Rudy Giuliani is expected to return to the presidential campaign trail on Saturday after a grim week during which he fell ill and saw his long-running lead in the Republican race evaporate.
The former New York mayor spent a night in hospital on Wednesday after suffering flu-like symptoms while campaigning in Missouri. He was released on Thursday after tests found no cause for concern. But the minor drama symbolised the sense of malaise surrounding his campaign.
After leading by double-digit margins for most of this year, several recent opinion polls have shown Mr Giuliani losing ground to Mike Huckabee, the former governor of Arkansas, and Mitt Romney, the former governor of Massachusetts.
Two national surveys published this week suggest that the Republican race is now a dead heat, less than two weeks before the first nominating contest in Iowa.
Mr Giuliani’s slippage follows a series of embarrassing headlines, drawing attention to his turbulent past.
First came the indictment of Bernie Kerik, a former New York police commissioner and Giuliani ally, on corruption charges. That was followed by allegations of a cover-up of police expenses incurred while protecting Mr Giuliani during his extramarital affair with Judith Nathan, his former mistress and now third wife.
The negative stories may have reinforced doubts among many social conservatives about Mr Giuliani's suitability for the Oval Office. But a bigger factor behind his poll slump may not be the stories that have been in the news but those that have been missing.
Mr Giuliani has become a peripheral figure in media coverage of the Republican race as attention has focused on the head-to-head Iowa duel between Mr Huckabee and Mr Romney.
The former mayor languishes in fifth place in Iowa, having chosen largely to ignore its caucuses and focus instead on bigger states scheduled to hold primaries later in January and early February.
Traditionally, presidential candidates have focused on winning the early-voting states of Iowa, New Hampshire and South Carolina to build unstoppable momentum. But Mr Giuliani reckons changes to this year’s nomination calendar – with many states moving their contests forward to early in the year – will allow him to bypass the earliest states.
Because of their greater populations, states such as Florida, which votes on January 29, and California, Illinois and New York (February 5) have greater weight in the nomination process than Iowa, New Hampshire and South Carolina.
As the most widely known and admired of the Republican candidates – stemming from his leadership of New York after September 11 2001 – Mr Giuliani is counting on winning several of these big states, regardless of his results elsewhere.
“No candidate has won a nomination in the modern primary era without winning Iowa, New Hampshire or South Carolina,” said Tony Fabrizio, a Republican strategist. “For his strategy to work, Rudy Giuliani has to defy history.”
Until recently, the strategy looked sound, as his national poll lead remained strong despite his trailing in all three early states. But as national polls tighten, doubts are growing over whether he will be able to bounce back from almost certain early setbacks.
Whit Ayres, another Republican strategist, says Mr Giuliani could still emerge victorious if the early states split between different winners. But if one candidate sweeps all three, he thinks it could be game over. “It’s a high-risk gamble,” he said.