Washington • Sen. Orrin Hatch will decide this fall whether he will seek an eighth term and one of the key factors weighing on his decision, he repeatedly says, is his health.

Hatch, who describes himself as “a tough old bird” at 83, acknowledges that his age has affected him — though he says it hasn’t slowed him down, and a medical report provided by his office says he’s physically fit.

The Utah Republican is the third oldest member of the Senate, and his office frequently jokes on social media about the senator’s age, quipping that he’s been around since the Civil War or the Louisiana Purchase in 1803.

When Iowa Sen. Chuck Grassley claimed to have been the first senator to use a fax machine, Hatch’s office joked that Grassley had shown them how it worked “as we stood by with our quills and scrolls looking like fools.”

Joking aside, some members’ age-related health issues have become as serious as life and death.

Sen. John McCain’s office recently blamed his awkward line of questioning of former FBI Director James Comey on his staying up late to watch an Arizona Diamondbacks baseball game, but after surgery weeks later, the 81-year-old senator acknowledged he had been diagnosed with brain cancer.

Sen. Johnny Isakson, R-Ga., said in 2015 he’d been diagnosed with Parkinson’s disease. He will turn 73 in December.

During his last campaign in 2014, then-77-year-old Sen. Thad Cochran, R-Miss., was accused during a bruising primary of “erratic behavior” and “struggling to recall recent events,” according to an Associated Press report. Cochran’s spokesman at the time called the criticism “not based on facts.”

Hatch and his aides remain firm that the dean of Utah elected office is solidly able to do his job and keeps up a brutal schedule that others would struggle to maintain.

Long days

It’s a Tuesday at 8:30 a.m. and Hatch’s top aides are briefing him about his upcoming day. The senator has already been up for hours and in the office readying for a jam-packed calendar that’ll keep him working until late evening.

He’s got a photo op with some Utah Boy Scouts followed by Finance Committee hearings on tax reform and pending nominations. Then there are phone calls and meetings with fellow senators, a Japanese government delegation, Utah health-care providers and local officials. And he really wants to drop by a hearing for a staffer appointed to a job with the Treasury Department to show his support.

I’m really busy every day like this,” the senator says in a drive to the Capitol steps where the Scouts are already lined up for their chance to meet him.

As the longest-serving Republican senator, Hatch is the Senate president pro tempore and third in line for the presidency — a position that earns him a round-the-clock security detail.

Hatch says he wakes up around 5 a.m., works out on a stationary bike and does some stretching exercises. On a recent day, his security detail is ready at 6:30 a.m. to drive him to his office.

I start really early every day,” Hatch says.

In recent interviews, the senator has vacillated between saying he’s running for another term and saying he’s still considering it. He plans to make a final decision this year, though he’s noted that it comes down to his health and his wife, Elaine’s.

In his 2012 bid for re-election, Hatch said that would be his final run. He later backtracked, saying he may seek another if he’s close to enacting tax reform and now says he’s being encouraged by fellow senators and President Donald Trump to continue serving.

A Salt Lake Tribune-Hinckley Institute of Politics poll from July showed that while Utahns were split as to whether they approved of Hatch’s job performance, a large majority didn’t want him to run again. Nearly 8-in-10 registered voters said Hatch should retire, with 57 percent saying he should “definitely not” run.

Hatch’s office says he isn’t paying attention to the polling and is focused on his work in Washington.

Hatch said he and his wife are healthy and “very few people” keep up the schedule he does.

I’ve always done that. I’ve always been very active,” he said. “I feel good. I work hard. And yeah, I feel it a lot more. I’m older but you know, nothing stops me. I keep going. I get a lot done here. I don’t think anybody doubts that.”

After The Tribune asked the senator about his health, his office requested a letter from the attending physician of the Senate.

Overall, Brian P. Monahan, a medical doctor certified in internal medicine, hematology and oncology, wrote that Hatch was in fairly good shape. Hatch’s blood pressure, cholesterol and blood count were normal at his last visit to the physician’s office in 2016. His most recent colonoscopy was normal, as well, the doctor wrote.

Hatch has decreased hearing ability and his eyes have suffered from “routine cataract and glaucoma surgery,” and the doctor stressed increasing his sleep time because of his long work hours.

Otherwise, Monahan wrote, “You are in overall good health and active in your professional work, and recreational lifestyle with minimal limitation.”

Hatch acknowledges his eyes have been bugging him of late — they’re frequently red and staffers print his remarks in large type to make sure he can read them — and he wears a hearing aid in his right ear. When he speaks, he’s often hard to hear, a point the senator attributes to his job.

I’m a little hoarse. Been using it too much,” he said earlier this year. “It’s an occupational hazard.”

But the senator says he’s healthy: a 12 on a scale of one to 10, he notes.

Up to the task?

Hatch began Memorial Day remarks in Utah this year by paying tribute to his wife, Elaine.

“She’s put up with an awful lot,” the Utah Republican said.

Although the introducer had noted that Hatch has 23 grandchildren only a moment before, Hatch paused when offering off-the-cuff comments leading up to his speech.

“Like they said, we have — uh, how many grandchildren?” Hatch said as some chuckled in the audience.

Eight minutes later, after extolling the virtues of those who serve in the military, Hatch again returned to talking about his wife.

She’s had to put up with an awful lot,” he said, repeating the earlier line.

At a Finance Committee budget hearing earlier this year, Hatch appeared completely befuddled when Sen. Claire McCaskill, D-Mo., started questioning the Utah Republican and chairman of the committee if he would hold a hearing on the GOP health-care bill.

Will we?” Hatch said.

Yes,” McCaskill responded.

I think we’ve already had one, but...” Hatch said, trailing off as an aide came to his side.

Hatch conferred with his aide for a few seconds and repeated her comments, captured for the most part on the microphone, that he wasn’t sure there would be a hearing but noted that Republicans had invited Democrats to participate, a point to which McCaskill objected.

Video of the exchange went viral.

Hatch’s office stressed that McCaskill’s questioning was an ambush in the midst of a budget hearing while the senator was focused on the topic matter.

Several people who work closely with Hatch noted privately their concerns with his occasional slips but none would speak on the record because they have an ongoing relationship with the senator.

There are times he’s as lucid as he can be but at other times you have to question if he knows where he is,” said one Republican who has worked with Hatch for years, speaking on condition of anonymity for fear of reprisal.

Others, though, forcefully pushed back, including Sen. Ron Wyden of Oregon, the top Democrat on the Senate Finance Committee who works with Hatch almost daily.

He puts in long hours,” Wyden said in an interview. “I don’t know how you can put in those kinds of hours without having real physical fortitude. He’s also straight with me and we have a lot of big challenges ahead and that’s what I’m counting on in a colleague.”

A day in the life

Hatch’s schedule on that day his office arranged for The Tribune to spend with him ran 27 items long, starting at 6:25 a.m. and wrapping up at 7 p.m. He was almost constantly on the move, from hearings to meetings to calls.

And he always stopped to talk to gaggles of journalists staking out the Senate’s underground train, committee rooms and the Senate floor.

I don’t have a problem with that,” Hatch later says of the hallway chats that can include a variety of questions from health reform to leadership tactics to tax proposals.

At one point in the day, he took a call from former Vice President Dan Quayle and made sure to ask about his wife, Marilyn.

Hatch is one of seven senators in their 80s, including Sen. Diane Feinstein, D-Calif., who is 84. Sixteen are in their 70s; 62 are in their 60s and 50s; and just 15 are in their 40s.

Hatch’s aides bristle at questions about the senator’s health, though Hatch was clear he was open to talking about it and does so frequently in his humorous social-media posts.

Ruthie Montoya, Hatch’s assistant for the last 30 years, says Hatch is “always going.”

“He loves the work and his schedule shows it,” she said in a statement from Hatch’s office. “He’s always the first one in and the last one out. After three decades of working for him, he hasn’t slowed down a bit. Even now that he’s the busiest he’s ever been, he shows no signs of wear.”