The Republican-leaning Chicago Tribune endorsed Sen. Kirk in his five successful runs for Congress and in 2010 when he won his seat in the U.S. Senate.
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After his 2012 stroke, he returned to work a year later using crutches and a wheelchair. Kirk's doctors said Kirk's cognitive abilities had not been affected.
But on Friday, eleven days after Kirk appeared before the Tribune editorial board, the newspaper wrote:
"We cannot tiptoe around the issue of Kirk's recovery and readiness...due to the forces beyond his control, Kirk no longer can perform to the fullest the job of a U.S. senator."
Illinois Democratic Senator Dick Durbin said he supports Duckwork in the election while also considering himself a personal friend of Kirk. Durbin was there for his colleague's return to the capitol in 2013.
"To go into deep analysis of the impact of a stroke on anyone is beyond me and I don't know that the editorial writers of the Tribune have a special expertise in that either," Durbin said.
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Fewer than 24 hours before the Tribune endorsed his opponent, Kirk was in a Springfield hospital to highlight the improved treatment and recovery of stroke victims.
"Remember, were going to have about 300,000 citizens of Illinois who may suffer a stroke this year. I want to make sure they are advantaged because Mark Kirk was their Senator," Kirk said.
Kirk's campaign said the Tribune citing the candidate's health was, "A low-blow and cheap shot by the Chicago Tribune that is not based on fact or reality."
The Chicago Sun-Times endorsed Duckworth but did not base it on any concern that Kirk is not healthy enough for the job.
The Duckworth campaign had no comment on Kirk's health.