John Fetterman has long been on a political island — and now his tendency to rebuff professional relationships is coming back to bite him.

Few fellow Democrats have rushed to Fetterman’s defense after an explosive article in New York magazine reported that current and former staffers are seriously concerned about his mental and physical health. The Pennsylvania senator, who has strongly denied claims that he is unfit to serve, is not doing traditional damage control, and most top Democrats aren’t going out of their way to do it for him.

Instead, private chatter about primary challenges to Fetterman has ramped up. And in recent days, some Pennsylvania Democrats have begun to quietly review the rules about what would happen if he stepped down and whispered about potential replacements. Fetterman has vowed to serve his full term, which ends in 2029.

Even some top Democrats in his state, who would normally be expected to be in contact with their legislative counterpart, aren’t speaking out in support of their party’s only senator.

“I have had no contact or conversation with him, so I have no way of weighing in on that,” said Rep. Chrissy Houlahan (D-Pa.), when asked to comment on the report. She added that “I couldn’t tell you” when she’d last talked to Fetterman.

Rep. Mary Gay Scanlon (D-Pa.) said she hadn’t spoken to Fetterman “recently” and didn’t know the “underlying facts” about Fetterman’s situation, but that the article “obviously raises questions.”

Rep. Summer Lee (D-Pa.), a progressive whose district includes the town where Fetterman lives, said she hadn‘t talked to him recently. Asked about the story, she responded pointedly that Pennsylvanians’ thoughts matter more than her own: “I hope they read it.”

The episode has illustrated Fetterman’s standing — or lack thereof — in a party where many who once embraced him as a potential model for the future have now ostracized him over his shifting political persona. The public defense of Fetterman has largely come from Senate Minority Leader Chuck Schumer and the few Democrats with whom Fetterman has existing relationships.

In a sign of evolving political allegiances, the home-state elected official offering the strongest defense of Fetterman is actually a Republican.

Sen. Dave McCormick (R-Pa.) told Blue Light News that Fetterman “is authentic and a fighter, and these disgraceful attacks against him are not the John that I know and respect.” McCormick said he and Fetterman have a “great relationship, both professionally and personally.”

Fetterman declined to comment for this story. But in a Tuesday interview with BLN, he said the New York article is “a one-source hit piece, and it involved maybe two or three and anonymous disgruntled staffers saying just absolute false things.” He denied missing medical check-ups or doses of medication.

Fetterman has always had a go-it-alone attitude, and while progressives once adored him, he has never been a favorite of the Democratic establishment. In his 2022 Senate primary, only a handful of elected Democrats endorsed Fetterman. Going as far back as when he was mayor of Braddock, he ruffled feathers among Democrats.

So it’s no surprise to Fetterman’s current and former aides, at least, that he finds himself relatively alone at a perilous moment in his career.

“He’s never been somebody that has all these long-standing relationships with other elected officials,” said a Fetterman adviser who was granted anonymity to speak frankly. “That’s been his whole career. So I don’t think it’s abnormal when it comes to him to not see an outpouring of defense or support for him.”

The adviser argued voters like “that he isn’t seen as his fellow colleagues’ best friend” and “he partly got elected for that reason.”

Recent Morning Consult polls have found Fetterman’s popularity on the rise in Pennsylvania, as Republican voters have increasingly given him a thumbs-up while Democratic voters have stood by him despite criticism from some on the left. Fifty percent of state voters approved of his job performance, while 35 percent disapproved. But a survey of adults across the nation painted a different picture, showing his approval rating underwater among Democrats and independents, but positive among Republicans.

Schumer told reporters that Fetterman is an “all-star” who is “doing a good job.” Peter Welch (D-Vt.), who joined the Senate in the same class as Fetterman, “recently had dinner with Senator Fetterman,” a spokesperson said. “He’s a friend and he’ll continue to support him.” Rep. Chris Deluzio (D-Pa.), a fellow western Pennsylvania Democrat, said Fetterman has been “up front in the past about his mental health treatment,” and “should get a chance to weigh in and address the reports here.”

Rep. Dwight Evans (D-Pa.), who has suffered his own health setbacks since having a stroke in 2024, said that he had “no” concerns about Fetterman’s fitness. But he also acknowledged that he has not talked with him recently, something he didn’t read too much into and said was “par for the course.”

When Fetterman faced medical crises in the past, Democrats united around him in a tight battleground election while Republicans expressed concern.

After Fetterman suffered a stroke in his 2022 campaign, top Democrats, especially then-Sen. Bob Casey (D-Pa.), strongly vouched for him. Democrats also came to his defense when he checked himself into the Walter Reed National Military Medical Center for clinical depression in 2023. They hailed him as courageous for speaking out about his mental health struggles — a marked departure from past elected officials.

But Fetterman’s personal and professional support has dwindled since then. Online progressives, once his social media army, now detest him over his hardline views on Israel and meeting with President Donald Trump. His congressional office has hemorrhaged staff. And Casey, who lost reelection last year, is no longer in the Senate.

The article in New York magazine reported that his former aides claim he has avoided doctor’s appointments, driven away people close to him and potentially not taken his medication.

The fallout has exacerbated existing party tensions. Even before the most recent accusations, Democrats had floated the prospect of primary challenges against Fetterman, including by current and former members of the congressional delegation.

Talk of a contested primary — an attempt to oust the party’s own swing-state incumbent — has also increased, years before the seat is up for election in 2028. Fetterman’s erstwhile primary rival, former Rep. Conor Lamb (D-Pa.), has drawn attention recently by criticizing Trump — and, now, Fetterman.

“I’ve seen politics be hard on people so I’m concerned for the Fettermans,” Lamb said. “I think I share the feeling of many that I don’t know his true condition, but if he is okay, as he says, I don’t understand why he’s rarely seen in our state and he doesn’t answer constituent questions on things like his vote for [Attorney General] Pam Bondi or his advocacy for war with Iran.”

Asked if he is weighing a challenge against Fetterman, Lamb said he is “not considering any campaign right now” and that his recent appearances at public demonstrations against Trump are aimed at “just trying to help others.”