Cast aside as leader by his colleagues, Sen. Trent Lott (search), R-Miss., was the man Republicans needed Monday to clear the path to approving the Medicare prescription drug bill that he opposes.

At stake was not just the $395 billion bill, which Democrats were attempting to halt with procedural roadblocks, but also the political prestige of Lott's successor as Republican leader, Tennessee surgeon Bill Frist (search).

Lott was forced to give up his leadership position in December after touching off a political controversy when he lauded Sen. Strom Thurmond's (search) pro-segregationist presidential run of 1948.

Lott called the bill "terrible," an extravagance in a time of budget deficits, and left no doubt he would vote against it.

But before he walked onto the Senate floor Monday afternoon, Bush administration lobbyists spoke to him privately to persuade Lott to vote with the president to overcome Democratic resistance.

Lott sounded skeptical about that. "I'm going to go in here and listen to their final plea," he said in a brief interview.

He must have known what was coming as the bill's supporters struggled to come up with the 60 votes they needed.

With five senators clustered around Lott, Sen. Charles Grassley, R-Iowa, an architect of the legislation, did most of the talking. At another point, Sen. Jon Kyl, R-Ariz.,and Grassley talked to Lott very intently. The Mississippi Republican kept on shaking his head.

The Republicans still were short of votes.

Sen. Pete Domenici, R-N.M., also took a turn, gesturing with great emphasis to try to pry loose Lott's vote.

After nearly half an hour, Republicans still were two votes shy. Then, Sen. Lindsey Graham, R-S.C., cut the shortfall to one.

Finally, Lott walked slowly up to the front of the Senate, pointed his thumb up without fanfare -- the 60th vote -- and walked briskly out of the chamber.

"I know Trent agonized on this large an entitlement bill," said Sen. Jeff Sessions, R-Ala. "It was hard for him to vote for it."

When he strode into the Senate, Lott chatted with reporters, telling one that the current partisan tension is typical of a congressional session's end. He politely declined another's request to talk about Frist's first year as leader.

After the vote, he curtly waved away a reporter's question and boarded a senators' private elevator.