In a cycle when many candidates are refusing to debate their opponents, Democrat John Fetterman took the stage Tuesday night for the first, and only, debate in the hotly contested U.S. Senate race in Pennsylvania.

Fetterman, the lieutenant governor of Pennsylvania, did so despite still struggling to recover his communication skills following a nearly fatal stroke in May. He has openly talked about his difficulty finding his words and accurately interpreting spoken conversation.

In a memo to reporters on Monday, Fettermans team set expectations low ahead of the debate, noting that Fettermans ongoing auditory processing challenges are real.

Those struggles were apparent in Tuesday nights debate while his Republican opponent, Mehmet Oz , showed his ease on TV, the medium that made him famous around America as Dr. Oz.

From the outset, Oz, who did not live in Pennsylvania until he decided to run for Senate, set the tone, pitching himself as a moderate who can bring balance back to Washington.

Asked by the moderators from Harrisburg ABC affiliate WHTM whether hed support Donald Trump if he ran for president again, Oz quickly replied that he would support the Republican nominee before pivoting to a celebration of bipartisanship.

I have reached out across the aisle on my campaign because I want to bring balance to Washington, he said. And Ive tried to work with Democrats and Republicans and people in the middle, people who are unsure people who got angry with where their party was headed.

He also sold himself as an agent of change for any voter dissatisfied with President Joe Biden, unified Democratic control in Congress and the state of the economy.

Are you unhappy with where America is headed? he said. I am, and if you are as well, then Im the candidate for change.

Fetterman has been open about his auditory processing issues since returning to the campaign trail in August after three months recovering from the stroke. Fettermans physician has said that he is fit to run and work full duty, but he still confuses words while speaking, and his brain can have trouble understanding spoken words, especially in noisy environments.

At Fettermans behest, he and Oz were able to use closed-captioning monitors above the debate moderators to ensure he understood every question. Its a practice he has already adopted for sit-down interviews with journalists.

Fetterman was at his best reciting lines that he had clearly rehearsed.

Im running to serve Pennsylvania, he declared in his opening statement. Hes running to use Pennsylvania.

He laid out what he called the Oz rule early on: that if Oz is speaking on television, hes lying.

Fetterman deployed the line to rebut allegations that he wants to adopt socialized medicine and that he does not support fracking, a controversial method of extracting natural gas.

In fact, Fetterman has supported Medicare for All, which would require all Americans to enroll in a health insurance plan run by the federal government.

But he has distanced himself from that position during his Senate run. His campaign website says that he would support any legislation that gets us closer to the goal of universal health care coverage.

Fetterman also had a clever retort when Oz tried to make him answer for endorsing Sen. Bernie Sanders (I-Vt.) for president in 2016.

Why dont you pretend that you live in Vermont instead of Pennsylvania and run against Bernie Sanders? Fetterman said. Because all you can do is talk about Bernie Sanders.

But at other critical moments in the debate, Fetterman struggled to keep up with Oz.

In his opening statement, Oz managed to squeeze in a critique of Fettermans support for granting clemency to a greater number of convicted criminals as chair of the states board of pardons.

John Fetterman, during this crime wave, has been trying to get as many murderers convicted and sentenced to life in prison out of jail as possible, Oz said.

I want Washington to be civil again, he added. We need it to be less radical.

Fetterman has emphasized that he advocated for pardoning or commuting the life sentences of nonviolent offenders, people subject to mandatory minimum sentences and a select number of convicted murderers imprisoned into late old age .

He did not get the chance to respond to Ozs charges until later in the debate, however, when he touted his record addressing crime as mayor of Braddock.

Working with the police and working with our community, I was able to stop gun violence for 5 years as mayor, he said.

Energy policy was another area where Fetterman faltered. Pressed to explain why he had initially criticized fracking before embracing it, Fetterman did not offer an explanation.

I do support fracking, he said. And I dont, I dont, I support fracking and I stand and I do support fracking.

Fetterman has previously clarified that he initially supported a moratorium on fracking due to concerns about the environmental impact but subsequently felt that the states adoption of tougher regulations of the industry had addressed his concerns.

Oz himself has been on record expressing opposition to fracking. In a 2014 column , he argued for prohibiting fracking until there were better studies of its effect on health.

But Republicans boast close ties to the oil and gas industry, perhaps making Ozs denial that he had ever had a change of heart seem more plausible. Ive been very consistent in support of fracking, he said.

Oz even turned his non-response to a question about whether he supports raising Pennsylvanias minimum wage from $7.25 an hour to $15 to an ode on the wonders of Pennsylvanias natural gas.

Claiming that the labor market had already driven wages higher than $15 an hour, Oz declared, If we can unleash the energy beneath our feet here in Pennsylvania, thered be plenty of money to go around.

Indeed, some of Ozs strength on Tuesday night was due to the ease with which he evaded questions about the issues.

Asked whether he would have voted for the bipartisan gun control legislation supported by retiring Sen. Pat Toomey (R-Pa.), Oz declined to respond.

I would have tried to improve that bill. There are things that I think most of us appreciate, he said. I wasnt there at the time, so I cant speak to what was possible.

But in other cases, he got the chance to clarify his views for a statewide audience for the first time.

He announced that he would oppose any cuts to Social Security and Medicare, notwithstanding a plan from Sen. Rick Scott (R-Fla.) to do just that, and House Republican Leader Kevin McCarthys promise to use the debt ceiling to press for deep spending cuts that would not spare the two universal social programs.

Oz also said that he would oppose any federal restrictions on abortion rights. Ive been very clear on my desire as a physician not to interfere with how states decide abortion laws, Oz said.

That would seem to preclude Oz supporting GOP Sen. Lindsey Grahams bill banning the procedure after 15 weeks nationwide, though three times Oz avoided saying specifically whether he would vote for or against that bill.

For his part, Fetterman tried to bring the conversation back to the stark contrast between how he and Oz responded to the Supreme Courts June decision to overturn a constitutional right to abortion.

I support on Roe v. Wade. That was the law of the land for 50 years, Fetterman said. He celebrated when it fell down, and I would fight to reestablish on Roe v. Wade.

If you believe that the choice of your reproductive freedom belongs with Dr. Oz, then you have a choice, he added. But if you believe that the choice for abortion belongs to you and your doctor, thats what I fight for.

Oz also inadvertently gave Fetterman ammunition to attack when describing his support for setting abortion policy at the state level.

I want women, doctors, local political leaders, letting the democracy thats always allowed our nation to thrive, to put the best ideas forward so states can decide for themselves, Oz said.

Democrats almost immediately seized on his words to show that Oz sees a role for local political leaders to make decisions about a womans right to choose.

Fetterman announced plans to debut a TV campaign ad that would include the political leaders snippet on Wednesday.

Our campaign will be putting money behind making sure as many women as possible hear Dr. Ozs radical belief that local political leaders should have as much say over a womans abortion decisions as women themselves and their doctors, Joe Calvello, a campaign spokesperson, said in a statement.