They call Peter Robinson rubber ball man... but can he bounce back from this latest setback?
Ivan Little analyses the intense pressure the DUP leader has been under in recent weeks, and throughout his career
Behind the smiles and the handshakes at one of his last public engagements on Thursday afternoon, Peter Robinson looked like a man with more than a Royal visit on his mind.
As Prince Charles toured a community network centre in east Belfast, several guests remarked that the First Minister at times looked distracted and distant, as if his thoughts were elsewhere - like up the road at Stormont.
Which was hardly surprising. For Mr Robinson has undoubtedly been a politician under intense pressure amid the furnace of the row with Sinn Fein over welfare reform which is threatening to bring down the Executive.
The former MP for the area had come to the old Templemore Avenue school from St Patrick's Catholic Church, where he and deputy First Minister Martin McGuinness sat side-by-side - even though they were miles apart on the budget cuts.
But clearly tired of claims that he and the DUP were crying wolf over the seriousness of the Stormont impasse, Mr Robinson hammered home his ominous warning about the future in an article for this newspaper on Friday.
Then yesterday, on the eve of the Assembly debate on a contentious Bill about welfare reform, came the shock news that Mr Robinson had been rushed to hospital with a suspected heart attack.
Ironically, the revelation about his health has united politicians on Twitter, with scores of get well messages for Mr Robinson, who is 66, but looks considerably younger than his years.
And friends say his health has been remarkably good. And that's despite a workload which has been more demanding than many other people his age would be expected to handle.
Friends say he rarely gets a chance to switch off and his constant travels across the world to promote Northern Ireland for potential investors is challenging - no matter what the rating of the hotels he stays in.
At home, however, any statesmanlike touch from Mr Robinson has deserted him on a number of occasions recently, especially when he weighed in with his support of Whitewell Metropolitan Tabernacle Pastor James McConnell who had denounced Islam as "heathen, satanic and a doctrine spawned in Hell".
But Mr Robinson didn't just back the Pastor. He said like him he wouldn't trust Muslims though he added that he would trust them to go to the shops for him. His language caused widespread offence and even his supporters questioned the wisdom of his words, forcing the First Minister to apologise and pay a humble pie visit to the Belfast Islamic Centre.
But Mr Robinson brought another furore to his door when he earned the wrath of gay and lesbians for attacking the Equality Commission over its "bonkers" financial support for a man in the recent "gay cake" court case against Ashers Bakery who were later ruled to have broken the law. However, supporters of the McArthur family, who own Ashers, welcomed the intervention.
Mr Robinson has never been far from controversy throughout his political life after his invasion across the Republic into Clontibret and his flirtation with shadowy Ulster Resistance paramilitaries.
But he has had to cope with more personal crises, too.
His wife, Iris, had an affair with a 19-year-old man, Kirk McCambley, which devastated Mr Robinson and his children, some of whom were said to have been totally estranged from their mother and there were claims she had demanded money for helping her lover develop a new cafe.
The heavy toll on Mr Robinson was all too evident as he went on television to talk about the scandal.
But the buzzards were circling and Peter Robinson stood down for six weeks as First Minister though commentators predicted he would never be back in his plush Stormont office.
And, when he later lost his Westminster seat to Naomi Long in 2010, the gloating was unmistakeable on the streets of east Belfast where the writing was also on the wall for Mr Robinson. Or so they said.
Last year, a Sunday newspaper which obviously had the ear of someone inside the DUP, but outside the Robinson camp, told their readers that his days as party leader were numbered. Or so they said.
For the rubber ball man, as one former political associate called him, bounced back.
Another former ally said: "No matter what you think of Peter, he has been the consummate survivor.
"You have to admire him for that.
"He doesn't have a great personal warmth and when the pressure is on he can easily blow a fuse and make life difficult for his underlings and for journalists who ask him difficult questions.
"But despite all the cutting edge to him, he is a very capable and shrewd politician, a brilliant strategist.
"And he may come across as dour and charmless, but he does have a sense of humour.
"After everything that he has come through, there is bound to be a personal price to pay. Most people outside politics don't realise the pressure on ordinary politicians.
"But in Peter Robinson's case that is multiplied tenfold. Yet against all the odds he has managed to keep it all on the rails.
"I just hope the survivor in him can fight back this time."