Anyone who was surprised when House Speaker Nancy Pelosi emerged this week as the heroine of the Obama administration's epic struggle over health-care reform clearly hasn't been paying attention.
To be sure, the soon-to-be-70-year-old grandmother has been widely ridiculed - for her collection of Hermès scarves, her once-a-day hairdressing appointments, the paucity of her oratorical power and for serving as a poster senior for Botox.
With President Barack Obama's declining poll ratings and the Republicans resurgent, many Washington insiders were skeptical of her ability to corral the 216 votes needed to win the historic bill's assent in the House of Representatives.
But as the bruising 14-month battle that culminated in Mr. Obama's signing of the bill yesterday clearly demonstrates, Ms. Pelosi is a savvy and pragmatic political operator, blessed with tenacity and strong leadership skills.
By some accounts, it was Ms. Pelosi who stared down White House chief of staff Rahm Emanuel, who had argued for a diluted piece of legislation.
For Norman Ornstein, resident scholar at the American Enterprise Institute, Ms. Pelosi is not just the most powerful female politician in America (her position puts her second in line to the presidency, after Vice-President Joe Biden) and the first woman to wield the Speaker's gavel. "She's the strongest Speaker we've seen in our lifetime," he says. "She's relentless. She knows how to push the right buttons. She makes things happen."
"She's the consummate insider," says Thomas Mann, senior fellow at Washington's Brookings Institution. "Her strength isn't public. It's understanding her caucus - knowing her members, their districts, their political and personal situations, where they can give and where they can't, and being tough."
The health-care bill, Dr. Mann adds, was no anomaly. Ms. Pelosi had previously manoeuvred several other contentious bills through the House, including those pertaining to the stimulus package, tobacco regulation and greenhouse-gas emissions.
"Pelosi functions like her own House Whip," adds Amy Kaufman, a research fellow at the Hudson Institute. "She knows exactly where to go to get the votes and how to wrangle them."
None of Ms. Pelosi's backstage sinew and dexterity is an accident; she virtually has politics encoded in her DNA.
The youngest and only daughter among seven children, Nancy Patricia D'Alesandro Pelosi literally grew up on House debates - sleeping on a bed under which her father, five-term Democratic Representative Thomas D'Alesandro Jr., stored copies of the Congressional Record. Later, her father served as mayor of Baltimore (for 12 years), as did one of her brothers.
The Pelosi family home was a non-stop whirlwind of political activity - strategy sessions, constituency meetings, building campaign organizations. As she once said: "We were all christened into the Roman Catholic Church and the Democratic Party.''
Although Ms. Pelosi did not seek public office until she was 47 - she and husband Paul, a wealthy San Francisco businessman, were busy raising five children, all born within six years - she was deeply embroiled in Democratic politics. She headed the California Democratic Party, raised money tirelessly for candidates and, overseeing 10,000 volunteers, chaired the Host Committee of the 1984 National Democratic Convention.
In his unauthorized 2008 biography, Madam Speaker: Nancy Pelosi's Life, Times, and Rise to Power, journalist Marc Sandalow documents her organizational agility: "Each day was a logistical labyrinth. Carpools. Fund-raising letters. School plays. Donor meetings. Birthday parties. Printing deadlines. Teacher meetings. Slate cards. Soccer practice. School supplies. Voter files. Press calls. Homework. Thank-you notes. Fund-raising dinners. Field trips."
It was winning the 1987 election to replace the late representative Sala Burton in San Francisco's 5th congressional district that first brought Ms. Pelosi to wider public notice. In the two decades that followed, she rose steadily in the party, becoming Minority Whip in 2001 and Minority Leader in 2002 - the first woman to lead a major party in the House. She became Speaker of the House in 2006.
Her voting record on Capitol Hill has largely reflected the attitudes of one of America's most liberal cities. According to biographer Sandalow, before becoming Speaker she was among the most left-wing members of Congress. "The only vote she took that disappointed the left was her vote in favour of NAFTA in 1994."
Brookings's Dr. Mann says he's not surprised by her success. "I told people from the beginning she would be a formidable Speaker. The surprise comes from those who had a simple-minded notion that she would lead as a San Francisco liberal. They did not understand her roots in party machinery politics or her ability to represent an unusually liberal district and still manage a body with great political diversity."
There has been only one significant political misstep, says Dr. Ornstein - her backing of congressman John Murtha for the post of House majority leader over the ultimate winner, Steny Hoyer. But she and Mr. Hoyer have since made amends.
On a personal level, "she has a tendency to divide the world into those who are with her and those who are against her," Dr. Ornstein says.
"She can be stubborn," Mr. Sandalow told one interviewer when his book was published. "She has a very clear, set sense of what's right and what's wrong. And she is not one to easily forgive. She does not soon forget."
Although some Democrats are expected to pay a price in the November midterm elections for supporting the bill, "their losses would have been much more significant if the health-care bill had not passed. So she's actually energized the party," Dr. Ornstein says.