Mitch McConnell’s latest health scare guarantees Republican senators will return from recess next week just as they left — publicly and privately discussing the future of their 81-year-old leader.

The Senate GOP leader paused for roughly 30 seconds during a press availability in Kentucky, a little more than a month after a similar episode in the Capitol in late July. His office attributed both episodes to lightheadedness, adding that McConnell would consult on Wednesday with a physician as a precautionary measure.

That explanation may not stem questions when the Senate reconvenes next week. While worries about McConnell’s first freeze had faded somewhat during August recess, with even some critics publicly defending his abilities, the second incident is sure to trigger increased scrutiny of McConnell’s hold on the conference, as well as who might succeed him.

Senators quickly sought more information about McConnell’s health after the incident, according to one person familiar with the dynamics. Shortly after the Wednesday incident, McConnell held calls with his closest allies including Minority Whip John Thune (R-S.D.), Conference Chair John Barrasso (R-Wyo.) and Sen. John Cornyn (R-Texas), according to people familiar with the calls. All of them are potential successors to McConnell.

“The leader sounded like his usual self and was in good spirits,” said Ryan Wrasse, a spokesperson for Thune. McConnell told Cornyn he was doing well, a Cornyn spokesperson said.

Sen. Shelley Moore Capito (R-W.Va.), the No. 5 GOP leader, also spoke with McConnell on Wednesday and said afterward via a spokesperson that McConnell sounded fine.

The questions over McConnell’s health began after he fell in March and suffered a concussion. That injury kept him out of Senate business for several weeks, and McConnell has sometimes struggled to hear reporters’ questions since that episode — in addition to the two public pauses that occurred on camera.

A spokesperson for the GOP leader asserted in a July statement that he “plans to serve his full term in the job.”

“After he fell, obviously he was a little bit groggy when he first got back. But he’s picked up a lot more energy since then,” Sen. Tommy Tuberville (R-Ala.) said in a July interview.

Internally, McConnell is facing dual dynamics: His potential successors — Cornyn, Thune and Barrasso — are backing his leadership, staying supportive and say he’s sharp. There’s no mechanism to force another leadership race until the end of next year, though a group of five senators can call a special conference meeting to discuss the matter.

There’s no sign of that yet, though some Republican senators privately say his grip on the caucus and his engagement in meetings has waned since March. The dynamics are complicated by McConnell’s 2022 leadership race, in which he both won handily and faced his first opposition ever. He beat Sen. Rick Scott (R-Fla.), a former chair of the National Republican Senatorial Committee, 37-10. That means he has a built-in group of detractors amid the latest health queries.

McConnell has led the conference since 2007, the longest run for a Senate party leader in history. He will be up for reelection in 2026, and his pause on Wednesday occurred after a question about whether he will run again.

The GOP leader still has unfinished business. He’s trying to facilitate more aid to Ukraine and offer an alternate vision to former President Donald Trump. Trump and McConnell haven’t spoken since December 2020, and Trump continues to advocate for Republicans to replace McConnell. The Kentucky Republican refuses to speak about Trump even as the presidential candidate cruises toward the GOP nomination.

McConnell is also highly focused on flipping the Senate in 2024, particularly after 2022’s disappointing election losses. And he’s hoping to help Daniel Cameron, a former aide, win the Kentucky governorship this fall, even dispatching his chief of staff to the state to help beat Democratic Gov. Andy Beshear. If there is a Senate vacancy, the governor would select the replacement from a small group of Republicans recommended by the state GOP.

It’s no stretch to say McConnell loathes discussing his health in public. He simply said he was “fine” after the July pause, brushing off questions about his condition and cracking to reporters after a call with President Joe Biden that he got “sandbagged,” a reference to Biden’s public fall earlier this year.

Biden on Wednesday called McConnell a “good friend” and said he planned to try and get in touch with the GOP leader.

McConnell quietly answered questions after his Wednesday freeze, which came at the tail end of an extended speech at a Northern Kentucky Chamber of Commerce event. It’s one of several events McConnell had in Kentucky during the August recess, a sign that the GOP leader is staying visible and active back home.

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