Five months after a stroke nearly took his life, Lt. Gov. John Fetterman, the Democratic nominee for Senate in Pennsylvania, clashed with Dr. Mehmet Oz on Tuesday in their one and only debate, disagreeing sharply over abortion, the economy and other partisan issues as Mr. Fetterman tried to assure voters of his fitness to serve.
Standing at red and blue lecterns in a television studio in Harrisburg, Pa., the two men could scarcely conceal their disdain for each other, or the scope of their disagreements. Dr. Oz returned repeatedly to the issue of crime while trying to position himself as a centrist candidate. Mr. Fetterman slashed Dr. Oz as a wealthy outsider unfamiliar with the economic struggles of Pennsylvanians.
The spectacle of the debate itself took on uncommon significance because of Mr. Fetterman’s stroke and the pace of his recovery. Mr. Fetterman sought to address the issue at the very start. “Let’s also talk about the elephant in the room: I had a stroke,” he said in his opening remarks, adding of his opponent, “He’ll never let me forget that.”
The debate was held under unusual conditions. Situated above the moderators were two 70-inch monitors to show the text of what was being said in close to real time — for both questions and answers. Professional typists were on hand to try to transcribe the debate as part of an agreed-upon accommodation for Mr. Fetterman, who has publicly discussed his lingering auditory processing issues after the stroke.
Mr. Fetterman’s words were frequently halting, and it was apparent when he was delayed in either reading or reaching for a phrase or word. But he was also fluent enough over the course of the hour to present his Democratic vision for a state that could determine control of the Senate.
Dr. Oz, the Republican nominee and a former television personality, displayed a sharpness and comfort honed by years in front of the camera. And from the opening minutes, he seized the chance to tack to the political center, casting himself as a problem-fixing surgeon and labeling Mr. Fetterman repeatedly as a radical.
“Washington keeps getting it wrong with extreme positions: I want to bring civility, balance,” said Dr. Oz, who won the Republican primary largely on the strength of an endorsement from former President Donald J. Trump.
In the primary, Dr. Oz fully embraced Mr. Trump’s “Make America Great Again” platform. But he has revised his pitch for the general election, saying he wanted “Washington to be civil again” and to be the “candidate for change.” He did say he would support Mr. Trump again in 2024.
Mr. Fetterman pounded Dr. Oz as an out-of-state phony with 10 homes. Dr. Oz criticized Mr. Fetterman as a soft-on-crime liberal who lived off his parents into his 40s.
“He’s on TV and he’s lying,” Mr. Fetterman said at one point. He repeatedly called that the “Oz rule.”
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“John Fetterman thinks the minimum wage is his weekly allowance from his parents,” Dr. Oz said at another point.
At least once, Dr. Oz seemed to condescend about Mr. Fetterman’s auditory issues. “Obviously I wasn’t clear enough for you to understand this,” he said.
Mr. Fetterman was able to reel off some made-for-TV one-liners, though he had difficulty going into greater depth over the course of full one-minute answers.
In defending his record on crime, Mr. Fetterman invoked his time as mayor of Braddock, a small town outside Pittsburgh: “I was able to stop gun violence for five and a half years as mayor — ever accomplished before since my time as mayor because I’m the only person on this stage right now that is — can successful about pushing back against gun violence and being the community more safe.”
Republicans quickly clipped and posted a verbal flub of Mr. Fetterman saying, “I do not believe in supporting the Supreme Court,” as he spoke about his opposition to court expansion.
Pennsylvania, one of the central battlegrounds for control of the Senate, is increasingly seen as a potential tipping-point state. On Tuesday, the leading Senate Republican super PAC announced it was adding $6 million to its television reservations in the state. The top Democratic super PAC had put a further $5 million into the state last week.
“We believe if we win Pennsylvania, we win the majority,” said Steven Law, who leads the Republican super PAC, the Senate Leadership Fund.
The evening unfolded with an intensity befitting the stakes.
Some of the most pointed exchanges came over abortion, which has featured prominently in Democratic advertising.
Dr. Oz said that there should be no role for the federal government on the issue but that he was open to state-level restrictions. He even tried awkwardly to come up with a new phrase to describe having state governments determine abortion rights, saying that he wanted the decision left to “women, doctors, local political leaders.”
Mr. Fetterman later interrupted to link Dr. Oz to the Republican nominee for governor, Doug Mastriano, who is trailing significantly in most polls and who has spoken about banning abortion beginning at six weeks with no exceptions. “You roll with Doug Mastriano!” Mr. Fetterman said.
The Democrat said he supported the framework of Roe v. Wade, as Dr. Oz pressed him for details about any limits he would impose on late-term pregnancies.
A blitz of commercials this fall about crime has helped Dr. Oz shrink what had been a summer lead in the polls for Mr. Fetterman. On Tuesday, crime was the first specific issue that Dr. Oz raised, and the final one he included in his closing remarks.
“I’ve talked to families who won’t let their kids go outside because of the crime wave that’s been facilitated by left, radical policies like the ones John Fetterman has been advocating for,” the Republican said.
Mr. Fetterman replied, “I run on my record on crime.”
For much of the evening, Dr. Oz was on the offensive, though he appeared less comfortable when it came to questions of how he has profited in the past from the sale and promotion of unproven medical treatments through his daytime TV show.
“The show did very well because it provided high-quality information that empowered people,” Dr. Oz said. When the moderator followed up to ask about his own profits, Dr. Oz did not answer directly, saying advertisers were entitled to run commercials during his show.
“I never sold weight-loss products as described in those commercials,” he declared. “It’s a television show like this is a television show.”
The two men also clashed over immigration.
“Pennsylvania is already a border state,” Dr. Oz said, accusing Mr. Fetterman, who has pushed for the legalization of marijuana, of wanting to legalize even more drugs.
Mr. Fetterman responded that Dr. Oz was affiliated with a company that was once fined for hiring people who were in the country illegally. “I believe that a secure border is — can be compatible with compassion,” Mr. Fetterman said.
Another key issue in Pennsylvania is fracking, the extraction of the state’s abundant natural gas from deep in the ground. Mr. Fetterman was once opposed to the practice, but supports it now. But when Mr. Fetterman was confronted with his past opposition, he struggled to answer. “I’ve always supported fracking,” he insisted.
It was not always clear a debate would happen.
The Oz team had needled Mr. Fetterman over the summer for failing to commit to any debates, but seemed to face some backlash for the focus on his health. The Fetterman campaign eventually agreed to the single debate late in October, trying to give the lieutenant governor as long as possible to recover.
Mr. Fetterman had the stroke on the Friday before the May primary election, though he waited until that Sunday to disclose it. On Primary Day, he had a pacemaker and defibrillator implanted. His campaign initially offered few details about his condition, saying in early June that he also had a serious heart condition called cardiomyopathy.
Mr. Fetterman stayed off the campaign trail until mid-August. He has since ramped up his activity, regularly holding rallies and giving television interviews. Before the debate, he released a letter from his primary care doctor that said he had “no work restrictions and can work full duty in public office.”
Mr. Fetterman was pressed by the moderators to release his full medical records. He declined. “To me, for transparency is about showing up,” he said.
Katie Glueck and Trip Gabriel contributed reporting.