He's the longest-serving party leader in the history of the US Senate, but - amid a very public health struggle - Mitch McConnell's time in office may be nearing its end.
In an age when many politicians take pride in being "outsiders", the 81-year-old is a political lifer and a consummate creature of the DC establishment.
Representing Kentucky in the Senate since 1985, he has won a reputation as a shrewd and tactical campaigner, even if not everyone finds him a particularly charismatic figure.
He has also been elected a record nine times by his fellow Senate Republicans to serve as their leader, a role in which he has been at the helm of some of Washington's most consequential decisions.