(NewsNation) — Pennsylvania’s lone Senate debate centered around Democratic candidate John Fetterman’s fitness to serve five months after suffering a stroke.

Fetterman, the state’s lieutenant governor, had difficulty speaking throughout the debate, but insisted he could get the job done if elected.

Addressing what he called the “elephant in the room,” Fetterman opened the debate acknowledging the stroke he suffered in May that has left him with difficulty speaking and processing others speaking to him. Fetterman used closed captioning during the debate to aid him in understanding the moderators.

“I had a stroke, (Republican candidate Mehmet Oz) has never let me forget that,” Fetterman said. “I might miss some words during this debate, mush two words together, but it knocked me down and I am going to keep coming back up.”

Fetterman’s campaign hinted that his speech struggles were due in part to the closed captioning system he used.

“We are thrilled with John’s performance. He did remarkably well tonight – especially when you consider that he’s still recovering from a stroke and was working off of delayed captions filled with errors,” a statement from Fetterman’s campaign said. “John won countless exchanges, counter-punched aggressively, and pushed back on Oz’s cruelty and attacks.”

Nexstar Media, which hosted the debate and also owns NewsNation responded to Fetterman in a statement saying:

“It is unfortunate that Mr. Fetterman is now criticizing the closed captioning process employed by Nexstar during tonight’s debate. Both candidates agreed to the technical set-up for the closed captioning process weeks ago, which was implemented at the request of the Fetterman campaign,” the statement said. “Both candidates were offered the opportunity for two full rehearsals with the same equipment used in tonight’s debate; Mr. Fetterman chose to do only one. In fact, Nexstar’s production team went to extraordinary lengths to ensure the effectiveness of the closed captioning process, and to accommodate several last-minute requests of the Fetterman campaign. The closed captioning process functioned as expected during rehearsal and again during tonight’s debate. We regret that Mr. Fetterman and his campaign feel otherwise.”

Oz, a Republican and celebrity TV doctor, did not address Fetterman’s medical condition directly. Instead, he repeatedly called Fetterman a “radical” and attempted to tie the lieutenant governor to President Joe Biden on issues such as crime and inflation.

“John Fetterman takes everything to an extreme and those extreme positions hurt us all,” Oz said.

Sen. Bob Casey (D-Penn.) said he thought Fetterman did “really well” and gave answers that were “very direct” despite his struggles speaking.

“When you consider what he has been through, as he said at the beginning of the debate and at the end, identifying with and understanding people that get knocked down and then get back up,” Casey told NewsNation’s Chris Cuomo. “People are dealing with that every day of the week, especially when the economy is tough for a lot of families.”

Fetterman and Oz cast each other as “liars” and “radical,” Tuesday night in what will be their only debate ahead of November’s midterms.

Fetterman, Pennsylvania’s Democratic lieutenant governor, referred multiple times to what he called the “Oz rule” which he dubbed as, “If he’s on TV, he’s lying.”

Oz immediately targeted Fetterman on the issue of crime, something Oz and other Republicans have made a key fixture of their campaigns across the nation. Oz accused Fetterman of wanting to “legalize all drugs,” release “1/3 of prisoners” from jail and has “undermine” police “at every level.”

“Half the murders in Philadelphia are committed by people under 18, we have got to get mental health services to those people and it’s not happening now,” Oz said. “Part of the problem is we have taken away the ability of police to do their job and that’s on John Fetterman.”

Fetterman said, unlike Oz, he was the “only person on the stage” to have ever actually worked on crime legislation. Republicans have marked Fetterman as “dangerously soft on crime,” a characterization he countered Tuesday night.

“I believe that I run on my record on crime,” Fetterman said. “I ran to be mayor back in 2005 in order to fight gun violence and that’s exactly what I did.”

Both Fetterman and Oz said they would support Joe Biden and Donald Trump, respectively, if they chose to run for office in 2024.

Fetterman said he would want Biden to do more to fight inflation if he ran again but ultimately said, “If he chooses to run, I would support him.”

Oz only offered up support for Trump when pressed to do so by the moderator, at first saying he would support “whoever” the Republican party nominated in 2024.

When asked if ongoing legal issues surrounding Trump, which include a House investigation into Trump’s role in the Jan. 6 Capitol riots and the FBI search of his Mar-a-Lago estate, would impede Oz’s support of the embattled former president, Oz danced around the question saying he hasn’t followed the stories “very carefully.”

“I haven’t followed them very carefully I have been campaigning pretty aggressively,” Oz said. “They’ll work themselves out, I have tremendous confidence in the American legal system, and I believe law and order will reign supreme.”

Moderators were able to pin down Fetterman on conflicting statements he has made about fracking, as he has both publicly supported and stood against the practice. In 2018, Fetterman said in an interview he “had never” supported fracking yet has said he supports it on the campaign trail.

When asked why he has taken competing stances on fracking, Fetterman said he “absolutely supports fracking.”

“I believe we need independence with energy and I believe I have walked that line my entire career,” Fetterman said.

Oz said he “strongly supports” fracking.

The hot-button issue of abortion, which Democrats have made a staple of their campaigns, saw the two candidates take starkly different stances.

Fetterman said he supports Roe v. Wade, the landmark abortion law that guaranteed federal protections for abortions but was struck down by the Supreme Court in the spring.

Oz said he feels each individual state should be left to decide its own abortion laws.

“As a physician I’ve been in the room during when there’s some difficult conversations happening, I don’t want the federal government involved with that at all,” Oz said. “I want women, doctors, local politicians, letting the democracy that’s always allowed our nation to thrive, to put the best ideas forward so states can decide for themselves.”

Oz, too, would not support a federal minimum wage of $15, saying instead the free market would naturally drive up wages to levels he hoped would have people “making a lot more than $15.”

Fetterman on the other hand called the current federal minimum wage of $7.25 a “disgrace.”

“I believe every work has dignity and every paycheck must have dignity in it as well,” Fetterman said.

On immigration, another hot-button campaign issue for both Democrats and Republicans, Oz said there was a “catastrophe” at the southern border and there should be no sanctuary cities in the United States.

Fetterman said Congress needed to come to a “bipartisan agreement” that was made with “compassion” to solve the immigration bottleneck in the southwest.