Cloistered at Walter Reed, Fetterman Runs His Senate Operation From Afar 

WASHINGTON — In a cheerfully decorated common room at the Walter Reed National Military Medical Center, with floral paintings adorning violet walls, Senator John Fetterman of Pennsylvania begins most days meeting with his chief of staff, who arrives at around 10 a.m. carrying a briefcase full of newspaper clips, statements for him to approve, legislation to review and other business of the day.

The contents of that briefcase encompass the majority of Mr. Fetterman’s connection to the outside world these days, as the first-term Democrat from Pennsylvania finishes his third week in the hospital being treated for severe clinical depression.

Doctors caring for him have said Mr. Fetterman should limit his exposure to cable television, the internet and social media — a major information detox for someone whose obsession, and occupation, is politics.

Mr. Fetterman, 53, rushed back to the campaign trail last year after suffering a life-threatening stroke days before the Democratic primary, a decision that those close to him believe may have taken a long-term toll on his recovery. This time, he is set on taking his time in treatment, with the hope of returning to work within the next few weeks.

After being sworn in to office in January, Mr. Fetterman struggled to adjust to life in Washington, where the lingering effects of his stroke made the transition exceedingly difficult. He was hospitalized briefly last month following an episode of lightheadedness, and then voluntarily admitted himself for psychiatric treatment, revealing to the world his depression diagnosis.

“We were honest with people about what’s going on, we put it out there,” said Adam Jentleson, his chief of staff. “The attacks will be what they’re going to be, but the attacks aren’t going to be any worse if he was in a few extra weeks. The main thing is for him to come out and not have to go back.”

That means that for now, Mr. Fetterman is spending his days not at the Capitol but 12 miles northwest at the sprawling Walter Reed campus, where he takes long walks on the trails and participates in talk therapy sessions. His doctors are continuing to monitor the dosages of his medications.

Mr. Fetterman often spends his afternoons and evenings with visiting family members — his parents and his brothers often come to the hospital and stay until dinner time. At least once a week, his wife Gisele visits from Braddock, Pa. There are no limits on how long his visitors can stay, or when they are allowed in. His small circle has been mostly limited to two staff aides and his family.

When Mr. Fetterman checked himself into the hospital on Feb. 15, the lead doctor told him that his case was treatable and guaranteed he would get back to his old self. Post-stroke depression, doctors said, affects one in three people and can be very serious, but is also highly treatable.

Yet his absence from the Senate has caught the attention of detractors who have publicly questioned Mr. Fetterman’s condition and suggested that his diagnosis renders him unfit to serve.

After his top aide tweeted pictures of Mr. Fetterman working from the common room this week, several people posted responses claiming with no evidence that the photographs were staged and that Mr. Fetterman was incapacitated. It is the type of discourse that his doctors and staff aides prefer that the senator not see.

The strict regimen may be working. People around Mr. Fetterman said they have noticed a palpable difference in him in recent days: His sense of humor has returned and he is more sociable, sharing with the nurses some of the sweets that have been sent to him by fellow senators.

As Mr. Fetterman continues his recovery, his staff is marching on in his absence, operating out of a dreary, windowless suite of offices in the basement of the Dirksen Senate Office Building, a typical work space for a freshman senator in an institution that runs on seniority.

Since Mr. Fetterman checked in to the hospital, he has co-sponsored a bipartisan bill designed to help prevent future train derailment disasters, opened new district offices across Pennsylvania and hired four new staff members. On Wednesday, Mr. Fetterman sent a letter to the agriculture secretary, pressing the administration to deploy resources to the site of the train derailment in East Palestine, Ohio, to help farmers concerned about chemical release threatening the viability of their farms and livestock. East Palestine is near the Pennsylvania border.

Meetings with constituent groups have continued as usual, albeit without the traditional few minutes of glad-handing by the senator at the end. But in the Senate, a staff-run institution even in the best of times, that is hardly atypical.

It is not unusual for lawmakers to be told by members of their staff, sometimes after the fact, what bills they are co-sponsoring. With the exception of calls to cabinet officials or meetings with the chief executives of companies that are important to their states, there are few meetings that cannot be handled by senior staff.

“Any lobbyist will tell you that if you get as high as the chief of staff, and that chief makes a promise to you that the senator will do something, that will be accepted,” said Ross Baker, professor of political science at Rutgers University and a former aide to Senator Harry Reid, Democrat of Nevada. “It will be as if the senator himself gave the OK.”

Mr. Baker added that even with a senator sidelined, “a Senate office, particularly under an experienced chief of staff, would run pretty much in a normal way.”

There are downsides to not being physically present. Mr. Fetterman can’t vote and on Thursday he will miss hearing the chief executive of Norfolk Southern, the company whose train derailed in East Palestine, testify before the Senate Environment and Public Works Committee. Instead of being able to question him directly, Mr. Fetterman plans to submit a written statement.

“If the rail safety bill were to come to the floor while he’s out, his physical presence would be helpful in whipping votes,” Mr. Jentleson said. But with Republicans balking at supporting a measure that would increase regulations, that situation is unlikely.

For many doing business with Mr. Fetterman’s office, the senator’s health is irrelevant. On Tuesday afternoon, a representative from Temple University sat down with senior members of Mr. Fetterman’s staff to talk about the issue of gun violence in north Philadelphia and concerns over the university’s shrinking enrollment, requesting congressionally directed spending. The issue of Mr. Fetterman’s health never came up.

Still, some of Mr. Fetterman’s colleagues are keenly aware of his condition and have tried to help bridge the gap while he’s away.

Senator Bob Casey, Democrat of Pennsylvania, and Senator Tina Smith, Democrat of Minnesota, have both come by his office to talk to members of his staff and offer their support. Ms. Smith sent out a fund-raising email on Wednesday on Mr. Fetterman’s behalf, describing her own struggles with depression that left her unable to “feel joy or love or contentment.” Her plea, which underscored the courage it takes to seek help, included directions for reaching the Suicide and Crisis Lifeline.

At the office, the senator’s aides joke that they are all gaining the “Fetterman 15” because of the constant flow of cookies, doughnuts and breakfasts being sent over from other Senate offices.

The jokes reflect a sense of optimism about Mr. Fetterman’s condition and a hope that his absence is only temporary.

When Mr. Jentleson recently showed up at Walter Reed on a weekend dressed in a plaid shirt, a beanie and boots, Mr. Fetterman took one look at him and commented, “I didn’t know you were a farmer.”

The teasing was a glimmer of the personality and sense of humor that have been all but dormant for the past few months, but are now resurfacing as he recovers.

“No one in the Senate has seen him being himself,” Mr. Jentleson said. “That person is going to be a force of nature as a senator.”