Ralph Northam, Virginia’s Democratic candidate for governor, makes an Oct. 14 campaign stop in Ashburn, Va. The doctor first won elected office a decade ago — and a political world away. (Salwan Georges/The Washington Post)

Crowds swarmed Gov. Terry McAuliffe at the free medical clinic in remote Wise County, Va., in July, and he worked them like a master politician.

“How’s that little baby?” the Democrat boomed at one family. Health care’s a mess, he thundered, “but we’re going to fix it. Darn right!” He hugged, he guffawed, he rolled up his sleeve to check his blood pressure (then bragged about the results), called people by name, prayed, prayed again and defied his handlers when they pointed to the clock.

The next day, Lt. Gov. Ralph Northam showed up. He is running to succeed McAuliffe, but it was hard to tell. Northam huddled quietly with a few leaders of the event, unnoticed by most.

Then Northam, a pediatrician, pulled out his stethoscope and ducked into a trailer to see a patient. Here he came to life. A 6-year-old girl with a blond ponytail clung to her mother, so Northam bent down and spoke with her — softly, earnestly, even sweetly, like a bushy-browed Mr. Rogers. She warmed to him instantly.

If 6-year-olds could vote, Northam would be the prohibitive favorite in this year’s race for governor. Instead, the Democrat is in a tight Nov. 7 contest with Republican Ed Gillespie, a much more polished politician.

Virginia has elected some high-octane Democrats, from the voluble McAuliffe to Sen. Tim Kaine, who was Hillary Clinton’s running mate last fall, and Sen. Mark R. Warner, who is helping lead the probe of Russian influence in U.S. elections.

Northam is different. An Army veteran from an old family on Virginia’s Eastern Shore, he built a successful medical practice in Norfolk and was a prominent community volunteer before entering politics a decade ago.

Local Democrats realized Northam had just the right qualities to challenge a vulnerable Republican state senator in 2007, launching him on an unlikely new career. He rose rapidly from state Senate to lieutenant governor and now the top of the ticket, aided by good timing, powerful mentors and a glittering résumé.

But he is playing on a different level now, in a world of career politicians and a time of vicious partisanship. It’s unclear how his quiet bedside manner, his warbly waterman’s accent or his reputation for bipartisanship will translate in the era of President Trump. His supporters hope an exhausted electorate will welcome that more soothing tone.

“He may not be your typical rah-rah politician,” said former longtime Norfolk mayor Paul Fraim, a Democrat. “But he’s very thoughtful, and I think that translates well. He’s a different type of politician.”

Hardy roots

More so than many for candidates, Northam’s identity as a public figure is rooted in the place he was raised. He grew up on the Eastern Shore, one of the most remote locations on the East Coast, where his family lived for centuries.

The latest stories and details on the 2017 Virginia general election and race for governor.

The peninsula straddles the Chesapeake Bay and Atlantic Ocean, a flat strip of farm fields and fishing villages, pine trees and crape myrtles and marsh grass. When Northam was born in 1959, the area was connected to the rest of Virginia only by ferryboats; the 20-mile Chesapeake Bay Bridge-Tunnel linked the region to Norfolk in 1964.

His father, Wescott Northam, was born on a farm in the community of Modest Town. An only child, Wescott was 14 when his father died; three years later, his mother had to sell their ancestral land to get by. He served in World War II, got a law degree and hung out a shingle near the Accomack courthouse.

In the 1950s, he bought an old farmhouse on the water outside Onancock. Wescott Northam’s wife, Nancy Shearer, was a nurse from Washington. The couple raised two boys in desegregated public schools. Thomas played football and liked to hunt; Ralph, two years younger, played basketball and baseball and loved to fish.

Ralph took risky jobs on the water at an early age, ferrying workers to Tangier Island and crewing fishing charters while still a teenager.

When Ralph was 15, a family friend gave him the rusted-out carcass of a 1953 Oldsmobile. He and his brother restored it together, and it still resides on a lift in their father’s garage.

In the 1960s, Wescott Northam was elected commonwealth’s attorney for Accomack County. He was the top prosecutor, bringing charges against people he’d known all his life. He won reelection three times and then lost. His wife declared that the family was finished with politics.

A few years later, Wescott Northam was appointed a circuit court judge. Their community is so tightly knit that the man who defeated Northam for prosecutor now shares law offices with Thomas Northam.

After high school, Ralph followed Thomas to the Virginia Military Institute. His response to the school’s harsh, macho culture was true to his roots: He found a few friends and stuck with them.

“At that time, you’re desperately looking for a friend and a bond, and he turned out to be it,” said J. Howard Conduff Jr., one of Northam’s freshman roommates and a lifelong buddy and campaign contributor. Last year, Northam officiated his son’s wedding.

By his senior year, Northam had reached the pinnacle of life at VMI — he was voted onto the honor court and then selected by leaders as its president, a position known as “the pope.”

Much as his father had done as a prosecutor and judge in their home town, Northam was now passing judgment on his friends, overseeing who would be expelled for honor code infractions.

Sometimes Northam would phone his father for advice. Thirteen times his senior year, the honor court convicted and expelled a student. And 13 times, Northam presided over the age-old ritual of “drumming out.”

In the middle of the night, cadets would awaken to pounding drums and then line balconies around the courtyard of the pre-Civil War barracks. The honor court members would march in from the darkness and then halt, and Northam would move to the center, naming the student who had been convicted and proclaiming that he would never be mentioned again.

For those who find the political Northam to be too gentle in his manner, supporters cite the honor court background as a rebuttal. His wife, Pam, said Northam’s style is deceptive.

“I would say you are confusing kindness with weakness,” she said.

Perfect for politics

After graduating from VMI in 1981, Northam spent decades building his career as a pediatric neurologist. The Army paid for his medical school, so he spent eight years on active duty, during which he treated troops wounded in Operation Desert Storm. He eventually settled in Norfolk.

He and four other doctors started a practice that now has more than 200 physicians in different pediatric specialties, and Northam spent 19 years as volunteer medical director of a children’s hospice.

He had no political profile in 2006 when Norfolk Democrats began casting around for a candidate to challenge the area’s Republican state senator, Nick Rerras, a colorful and controversial figure.

They needed a challenger who was conservative, preferably with a military background, to suit the area’s heavy population of service members and retirees. But they also needed someone with connections on the Eastern Shore, a major component of the 6th District.

There were practically neon arrows pointing to Ralph Northam. Some knew him as a prominent doctor; others knew of his father the judge and brother the lawyer. Fearing that Republicans might be wooing him to wage a primary challenge to Rerras, Democrats moved quickly to sign him up.

Northam’s decision to run surprised those closest to him. He voted twice for President George W. Bush but today disavows those votes as a sign of how little attention he was paying to politics. He says he was fed up with wrestling with insurance companies and worried about the health of his precious Chesapeake Bay. A frustrated colleague told him to stop complaining and “do something about it,” Northam said in an interview.

So he did.

Northam chipped in some $34,000 of his own money and got his biggest donation — about $240,000 — from his father. He ran hard, even ugly. He lambasted his opponent for suggesting that mental illness was a punishment from God, a claim some said stretched Rerras’s words.

The local newspaper found that other claims were exaggerations or just plain wrong. Northam later apologized for some tactics.

But he also won, by more than eight points. Friends say the harsh tone was a sign of what some call Northam’s “commitment to mission” — a military-bred tendency to go all in once he’s decided to act. It’s also evidence of a lifelong competitive streak.

He still boasts about batting .600 in high school, and he makes the hard-to-prove claim that he was the first person to dunk a basketball on Tangier Island. Last year when the General Assembly held a FitBit challenge to see who could pile up the most exercise steps, Northam won — by 70 miles over the next-closest competitor.

In a guy who otherwise seems most natural talking gently to small children, sharp edges can be jarring. Earlier this year when Northam made international headlines by calling President Trump a “narcissistic maniac,” at least one friend scolded him for it.

“I said, ‘I wish you wouldn’t use that term for this guy. Use something else,’ ” said Clarence Holland, a physician and former state senator from Virginia Beach who has known Northam since before he got involved in politics.

Northam stands by the term, which he came up with. But asked in an interview whether he feels the statement went too far, he paused for several seconds, then grinned and said no.

A GOP dalliance

As soon as Northam was sworn in to the state Senate in January 2008, Gov. Tim Kaine (D) summoned him.

“I told him, ‘Ralph, you are a person who would be a really good governor one day,’ ” Kaine said in an interview. “I just had that feeling about him because of his unusual track record of public service.”

Kaine still marvels as he ticks off the ways Northam seems like a laboratory-grown statewide candidate: military service in a state that depends on the defense industry; physician at a time when health care is a top issue; country roots when Democrats are desperate to reconnect with rural voters.

But despite that rapport with Kaine, Northam proved to be an unexpected headache for his party. First he cut a deal with Republicans to fill three long-vacant Norfolk judgeships, infuriating some fellow Democrats. In working that out, Northam built on his already friendly relationship with Ken Stolle, who at the time was a Republican state senator from Virginia Beach.

Not long after, Northam went to Stolle about another issue: his frustration that the General Assembly was failing to fund Norfolk’s Eastern Virginia Medical School, where he had studied.

Stolle suggested that Northam could help. At the time, Democrats had a 21-19 majority in the state Senate and claimed the chairmanship of all committees. But if just one Democrat would agree to vote with Republicans, a power-sharing arrangement to split the chairmanships could be triggered.

“Ralph would come and talk to me,” said Stolle, now the sheriff of Virginia Beach. “He got really upset about [the medical school funding] and said he’d had it. I said, ‘Well, Ralph, we’d always welcome you in the Senate as a Republican.’ He said he’d consider that.”

Northam denies he seriously thought about switching parties. But amid rumors, Kaine sat him down to explain that things are not always what they appear in the General Assembly. Stolle was rolling him.

“I frankly think people were taking advantage of Ralph’s being a newcomer,” Kaine said. “He had the right instinct on EVMS but maybe didn’t fully read the motives of the people on the other side.”

By the time Northam walked out of their meeting, Kaine had agreed to fund the medical school.

Kaine later asked Northam to carry a major piece of legislation — a restaurant smoking ban — and credits Northam for putting together a coalition to get it passed. Northam also used his medical background to torpedo Republican efforts to require women to get an invasive ultrasound procedure before getting an abortion, giving him enduring status with women’s health advocates.

Northam went on to build a reputation as one of the most generous Democrats in Richmond in terms of helping other party candidates around the state. Vivian Paige, a longtime Democratic activist in Norfolk, said she felt that Northam was atoning for his dalliance with the Republicans.

“This is his evolution,” Paige said.

Ambition and criticism

A year after winning reelection in 2011, Northam again found himself in demand. McAuliffe was gearing up for another run for governor after coming up short in 2009. State Sen. Mark Herring of Loudoun County was on the ticket for attorney general, and former White House adviser Aneesh Chopra was running for lieutenant governor. But that meant that all three candidates would be from Northern Virginia.

McAuliffe figured Northam could balance the ticket. “I liked him a lot,” McAuliffe said. “Liked his military record. It was a good regional balance for me to have him from Hampton Roads. So, you know, I spent a lot of time with him.”

Friends say Northam was reluctant. Holland, the physician and former state senator, remembered discussing it during a car ride to a medical conference.

“I said, ‘Oh, for crying out loud, what the hell would you want to do that for?’ ” Holland said. He told Northam he could accomplish more as a lawmaker.

But McAuliffe persuaded him. Northam won the nomination and had the good fortune of running against a weak Republican opponent, E.W. Jackson, whose extreme statements proved unpopular statewide. All three Democrats won. Then Herring decided early not to seek the governor’s chair, clearing the way for Northam.

Those plans were almost derailed when former congressman Tom Perriello shocked the party by jumping into the Democratic primary in January. According to McAuliffe, it was a rare moment when Northam lost his cool.

But the contest forced Northam, not a natural campaigner, to work for the nomination. Mobilizing support from party officials around the state, he won by an unexpectedly wide 11-point margin.

Now he’s in a neck-and-neck race with Gillespie, running during a time that looks very different from just a decade ago, when he took the plunge into politics. It may no longer be desirable for a Democrat to seem conservative or willing to compromise. Both national parties consider the Virginia race a bellwether for the 2018 midterms, and both have poured in money and staff, raising the ante.

Nonetheless, as Gillespie has aired hard-edge ads that suggest Northam will let gangs run loose in the streets, Northam has continued to campaign on the promise that he can “bring all sides to the table” and work out solutions to difficult problems.

Before debates, to get himself psyched up, he listens to Elvis Presley’s version of “My Way.”

Once in a while, Northam takes refuge from the campaign back in Onancock, where he can tinker on his classic cars or take the boat out into the bay. His brother lives in the house where they grew up, down a tree-lined lane through fields of sorghum.

Wescott Northam, 93, has heard people say that his son lacks a killer political instinct; he heard the same thing about himself 40 years ago. “When you get this kind of criticism, it really hurts,” he said.

But you have to be true to yourself, he said. And if you’re ambitious, you have to be willing to take the criticism and sacrifice some comfort in life.

“It takes balls to give that up,” he said. “He can handle it. Better him than me.”

This is the first of a two-part examination of the candidates vying to be Virginia’s next governor. Tomorrow, Republican Ed Gillespie.