The race for one of Pennsylvania’s Senate seats is shaping up as one of the strangest in recent memory. Polls show Lieutenant Governor John Fetterman — 6 foot 8, tattooed, with a scraggly goatee and left wing politics —  leading Mehmet Oz by a healthy margin, despite the former’s convalescence from a stroke that has at times entirely precluded Mr. Fetterman’s ability to campaign.

The contest for the seat being vacated by Senator Toomey, a Republican who is retiring, is being closely watched nationwide as Democrats endeavor to hold onto the upper chamber in the midterm elections. Dr. Oz, who beat hedge funder David McCormick by less than 1,000 votes in the Republican primary, is backed by President Trump, who will campaign for him next week.   

Mr. Fetterman’s health has become a central issue in the race. After a video of Dr. Oz shopping for crudité for his wife went viral — Mr. Fetterman said it’s called “a veggie plate” — the Republican’s senior communications staffer, Rachel Tripp, opined: “If John Fetterman had ever eaten a vegetable in his life, then maybe he wouldn’t have had a major stroke.”

That comment prompted outrage from Mr. Fetterman, who tweeted, “I had a stroke. I survived it. I’m truly so grateful to still be here today. I know politics can be nasty, but even then, I could *never* imagine ridiculing someone for their health challenges.”

Ms. Tripp fired back that “Dr. Oz has been urging people to eat more veggies for years. That’s not ridicule. It’s good health advice. We’re only trying to help.” Thus far, Mr. Fetterman has raised more than $500,000 off of Dr. Oz’s ill-fated grocery store excursion. 

Mr. Fetterman’s health challenges have been so severe that he acknowledged, “I almost died.” He won the Democratic primary days after his stroke and concurrently with a procedure to implant a pacemaker and defibrillator. His cardiologist, Ramesh Chandra, has diagnosed him with cardiomyopathy, which the Mayo Clinic defines as “a disease of the heart muscle that makes it harder for the heart to pump blood to the rest of the body.”   

To bolster his case, Mr. Fetterman released a letter from 100 Pennsylvania doctors who castigated Dr. Oz, a fellow physician, for exploiting “the hopes and fears of his viewers by promoting unproven, ill-advised, and at times potentially dangerous treatments.” 

Now that Mr. Fetterman is back on the campaign trail, questions about his ability to serve in the office to which he aspires have only intensified following footage of him speaking this week at the international headquarters of the United Steelworkers at Pittsburgh, on the heels of an address at Erie.

In those appearances at the rostrum, Mr. Fetterman has been halting and at times struggled to speak. A Pittsburgh radio station, WESA 95.5, reports that at Erie “his delivery was at times stilted and lacked some of the forcefulness that often characterized his appearances before the primary election in May.”

In response to his heart trouble, Mr. Fetterman’s campaign appears to be pioneering a different form of campaigning, one native to meme culture. It is focused on virality with the end of portraying Dr. Oz as a carpetbagging New Jerseyan in contrast to the indigenously Pennsylvanian Mr. Fetterman, who once served as the mayor of the small and hardscrabble town of Braddock.       

To that end, Mr. Fetterman has paid reality television personality Nicole “Snooki” Polizzi to muse on Dr. Oz’s Garden State roots, and contracted with an airplane to buzz over the Jersey Shore with a banner that read, “HEY DR. OZ, WELCOME HOME TO NJ! ♥ JOHN.” He has hammered away at the one-time television host’s multiple homes.

While Mr. Fetterman was laid low by his stroke, Dr. Oz released a “John Fetterman Basement Tracker.” His communications director, Brittney Yanick, insisted it’s “time” Mr. Fetterman “starts answering for his crazy views on things like sanctuary cities, releasing one-third of Pennsylvania’s prison population, the Green New Deal, and trillions in wasteful spending.”