Former Fetterman Aide Expressed Concern to Doctor About Senator’s Mental Health

The former chief of staff to Senator John Fetterman, Democrat of Pennsylvania, was so alarmed with his ex-boss’s erratic behavior last year that he wrote a lengthy letter to his doctor warning that the senator was spiraling out of control and that his mental health issues could cost him his life.

“I’m worried that if John stays on his current trajectory he won’t be with us for much longer,” Adam Jentleson, the former chief of staff, wrote on May 20 to a doctor who had treated Mr. Fetterman at Walter Reed National Military Medical Center.

Mr. Fetterman’s behavior, according to former aides who are still connected to his diminishing circle, is still at times a cause of concern. Other former members of his staff, speaking on the condition of anonymity, report that their colleagues sometimes were frightened to be in the senator’s presence, if he was in an amped-up mood.

They have also long been warned never to get in a car if Mr. Fetterman is behind the wheel because of his dangerous driving habits. His volatile and concerning behavior, which aides noticed last year was taking a turn for the worse, has only increased since the election, people who have spent time with him said. That has coincided with a period when his politics have become more conservative, as he has watched his home state of Pennsylvania swing for Mr. Trump.

“He does not see his doctors,” Mr. Jentleson wrote last year to the medical director who oversaw his 2023 hospitalization for mental health issues. “I am not sure when he last saw a cardiologist, but I don’t think he’s seen one since he was released. He long ago ordered us to stop putting regular drop-bys with Dr. Monahan on his schedule, despite the fact that he had agreed to those as part of the plan.” Dr. Brian P. Monahan is the Navy doctor who has served for nearly 15 years as the on-site physician in the Capitol.

Mr. Jentleson’s letter, which was obtained by The New York Times, was first reported by New York magazine.

Mr. Fetterman said in a statement that “my ACTUAL doctors and my family affirmed that I’m very well.” He called the New York magazine article a “hit piece” and suggested that Mr. Jentleson and the author of the article, Ben Terris, were “best friends” with a joint ax to grind, and that they “sourced anonymous, disgruntled staffers with lies or distorted half-truths.”

(Mr. Terris revealed in his article that Mr. Jentleson is a personal friend.)

A spokesperson for Mr. Fetterman also raised questions on Friday about Mr. Jentleson’s motivations for making public a deeply personal letter, given the stigmas that already exist around mental health issues among men.

Mr. Jentleson declined to respond.

Mr. Fetterman, the first-term senator from Pennsylvania who had a near-fatal stroke during his campaign, spent six weeks at Walter Reed in 2023 being treated for clinical depression. When he was released, Mr. Fetterman seemed to have turned a corner. He began adjusting to his life in the Senate, mixing it up with reporters and colleagues in the hallways, and looked at it as a unique responsibility to speak out on mental health issues.

“It’s a burden, but a privilege, too, to talk about it,” he told The New York Times in an interview in 2023. “It’s also an opportunity to be very bipartisan. Red or blue, if you have depression, get help, please. Don’t ever, ever, ever harm yourself. Do not leave behind a blueprint of that.”

The auditory processing issues associated with his stroke also seemed to diminish, and Mr. Fetterman began to casually converse with people without having to rely on audio transcription.

As he has adjusted to life as a senator, Mr. Fetterman also grew more conservative, mostly on Israel, but also on a range of other issues. The senator was the first Democrat to meet with Mr. Trump at his Mar-a-Lago estate after the election and appeared to think that finding common ground was politically savvy at a moment when his state was swinging further to the right.

An avid Fox News watcher, Mr. Fetterman even seriously considered voting to confirm Defense Secretary Pete Hegseth, a former weekend host on “Fox & Friends,” according to a former aide. The vote would have signaled a green light to a cabinet appointee who faced accusations of excessive drinking and abusing women that made it difficult even for Republican senators to get behind him.

It’s not clear to everyone who has worked closely with him that Mr. Fetterman’s political transformation, or his current challenges, is directly related to the mental health crisis that first sent him to the hospital two years ago. But in his letter, Mr. Jentleson describes unstable behavior he says could be a result of the senator’s failure to follow the medical plan, including taking prescription medications, outlined then by his doctors.

“John has pushed out everyone who was supposed to help keep him on his recovery plan,” Mr. Jentleson wrote in the letter to Dr. David Williamson, the medical director of the neuropsychiatry/traumatic brain injury unit at Walter Reed. “We do not know if he is taking his meds, and his behavior frequently suggests he is not.”

He said in the letter that people around Mr. Fetterman often witnessed the “warning signs” his doctor had warned of, including “conspiratorial thinking, megalomania (for example, he claims to be the most knowledgeable source on Israel and Gaza around but his sources are just what he reads in the news — he declines most briefings and never reads memos); high highs and low lows; long, rambling, repetitive and self-centered monologues lying in ways that are painfully, awkwardly obvious to everyone in the room.”

He said Mr. Fetterman spent most of his time scrolling on this phone and formulating tweets, and that things with his wife, Gisele, were “tense.”

“He engages in risky behavior. He drives recklessly. He also recently bought a gun.” Mr. Jentleson wrote, noting that purchasing a firearm was a warning sign that he had been directed to report back to a medical professional.

Gisele Fetterman, in a statement to New York magazine, disputed the claims in Mr. Jentleson’s letter, accusing him of lying about her husband’s condition.

In recent months, Ms. Fetterman has presented a united front with her husband. She accompanied him to his visit to Mar-a-Lago after the election, and to a meeting in Israel last month with Prime Minister Benjamin Netanyahu.

Still, many on his staff remain anxious about working for Mr. Fetterman, whose mood can change dramatically from one day to the next. His driving remains an area of particular concern.

The senator has long been known as a reckless driver, sometimes going more than 70 miles per hour in a 30 miles per hour zone. Last year, he and his wife, as well as a 62-year-old woman, were hospitalized after he rear-ended the woman’s car on the Eisenhower Memorial Highway in western Maryland.

Mr. Fetterman was driving well over the posted speed limit of 70 miles per hour, according to the police report. Pennsylvania records indicated that Mr. Fetterman had at least two prior driving infractions in the state in which he was going more than 20 miles per hour above the speed limit.