He’s a doctor and a progressive. Will he win a key US Senate race in Michigan?

But ask him after a long day on the campaign trail to explain the difference between a virus and a bacterium, and the epidemiologist takes over from the entertainer.

El-Sayed, running in Michigan to be the Democratic candidate for US Senate this November, is trying to strike a delicate balance between policy wonk and performer – capable of detailing the mechanics of the proposed Medicare for All system of universal healthcare one minute and delivering a punchline the next.

At a moment when American politics has become conspicuously humorless, he is an unusual political persona. And in a matter of days, on 4 August, Michigan Democrats will decide whether he’s their type to send him to the United States Senate.

El-Sayed faces the more moderate representative Haley Stevens, who has the backing of the Democratic party establishment. The duo are virtually neck-and-neck at the polls – raising the prospect of the party’s grassroots voters again defying the wishes of its leaders.

While a string of socialist victories across Democratic primaries in recent months has boosted the left of the party, El-Sayed rejects the label. He just wants capitalism that works.

El-Sayed, 41, has tried, and failed, to win office before: in 2018, he lost the Democratic gubernatorial race in Michigan. Has the younger, anti-establishment coalition he now represents grown larger than the one that rejected him eight years ago? El-Sayed believes it has.

“I think people are sick and tired of the establishments on both sides of that, and I think we are having success because we’re speaking to that frustration,” he said. “And politics doesn’t have to suck, and you can build a politics that doesn’t suck.”

Matt Grossman, director of Michigan State University’s Institute for Public Policy and Social Research, points to a broader realignment inside the Democratic party. Voters in Michigan are united more by frustration with Democratic leadership, he suggested, than by agreement on every policy question.

“In the previous campaign, El-Sayed was more the Bernie candidate – affiliated with a particular faction of the Democratic party,” Grossman said, referring to the progressive US senator Bernie Sanders. “Now, he’s more representative of a broader group of voters on the left side of the Democratic primary, who are anti-institutional or newly grassroots.”

Next month’s Michigan primary will test whether that coalition is now large enough to nominate one of its own as a Democratic candidate for Washington.

El-Sayed insists he didn’t plan to run in this year’s US midterm elections. Heading into 2025, he said, “I thought I was going to keep doing what I was doing” – running Wayne county’s public health department, trying to keep key programs and health centers afloat as Donald Trump’s administration wielded the axe.

“The straw that broke the camel’s back was when they froze federal funds,” El-Sayed recalled in an interview. “I’m sitting here trying to figure out how to flow programs like [nutrition support initiative] Wic and federally qualified health centers and vaccines, and meanwhile we’re watching our tax dollars get sent abroad to drop bombs on other people’s kids.”

Throughout his campaign, El-Sayed has frequently tied the Israel-Gaza war, which he unflinchingly calls a genocide, and other conflicts involving the US to affordability at home. “Every time you want to put glasses on kids, people ask you: ‘Doctor, how are you going to pay for that?’” he said. “Nobody asks the general how he’s going to pay for the next war.”

The roots of this worldview long predate this campaign, and run through Egypt, where El-Sayed spent childhood summers with his father’s family.

He describes the country as both “glorious”, because of the fullness of family and social life, and “painful”, because of the strict political order surrounding it, and the role that decades of US military support helped play in sustaining it.

“There’s no world in which, had I been born in Egypt, like I was supposed to, I would ever be able to run for office,” said El-Sayed. “That’s the thing I got to do, because I’m an American.”

El-Sayed credits his grandmother, whom he calls the smartest person he ever knew, for teaching him that, while talent is distributed widely, opportunity is not.

“I’m playing with house money, man,” he said. “Put all the chips back on the table and try and do something new. I was supposed to be a cab driver in Egypt. That’s not my life.”

Instead, as a student, he was a starting defenseman on the University of Michigan lacrosse team, vice-president of its Muslim Students Association and, in 2007, the university’s first Rhodes scholar in years. He studied at Oxford, attended Columbia medical school and eventually entered public health, rather than private practice.

“He was always the smartest guy, the awesome guy who can work the room,” said Mohamad Issa, a head and neck cancer surgeon in Ohio who knew El-Sayed during his college years. “The first person there. The last person to leave.”

Issa remembers approaching El-Sayed after a game of basketball as a nervous freshman, having earned disappointing grades in his first science classes. He had been told by an adviser that medicine might not be for him.

El-Sayed, then a student athlete, spent months mentoring him, offering study strategies that Issa says transformed his academic career. Two decades later, Issa says, he still teaches those same techniques to students he mentors today.

“He’s a bro,” Issa said. “That’s all you gotta know.”

After years of research and being an instructor, El-Sayed led Detroit’s health department after the city’s bankruptcy, then took over Wayne county’s, where he helped cancel roughly $700m in medical debt affecting 300,000 Michiganders.

“He almost has an idealistic pressure in his mind about wanting to live fully, in a way that is admirable,” said Dr Sandro Galea, dean of public health at Washington University, who has known El-Sayed for more than 20 years. “It comes from a sense of wanting to do right by people, wanting to help in a better world for people.”

El-Sayed sees government service, and elected office, “as an important pathway to doing that”, suggested Galea.

In part, that is why he pushes back when the socialist label is used to describe his platform. “I’m a scientist,” he said. “I want to solve problems.”

His critique of the economy is not that markets can never work, but that concentrated corporate power has prevented them from working as advertised. “If the markets actually worked the way they’re supposed to, you might have some efficient movement of money,” he said. “The problem is, we don’t live in capitalism, we live in oligopoly.”

El-Sayed points to universal healthcare. Private insurers make money from people when they are younger and healthier, he says, before handing them to the government at 65, when their care becomes more expensive. A rational system would spread those costs across a lifetime, according to him, rather than privatize the profitable years and socialize the costly ones.

For El-Sayed, the question is ultimately the same one he absorbed in Egypt, at school, in his research and from his grandmother: who is permitted to benefit from the institutions around them – and who is expected merely to endure them?

With that message, he has gained ground inside the Democratic electorate, with rallies attended by hundreds of eager Michiganders from across the political spectrum, though the party establishment has been considerably slower to follow.

Chuck Schumer, the US Senate minority leader, and retiring senator Gary Peters have backed Stevens, reflecting the party leadership’s preference for the more conventional candidate. El-Sayed, meanwhile, has assembled a different coalition, winning recent endorsements from the likes of progressive representative Alexandria Ocasio-Cortez and Sanders.

The divide reflects a broader disagreement inside the party over what will help it win.

Grossman, at Michigan State University, does not believe the concern driving figures at the top of the Democratic party to oppose El-Sayed is primarily ideological. It is, he said, more about what a victory by someone to Stevens’s left would signal nationally.

“The concern from Washington is more about the long-term image of the Democratic party and whether someone closer to El-Sayed’s politics would make it harder to hold the seat in future elections,” said Grossman. “I don’t think Abdul will suffer a major penalty for ideology in this election.”

El-Sayed has faced unusually determined resistance.

Not everyone inside the party embraces his offering. Lon Johnson, a former chair of the Michigan Democratic party who supports Stevens, argued El-Sayed’s politics could ultimately cost Democrats one of their best opportunities to retake control of the US Senate. “There is real concern that Abdul would not be able to beat [Republican Mike] Rogers and then potentially lose us a majority possibility in the Senate,” Johnson said.

Outside groups, led by the pro-Israel lobbying network Aipac and its affiliated political funds and committees, have poured roughly $30m into the race on behalf of Stevens, making Michigan one of the most expensive Democratic primaries in the country.

While El-Sayed continues to speak out about Israel’s destruction of Gaza, ads have leaned heavily on domestic issues, highlighting Stevens’s experience working with the Obama administration’s auto rescue in 2008.

An uncertain race

The race remains unusually difficult to read.

Stevens, a four-term representative who has repeatedly won competitive districts, has cast herself as the Democrat with the proven record against Republicans, and sometimes aligning with them – and warned that national Republicans would rather face El-Sayed in November.

A Detroit News/WDIV poll in mid-July showed Stevens ahead by seven points. Roughly 10 days later, another tracking poll showed El-Sayed ahead by the same margin.

He will face one of his biggest challenges in Detroit, particularly in winning over the city’s Black voters, who have decided most competitive Democratic primaries in Michigan.

Asked directly whether he’s done enough outreach, El-Sayed did not argue with the premise. “We’ve never done enough in politics,” he said. “There’s always more that could be done.”

Republicans have already begun preparing for a potential El-Sayed nomination. The National Republican Senatorial Committee has branded him “the most radical Democrat Senate nominee of the cycle”, highlighting his support for Medicare for All, abolishing ICE (Immigration and Customs Enforcement) and his criticism of Israel as evidence he is out of step with a battleground state like Michigan.

Waiting in November for whomever emerges from the Democratic primary is their party’s candidate, Mike Rogers.

El-Sayed dismisses the man he may face in November as a beneficiary of the same political system he argues has rewarded corporations while leaving ordinary Americans behind.

When it comes to the tens of millions of dollars from pro-Israel organizations spent against him, he remains similarly unfazed. “If your product sucks, don’t be surprised if people don’t buy it,” he said.

That the race remains uncertain despite support for Stevens from powerful figures in the Democratic party shows how far El-Sayed has come since 2018.

Eight years ago, he represented a faction. Today, he represents a coalition the party establishment is no longer certain it can stop.

This broader voter base is younger, more skeptical of party institutions and increasingly unwilling to separate economic inequality from US foreign policy, particularly on Israel. El-Sayed says he’d rather lose than win and compromise on these beliefs.

“The paradox here is that the way to win is to actually have values, because people at least know what you’re for,” he said. “The hope is that people with more power than me fear that I’ll step up to them, and people with less power than me never think I’m arrogant.”