The Washington PostDemocracy Dies in Darkness

A lieutenant governor shows medical expertise in bid for higher office in Va.

Virginia Lt. Gov. Ralph Northam talks on Saturday with Tahqualan Brooks, 8, from Colonial Beach. The clinic at Richmond County Elementary was organized by an organization called Remote Area Medical. (Reza A. Marvashti / For the Washington Post)

WARSAW, Va. — Angela Rogers had just had five bad teeth yanked in the elementary school gym on Saturday and was on to the next doctor, in a classroom with all the little desks pushed to the side.

Ralph Northam gently examined her for arm and neck pain, tuning out the chaos of a schoolhouse turned upside down for the weekend to provide health care for the poor in this rural town in Virginia’s Northern Neck.

“You’re strong," he said, eliciting a giggle from the 45-year-old former waitress, still dabbing her gums with gauze. “You must have been lifting a lot of plates.”

Northam — a pediatric neurologist who also happens to be Virginia’s lieutenant governor and the Democrats’ leading contender for governor in 2017 — has a calming bedside manner, one that carries over into politics.

In the rough-and-tumble of Richmond’s fiercest battles, Northam is Ben Carson-mellow. But he is on the other end of the political spectrum from the famed pediatric neurosurgeon and presidential contender, with whom Northam has rubbed elbows professionally.

Northam’s sunny, low-key ­demeanor makes him widely liked in Richmond, but it could cut both ways as he seeks to replace term-limited Gov. Terry McAuliffe (D), especially since he is likely to face a Republican with sharper edges. In an ever-more-partisan Virginia, nice guys risk finishing last.

“Mark Warner almost lost his race by doing the too-nice Mark Warner,” said Stephen Farnsworth, a political scientist at the University of Mary Washington.

Farnsworth was referring to U.S. Sen. Mark Warner. The Virginia Democrat was elected governor in 2001, then won a Senate seat in 2008 with an appeal to moderates. But he barely squeaked past Republican Ed Gillespie for reelection last year.

Gillespie, a former Republican National Committee chairman, is the GOP’s top contender for governor in 2017. He confirmed last month that he will run, and last week he set up a political action committee. Gillespie is an establishment figure who is not prone to harsh rhetoric, but he is no stranger to hardball politics: A former White House counselor to President George W. Bush, Gillespie helped invent the fundraising engine known as the super PAC with Karl Rove.

Gillespie forms PAC — next step in bid for Virginia governor

Former state attorney general Ken Cuccinelli II (R), who narrowly lost to McAuliffe in 2013, has not ruled out another try in 2017. The Republican Party plans to pick its nominee at a convention, a day-long forum that tends to favor the most conservative candidates.

Regardless of whom he faces, Northam will represent a stark contrast to the incumbent.

McAuliffe is a swaggering creature of Washington, prone to hyperbole and partisan bombast, who narrowly won by rallying the Democratic base against Cuccinelli. Northam, an Eastern Shore native more inclined to aw-shucks understatement, seems unlikely to run in the McAuliffe mode.

Analysts wonder if a more moderate style still works in Virginia.

“He’s kind of a Warner type: He can appeal to the moderates,” said Bob Holsworth, a former Virginia Commonwealth University political scientist. “But we’re seeing the limits of that model. . . . The challenge for Northam, I think, is to be the kind of Democrat who can mobilize, get the base excited, win these elections that are geared toward turning out the passionate.”

Northam is launching his bid from the lowest-profile statewide elective office in Virginia — a part-time gig that pays just $36,000 a year. As lieutenant governor, he presides over the state Senate but cannot sponsor legislation. He can break most tie votes in the chamber — a power he might have wielded daily had Democrats picked up a seat in elections this month. As it turned out, Republicans retained their 21-to-19 majority, so there will be fewer chances for Northam to have an impact.

His campaign is likely to rely heavily on his biography. In addition to being a doctor, Northam is a Virginia Military Institute graduate, Gulf War veteran and former state senator. He is widely liked by Democrats and Republicans alike in the state Capitol.

His résumé and personality present a challenge for the GOP: How do you go after a guy who seems so likable? At the same time, there are risks associated with building the campaign around a biography.

“It’s a compelling message and it’s a compelling story, but a story that’s based purely on character, that’s based purely on biography, is not without its own risk,” said one GOP strategist, who spoke on the condition of anonymity in order to be frank. If “you find a couple issues in the biography that cast doubt, it can blow up the whole thing.”

Northam did not face high-level scrutiny in 2013, when ­media interest was concentrated on the top-of-the-ticket governor’s race. What attention was paid to the lieutenant governor's race was primarily focused on Northam’s Republican opponent, E.W. Jackson. The Chesapeake minister made a series of controversial comments — suggesting, for instance, that birth defects are caused by sin and that yoga-style meditation presents an opening for Satan.

“Northam really had the easiest campaign of anyone at that time because he was running against a candidate that most people felt was virtually unelectable,” Holsworth said. “How formidable he will be as a gubernatorial candidate is really unknown.”

The pressure to wage a more partisan campaign could threaten Northam’s good-guy brand. Analysts expect surrogates to spout harsh rhetoric if Northam does not. When Gillespie announced he was running, the Democratic Party of Virginia issued a statement calling him “Enron Ed,” a reference to the one-time lobbyist’s work for the now-collapsed energy giant.

Northam’s fundraising arm took a sharply partisan tone in the lead-up to legislative elections this year. Once and sometimes twice a day came breathless appeals in Northam’s name for contributions to “put an end to the backwards agenda Republicans have been trying to impose on Virginia families for the past two years.”

“We just found out: A top elections forecaster predicts that Republicans will keep their majority in the Senate,” began one.

The flurry of messages drew mocking Twitter commentary from Tucker Martin, a senior adviser to Gillespie’s 2014 campaign and an informal adviser to him now.

“I know it gets stressful this time of year, but Ralph Northam’s pollster needs to pull it together,” Martin tweeted.

In an interview, Martin predicted that a Northam-Gillespie matchup would be a respectful, policy-oriented campaign.

“If two Boy Scouts can run against each other, maybe it’s a debate about who can build the best fire,” Martin said.

Northam’s appearance here Saturday showed off his professional expertise. The clinic at Richmond County Elementary was organized by an organization called Remote Area Medical.

RAM has operated in Southwest Virginia for 16 years, but this was the first time it had come to the state’s Northern Neck. About 600 patients were expected Saturday and Sunday. Some slept in cars overnight for the chance to see a dentist or doctor.

It was a chance for Northam, who still sees patients several days a week, to help out and make his case for expanding Medicaid under the Affordable Care Act.

Rogers, the woman who saw Northam after having her teeth pulled, had no idea that he holds one statewide office and is seeking another. She was just glad to get medical help. For her, the event was completely apolitical.

“We’re a small town,” she said. “It’s great to have different doctors.”