He has to put out a hand to steady himself as he shuffles the few steps from the chair to the podium; his voice is faltering and unsteady and he has trouble pulling a crowd even at home in northern India.
But such appearances can be deceptive.
As Indian politics grows ever more image-driven, the idiosyncratic Prime Minister Atal Behari Vajpayee, 79, grey-haired and portly, is riding high as the most successful politician outside the Nehru-Gandhi dynasty that rules the once indomitable Congress party that led the nation to independence.
"No PM outside of the Congress or even the family that dominates its politics has ever been as popular," says political analyst Mahesh Rangarajan. "Since around the mid-1990s, he has been the most pivotal figure for non-Congress parties."
Surprise polls suggest Vajpayee's Hindu nationalist Bharatiya Janata Party (BJP) and its allies are in trouble and may struggle to retain their majority after the national election that entered its last round of voting yesterday. Results are due on Thursday.
The BJP's "India Shining" campaign slogan has turned off many rural voters who see the party's hard-sell of economic progress as smug and out of touch with the hundreds of millions of farmers who remain mired in poverty.
Caught off guard by the polls, Vajpayee has dropped the issue of economic management to go straight for the opposition.
"If the coalition does not get a majority, the country will slip into political anarchy," he told an election rally in Bulandshah in the northern state of Uttar Pradesh last week.
Vajpayee himself still has a strong lead in opinion polls over Congress' Italian-born leader, Sonia Gandhi, but campaigning by her popular daughter, Priyanka, and son, Rahul, has helped revive the party and narrow the gap with the BJP.
His appeal and carefully honed image as a moderate elder statesman are key weapons in the BJP's bid for an unprecedented second five-year term.
"Vajpayee -- personally, he is a good man. But he is a good man in a bad party -- his party has people that are fanatics," says Perwez Abedin, manager of a shoe factory just outside Vajpayee's northern constituency of Lucknow.
Vajpayee's age and health could also be against him after two knee replacements, although he has pledged to see through another five-year term if he wins office. However, his concentration and his oratory appear to have weakened in recent years.
But he rejects his opponents' demands to retire.
"People say I am forgetful and I am incapable. Nowadays, everyone tends to twist statements. But I think the voter will understand and I am confident that the people will give us their mandate," he was quoted as saying in Saturday's Indian Express.
Analysts say that Vajpayee's heir apparent, hardline Deputy Prime Minister Lal Krishna Advani, lacks his appeal to both voters and political allies.
Vajpayee, an MP for almost half a century, is a man friends say keenly wants to forge a place in history for himself and a role on the world stage for India as a great power.
"I still remember the day when I became a candidate for the Lok Sabha for the first time," he told a small, restrained gathering of party workers last month, referring to parliament. "I went into the field only with one weapon -- and that was to make India a great nation."
Says one close aide: "He really wants a place in history. He doesn't want to be just another politician."
It is this desire, analysts say, that drives Vajpayee's efforts to strike a lasting peace with neighboring Pakistan, the most recent of which he launched a year ago after the nuclear-armed rivals came close to war over Kashmir.
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