The symptoms had been there for months.
His weight was down. He was tired. Mike Fitzpatrick - a politician renowned for hard work and long hours - felt like his tank was empty.
Pushed by his wife to undergo tests, Fitzpatrick got the humbling news in June 2008. At 45, the former congressman and father of six had advanced colorectal cancer.
"It certainly wakes you up," he said recently. "No doubt about it, it was life-changing."
Months of aggressive chemotherapy succeeded. Fitzpatrick, cancer-free for the last two years, had been given a second chance at life.
Whether voters in Pennsylvania's Eighth Congressional District will give him a second chance at Washington will be determined Nov. 2.
Now 47, Fitzpatrick wants to reclaim the House seat covering all of Bucks County and slivers of Montgomery County and Philadelphia. After one term, he narrowly lost it to Democrat Patrick Murphy after a bitter 2006 campaign.
Murphy won by less than 1 percent, and both sides expect another squeaker.
That year, Murphy capitalized on voter dismay with President George W. Bush and the Iraq war to sweep Fitzpatrick out on a Democratic tide.
This year, in a race dominated by economic issues, Fitzpatrick has sought to broad-brush himself as a tax-cutting friend of job-creating small businesses, and Murphy as a big-spending lapdog of House Speaker Nancy Pelosi and President Obama.
He also stresses to voters his Bucks County roots. A lifelong resident, he spent 10 years as a county commissioner before entering Congress.
"I don't think you would find anyone who works harder," said County Commissioner Charles Martin, who served with Fitzpatrick and recalls his relentless pace.
"It would be nothing to get e-mails from him at 2 o'clock in the morning," Martin said. After attending evening functions together, "I would go home. He would go back to the office to do work."
His brush with mortality provided some needed perspective, Fitzpatrick said.
Getting to work at dawn became less important. Seeing his sons in the morning, driving them to school, and arriving at his law office at Begley, Carlin & Mandio in Middletown Township by 8 was fine.
Fitzpatrick tells of chemotherapy, of sitting with 15 other patients "and asking how they're doing, how they're feeling, how their kids are."
"And you really listen to the answers more. It's not just perfunctory, shallow conversation," he said. "So, yeah, it changes you for the better."
Such words are a departure for the accessible, soft-spoken Fitzpatrick, whose serious, on-point presence seldom turns to personal yarns.
Unchanged is his appetite for the public arena in which he has spent his adult life.
"If you believe the country is headed in the wrong direction," he said, "you can either sit back and watch it or you can do something."
Long a favorite of the formidable Bucks GOP machine, Fitzpatrick hails from a family of Kennedy Democrats. He was its first Republican.
His father, Jim, a pharmaceutical salesman, and his mother, Mary, a homemaker, moved to Levittown in 1957 from New York City's Queens borough. They were drawn by the affordable housing of the new suburb rising in the county's lower end.
Fitzpatrick was the fifth of eight children. He recalls a Levittown filled with young families, where "you could get around the whole town on a bicycle" in search of pickup basketball and hockey games.
He became an Eagle Scout, played saxophone in the high school band, and briefly was a Mummer. He did well enough at Bishop Egan High School to snare a full scholarship from St. Thomas University in Miami, where he studied political science.
After law school, Fitzpatrick returned to Bucks, where County Commissioner Mark Schweiker - a family friend from Levittown and the state's future governor - became his political mentor.
Years earlier, Jim Fitzpatrick had chaired Schweiker's campaign for Middletown Township supervisor.
In 1989, Schweiker helped appoint Fitzpatrick to the county's nonprofit housing development board. He backed Fitzpatrick's 1990 and 1994 campaigns for the state House against popular Democratic incumbent Anthony Melio.
After Fitzpatrick impressed his party by nearly knocking off Melio in 1994 - losing by fewer than 220 votes - Schweiker wanted Fitzpatrick to replace him as county commissioner in 1995, when he became lieutenant governor.
"It certainly was not a matter of passing interest to me," Schweiker recalled. "There was no doubt in my mind that Mike Fitzpatrick had the resumé, the proper perspective, and the right philosophy to be a county commissioner."
Fitzpatrick got the job, and worked to end no-bid contracts, back the county's first enterprise zone, and design an open-space program that preserved more than 10,000 acres and 100 farms.
Murphy notes that property taxes went up in seven of Fitzpatrick's 10 years. Two of those increases were voter-approved, Fitzpatrick said, and the others helped the county keep its debt low and its bond rating high.
"It couldn't have been so bad, because Patrick Murphy moved here," he said. "It's called pay as you go."
When longtime U.S. Rep. Jim Greenwood stepped down in 2004, GOP leaders nominated Fitzpatrick over Greenwood's choice, State Sen. Joe Conti. "I think they felt I was more conservative, and perhaps more accessible," Fitzpatrick said.
While Fitzpatrick did side with the Bush administration most of the time, he was rated as one of the most independent House members by Congressional Quarterly, a nonpartisan publication. He came away convinced that his loss had less to do with him and Murphy than with Bush and Iraq.
Today, with the economy still floundering, unemployment high, and Obama's approval rating low, Fitzpatrick hopes to pay Murphy back.
"In 2006, he had the benefit of attacking me without having a record of his own," he said. "Today he has a record, and it's not a good one."
Age: 47. Born June 28, 1963, in Philadelphia.
Residence: Levittown area of Middletown Township, Bucks County.
Education: Levittown's Bishop Egan High School. B.A. in political science, St. Thomas University, 1985. J.D., Dickinson School of Law, 1988.
Professional experience: Private lawyer: Jackson & Sullivan, 1988 to 1992; Begley, Carlin & Mandio, 1992 to 1995 and 2007 to present; Saul Ewing, 1995 to 2004.
Political experience: Bucks County commissioner, 1995 to 2004; U.S. representative, 2005 to 2006.
Family: Wife, Kathleen, six children.