Fetterman’s current condition presents a unique challenge for the daily tasks of a senator. 

Dan Crenshaw, former Navy SEAL and current representative from Texas, wears an eyepatch on the floor as a result of losing an eye during combat in Afghanistan. Bob Dole, Republican Senate Majority leader in the mid 80s and later in the mid 90s, learned to write with his left hand because of a damaged right arm from World War II. Illinois Senator Tammy Duckworth, who lost both legs while deployed in Iraq in 2004, has shown she belongs, too. In fact, according to the Center for Effective Lawmaking, Duckworth’s “Legislative Effectiveness Score” was the 11th highest out of the 48 total Democrats in the Senate.

However, no Senator has ever had to return to the floor after enduring a severe stroke in the aftermath of a highly publicized Senate race. Fetterman has acknowledged that the tense race between him and Republican Dr. Oz further exacerbated his depression and has contributed to his unstable start to his term as Senator. 

Skeptics rightly doubt whether he can effectively fulfill his role, and they have a long list of compelling concerns. 

Since his stroke, Fetterman has suffered from increasingly poor hearing. According to the Philadelphia Inquirer, Fetterman has been walking around the Capitol with an aide carrying an iPad that transcribes conversations to help add further communicative transparency beyond the capability of his hearing aids alone. 

Still, his hearing loss prevents him from participating in Senate meetings and conversations with the same speed and mental processing as a healthy person, and the transcription software leads to even more hesitation and delays. 

Given the highly impromptu nature of a day in the Senate and the frequent, spontaneous conversations that are viewed as essential to the job, this assistance will continue to inhibit his ability to debate legislation connect with other members of progress, but so far, he has been very persistent in making an effort with transcription technology. His office includes large monitors that display transcripts of conversations during meetings. 

What is more problematic is Fetterman’s ongoing slurred speech. This past week, he led a hearing in the Senate Agriculture Committee’s Subcommittee on Food and Nutrition, Specialty Crops, Organics and Research. 

He struggled to get through his opening remarks, including a discussion of SNAP Employment and Training, a federal program offering employment training, transportation, childcare and other basic necessities. 

Republicans have questioned Fetterman’s suggestion to increase funding to this program, a part of a larger farm bill, and Fetterman’s stumbling propositions certainly didn’t have a positive effect on the opposing point of view. 

The ability to communicate clearly is essential in the Senate, and given that most neurological improvement is not likely to keep getting better after a year’s time, Fetterman’s path looking forward is grim. 

Nonetheless, the Philadelphia Inquirer stressed Fetterman’s work ethic to best fulfill his duty, reporting the remarks of Fetterman’s Chief of Staff Adam Jentelson.

“[Fetterman] wants to be accessible and wants to answer questions and with a little trial and error, we’ll figure out a system,” Jentelson said. “He’s not gonna be hiding.” 

Indeed, Fetterman’s accomplishments in his return have been admirable and are without doubt an important step forward for the Senate’s often stigmatizing view of members with mental health issues. 

Even still, his ongoing challenges will clearly hamper his effectiveness as a legislator in the remainder of his six-year term. 

Questions remain prevalent about whether or not the senator will be able to fully participate in congressional subcommittees that align with his political priorities. In an interview with NPR, Fetterman has admitted he is “not the kind of senator” Pennsylvania deserves. 

The months ahead will be busy for Fetterman and the Senate, with no prolonged recess until a 30-day break in August. Fetterman will have to continue to adapt quickly and work around a professional environment that has presented enormous challenges to his condition. 

As it is, Fetterman is not in position to be an effective politician, and the costs of his incompetence could be devastating for Pennsylvania and beyond.