HARRISBURG, Pa. – John Fetterman, the Democratic nominee for Senate in Pennsylvania, released a doctor’s note Wednesday saying he is recovering well from a May stroke as he vies for an open seat in a bare-knuckle campaign against Republican Mehmet Oz, who has questioned Fetterman’s fitness to serve.

Five months after the medical emergency from which Fetterman said, “I almost died,” he is fighting some lingering effects of the stroke — “the elephant in the room,” he called it at a recent rally. The lieutenant governor uses closed-captioning to quickly interpret and respond to questions, and sometimes stumbles over words.

In the one-page letter, Dr. Clifford Chen noted that Fetterman continues to endure effects of the stroke that involve speech and being able to respond quickly. But he said Fetterman exhibited no effects on his “cognitive ability” or his ability to think and reason after the stroke, which occurred just days before the primary election.

Fetterman “is recovering well from his stroke and his health has continued to improve” Chen wrote in the report after examining Fetterman on Friday. Chen, a primary care physician in Duquesne affiliated with the University of Pittsburgh Medical Center, concluded that Fetterman “has no work restrictions and can work full duty in public office.”

Fetterman has declined to release a fuller suite of his medical records or provide access by reporters to his doctors or specialists. Some independent stroke experts consulted by The Associated Press said Fetterman appears to be recovering remarkably well as he campaigns.

Chen did note a couple lingering effects that Fetterman’s campaign has disclosed. An auditory processing disorder makes it hard for him to understand what someone might say to him. Fetterman has occasionally stumbled over words while speaking, but Chen said Fetterman’s communication is significantly improved after working with a speech therapist.

Fetterman’s recovery has played a significant role in the campaign.

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Oz, a heart surgeon who has treated stroke patients, has accused Fetterman of lying about his health and suggested that the stroke has left Fetterman unequipped to serve effectively in the Senate.

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Neergaard reported from Washington.

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