For the first time in nearly two decades, the state of Arizona is going to the polls on Election Day guaranteed to pick a new U.S. Senator. The race to replace retiring Republican Jon Kyl is the closest in a generation, with Democrat Richard Carmona -- perhaps the most interesting man in American politics -- running neck-and-neck with Jeff Flake, a GOP congressman.
Carmona was handpicked and recruited by President Obama to take on Flake, who holds a statistically insignificant lead in most of the latest local polls. Democrats are banking on Carmona's surprising, occasionally dangerous life and lively political background – an independent running as a Democrat for the first time, he was surgeon general under President George W. Bush – to swing a campaign that's cost millions and won him some high-profile supporters.
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The son of Puerto Rican parents, Carmona served as a Special Forces medic in Vietnam and earned two Purple Hearts and two Bronze Stars. After his return, Carmona joined the Pima County Sheriff's Department as a deputy, serving as a SWAT team leader, while also practicing as a surgeon.
In 1992, Carmona rescued a man from a cliff in the snowy Pinaleno Mountains, rappelling down a 75-foot line from a helicopter.
He was serving as head of the Tucson Medical Center trauma unit at the time.
Seven years later, while Carmona was off-duty from his sheriff's deputy service, he saw a traffic accident in Tucson and stopped to offer medical assistance. One of the drivers shot at him and the bullet grazed his head. Carmona shot back and killed the man. It was later discovered that the man was mentally unstable and wanted for murder.
But Carmona hasn't always been cast in such a positive light. Upon his nomination for U.S. surgeon general, a 2002 Los Angeles Times story portrayed Carmona as belligerent and difficult to work with, digging into his tenure at Tucson Medical Center.
It's a theme Flake's campaign seized on as the race tightened this fall and the candidates exchanged extremely personal, nasty ads.
Cristina Beato, a senior Health and Human Services official during the Bush years, accused Carmona in a TV commercial of knocking loudly on her door late at night when she was his boss.
"There was an angry pounding on the door in the middle of the night. I'm a single mom. I feared for my kids and for myself," Beato says. "It was Richard Carmona, and I was his boss. Carmona is not who he seems. He has issues with anger, with ethics, and with women. I have testified to this under oath to Congress. Richard Carmona, should never, ever be in the U.S. Senate."
Carmona's campaign denied the incident took place and responded with another ad featuring another former boss. In it, former SWAT commander Kathleen Brennan, under whom Carmona served in Pima County, Ariz., for years, vouches for Carmona's treatment of women and attacks Flake.
"When I see a career politician like Jeff Flake attacking Rich Carmona, who has spent his life helping others, it's despicable. Congressman Flake should be ashamed," Brennan says in the spot.
Later, when Carmona joked that a male debate moderator was "prettier" than CNN anchor and presidential debate moderator Candy Crowley, Flake released another video, this one saying the Democrat "repeatedly demeans women."
The ad wars soon took darkly comic turn when Carmona released a spot showing current Arizona Senators McCain and Kyl, both Republicans, praising him during confirmation hearings after his 2002 appointment as U.S. Surgeon General.
In response, the senators cut an ad of their own, calling Carmona dishonest for "implying" that they supported his candidacy.
Now, on Election Day, there is one last controversy: Arizona Democrats have told local media they are receiving robocalls from the Flake campaign that provide incorrect information about when and where they can vote.
In response, The Arizona Republic reports, they are demanding "that the Arizona Secretary of State's Office, the Arizona Attorney General's Office, the FBI and the U.S. Department of Justice look into the Flake calls."
The exchanges with Flake, and then McCain and Kyl, weren't the candidate's first experience with the kind of deeply partisan controversy that threatens his All-American, last-action hero brand.
After leaving the Bush administration following nearly four years as surgeon general, he accused the administration's political appointees of stifling science in the health sphere. He testified before a congressional committee that officials had delayed and watered down his damning report on second-hand smoke and forbidden him from speaking about or releasing studies on stem cells, the morning-after pill, and sex education. Carmona also accused officials of advising him not to attend the Special Olympics because of the organization's ties to the Kennedy family.
Carmona says he's maintained good relationships with Republicans since then. His testimony wasn't about payback, he explains, and that he was simply answering the questions put before him. He notes that he sought counsel from senior GOP senators before entering the 2012 race.
Perhaps more importantly, he's received endorsements from a number of high-profile and popular figures. Astronaut Mark Kelly, husband of former Rep. Gabrielle Giffords, D-Ariz., is a prominent supporter and fundraiser. Carmona also has the endorsement of former President Bill Clinton, the most popular character in the Democratic Party.
And then there's President Obama.
"We had a nice conversation," Carmona said told ABC News in February, "and he did urge me to consider running, because he felt that we needed new blood in Washington."
Also on Carmona's side: his position in immigration reform.
Ever since Gov. Jan Brewer signed the SB 1070 Arizona immigration law, the issue has dominated the state's politics. Democrats think that could be a boon, and have used it to motivate the law's opponents to volunteer and vote. The Obama campaign had also included Arizona in its early swing state plans, thanks largely to a riled-up Latino base, though they have long since conceded the state to Mitt Romney.
Flake, meanwhile, has turned hard to the right, after he co-authored a major immigration reform bill with Democratic Rep. Luis Gutierrez (D-Ill.). Their bill contained the same broad strokes as the reform push undertaken in 2007 by Sens. John McCain and Ted Kennedy. Flake has since abandoned the comprehensive approach, making the same turn McCain did before his Senate reelection campaign in 2010.
"I've been down that road, and it is a dead end," Flake said in March 2011. "The political realities in Washington are such that a comprehensive solution is not possible, or even desirable given the current leadership. Border security must be addressed before other reforms are tackled."
Carmona supports the broad strokes of comprehensive reform -- enhanced border security and a pathway to some form of permanent residency -- thereby setting up a campaign in which Flake runs against his own former policies and Carmona touts the general outline of Flake's own bill.
Immigration, it so happens, is part of the reason Carmona is running as a Democrat.
"I couldn't buy into the value proposition that some of the Republicans were touting," Carmona told ABC, speaking about the GOP tendency to rally around deportation – Mitt Romney has suggested a short-term policy that encourages immigrants to "self-deport" -- and loudly decry the large population of illegal immigrants in the U.S.
Despite it all – decades of adventure and triumph, his unique political course, and plenty of money spent to tell the story -- overcoming Flake and Arizona's heavy Republican bent could still prove a bridge too far.
Arizona has only elected one new Democratic Senator – Dennis DeConcini in 1976 – since Carl Hayden retired in 1962 after 36 years in office. DeConcini left the Senate to join the board of Freddie Mac in 1995. Since then, Kyl and Sen. John McCain, who was first elected in 1986, have run and won six elections without a serious Democratic challenge.
Gov. Brewer, a leading architect of that controversial immigration law and author of "Scorpions for Breakfast, once infamously confronted President Obama on a airport tarmac in what she called a "terrible encounter." The state has only elected one Democratic governor since Raul Hector Castro in 1974.
If Carmona can break through, he will likely have Flake, whose conservative, anti-spending platform has never been put under the statewide spotlight, to thank. Not that at anyone should be surprised to see Richard Carmona get what he's after. History in Arizona today would be worth little more than a chapter in the final account his improbable life.