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Sen. Tom Coburn’s office is the rare Capitol Hill work space without a “me wall” — the display of photographs of a lawmaker standing beside presidents, foreign leaders and other dignitaries, all illustrating How Big a Deal he is.

Instead, hanging above Coburn’s desk is a large framed print of the word “no.” It was a tribute from a liberal voter in New York thanking Coburn, a conservative Republican from Oklahoma, for his efforts at thwarting expensive legislation.

Known as Dr. No, Coburn, a family practice physician, views legislative battle less in terms of Republicans versus Democrats than as a matter of yes versus no. He sees himself as a one-man treatment center helping Congress beat its bipartisan addiction to misguided spending.

“I’ve always considered myself an opposition within the opposition,” said Coburn, whose willingness to block, delay or neuter bills through an array of procedural measures has made him an effective nuisance during his five years in the Senate.

As the health care overhaul heads to the Senate floor, Coburn is preparing for what he considers a career pinnacle of havoc. Enacting the proposal, he says, would be catastrophic, and so if precedent holds, he will try to thwart it with every annoying tool in his arsenal: filing amendments (he has done that 508 times since joining the Senate, second only to John McCain’s 542 in that period), undertaking filibusters and objecting strenuously.

“When it comes to obstructing bills, he is part of a very tiny pantheon in the history of the Senate,” said Ross Baker, a Senate historian at Rutgers University.

To Coburn, charges of obstructionism are a mark of honor he will wear as proudly as ever in the coming weeks.

“My mission is to frame this health care debate in terms of the fiscal ruin of this country,” said Coburn, 61, who recently railed on the Senate floor that the federal debt was “waterboarding” his five grandchildren. “I have instructed my staff to clear my schedule for every minute that bill is on the floor.”

After inflicting migraines in Washington, Coburn goes home on weekends to Muskogee, where he treats patients on Mondays. He says he does his best thinking aboard his John Deere mower, which can run 20 mph and slash through pretty much anything on his seven-acre meadow. Coburn dons earplugs, stares straight ahead and cuts a determined swath, just as he does in the Senate.

His at-times hyperbolic rhetoric, fervent social conservatism and seeming indifference to whether or not people like him have drawn a lot of attention. “If we wiped out the entire Congress and sent common people who have no political experience, we would get far better results than we have today,” he said in a remark typical of how he views the institution.

And in a remark typical of how some members of the institution view Coburn, Jim Manley, a spokesman for the Senate majority leader, Harry Reid of Nevada, said: “Sen. Coburn relishes it when people call him Dr. No, but he is more appropriately called Dr. I Know Best. He has routinely blocked and delayed bills that have wide bipartisan support, often based on specious arguments.”