Here's what senior House GOP lawmakers and aides tell us behind the scenes: It's amazing anyone wants to be their leader in this era.

• Why it matters: Top Republicans tell us they're stuck with four parties under one leaky roof — MAGA, ultra-MAGA, establishment, moderates — leaving them at a loss for how to organize, let alone govern. The GOP won midterms — and, with no one able to clinch the speakership, can't govern yet.

👂 What we're hearing: The complexities of modern conservatives — and the waning power the gavel holds over members — make it a very tough time to be a Republican leader, at any level.

1. You need to navigate the tricky politics and touchy temperament of former President Trump.
2. You need to understand and speak the language of the post-Trump MAGA crowd, which is more about style than policy substance.
3. You need some fluency in establishment Republicanism and electability — but not so much that it anchors you to a dead past.
4. You need to thread the needle of old-line Fox News pugilism and the rising podcast + Twitter punchiness.

What's happening: The House staggered to adjournment last evening after House Republican Leader Kevin McCarthy lost a humiliating three votes for speaker.

• It's the first time in a century that no one won the speakership on the first ballot. The havoc left the House without officially sworn-in members, and with no official rules or committees.

State of play: McCarthy last night told reporters he won't drop out. Some of his strategists tell me it won't be pretty, but he'll fight to a win.

• But some allies say that's become hard to see. "After the third ballot, the lights went out," said an aide who has spent months telling me McCarthy would win.

Possible alternatives: Reps. Steve Scalise of Louisiana, Patrick McHenry of North Carolina, Jim Jordan of Ohio or Elise Stefanik of New York.

• But in this crazy chaos, it could be a reluctant or low-profile member no one's talking about.

💡 Between the lines: Senate Republican Leader Mitch McConnell holds power — but is unpopular as hell with his own party, and an enemy of Trump and his forces.

Florida Gov. Ron DeSantis (R) — who was sworn in for a second term yesterday, and has begun eclipsing Trump in 2024 primary polls — has shown the formula for navigating this mess.

• It requires sky-high popularity, fundraising dominance, a winning record — and a natural feel for picking the right cultural scabs at the right moment.

But who knows if that will translate outside of Florida.

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House Republican Leader Kevin McCarthy is suffering a nightmare Speaker Pelosi dodged when she regained the gavel in 2019.

• Why it matters: Today's Republican rebels are a much bigger threat to the party than the left-wing Squad ended up being for Dems, Axios' Alexi McCammond writes.

After the 2018 midterms, newly elected progressives — led by Rep. Alexandria Ocasio-Cortez (D-N.Y.) — wanted generational change.

• Pelosi ended up winning 220 votes in 2019 to become speaker, including those of the freshman critics.

But Pelosi had a bigger cushion than McCarthy:

• She lost 15 Dems, three of whom voted "present." They were mostly members in competitive districts who'd campaigned on opposing her.
• McCarthy can only afford to lose four Republicans. The best he's done after three ballots is to lose 19.

Zoom in: Pelosi's big concession to her opponents was that she wouldn't serve more than four years as speaker.

• McCarthy's biggest concession would make it possible for five Rs to boot him any time.

🥊 Pelosi said about the speakership in the new HBO documentary, "Pelosi in the House," made by her daughter Alexandra Pelosi: "If I didn't know I had the votes, I wouldn't be running."

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Cardiologists are hesitant to speculate about what happened to Buffalo Bills safety Damar Hamlin. But many experts say he likely experienced commotio cordis, a rare event caused by a blow to the chest wall.

• Fewer than 30 cases are reported every year, Axios Sports editor Kendall Baker writes.

If the impact happens during a "brief, vulnerable moment in the heart cycle, it can cause the heart to go out of rhythm and basically stop," Dr. Scott Jerome, a cardiologist at the University of Maryland Medical Center, says.

• Most sports-related cases involve objects like baseballs and pucks, according to Jerome.

Hamlin's uncle told NFL Network last night he was still on a ventilator, but that he'd improved to 50% oxygen after needing 100%. He remains sedated and in critical condition.

Pelé's casket was borne by a firetruck to a private burial yesterday in Santos, Brazil — the city where he became famous after moving there at age 15 to play for Santos FC.

• The funeral Mass was held at the team's Vila Belmiro stadium, where 230,000 mourners filed past his open casket. Keep reading.

Microsoft is working to incorporate OpenAI's ChatGPT technology in its Bing search engine, The Information reports.

• Why it matters: Bing has been a distant second to Google for years. The hot new AI-driven chatbot could give people a fresh reason to try out the Microsoft-owned search service, Axios' Ina Fried writes.

Microsoft has already poured $1 billion into OpenAI, and has a business arrangement that gives it dibs on commercial use of various technologies.

• Last year, Microsoft added image generator Dall-E 2 (another OpenAI product) to a new Designer app as well as to Bing's Image Creator tool.
• Microsoft has been reselling GPT and other OpenAI technologies to large businesses.

🖼️ The big picture: Industry watchers have speculated that the rise of large language models — the branch of AI that powers ChatGPT — could reshape the search industry, now dominated by Google.

• Instead of providing lists of links, a ChatGPT-style search engine would answer questions directly.
• That could be a boon for users — but could also undermine the business of selling paid search results.

Google has been working on similar technology, but has been slow to make it publicly available.

• But CEO Sundar Pichai has personally intervened, viewing ChatGPT as a "code red" moment for the company, the N.Y. Times reports.

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The FDA yesterday made a regulatory change that may allow retail pharmacies to offer abortion pills, effectively expanding access as more red states move to ban or restrict the procedure.

• At the same time, anti-abortion groups are mounting a unique legal challenge against the approved use of the drugs, Axios' Oriana Gonzalez reports.

Why it matters: The developments underscore how much access to mifepristone, which is used in first-trimester abortions, has become a focal point in the reproductive health wars since the Supreme Court struck down precedents that established a federal right to abortion.

What's happening: Medication abortion accounts for over half of U.S. abortions.

• Abortion pills are frequently prescribed online and mailed to patients, effectively providing a way to circumvent state restrictions that took effect after the high court decision.
• 18 states require that a patient take the pills in person.

CVS and Walgreens said they're reviewing the FDA change.

• Keep reading.

Geoff Morrell — a former White House correspondent, Pentagon press secretary, and senior exec at BP and Disney — will join Teneo, the global CEO advisory firm, in the new role of President, Global Strategy & Communications.

• Morrell, 54, will be based in D.C. — but expects to be on the road a lot.
• Teneo — which combines management consulting, reputation management and financial restructuring — has 1,500 employees in 40+ offices around the world, with $500 million in annual revenue.

Teneo CEO Paul Keary told me in a phone interview that he went after Morrell because he has "worked with presidents, CEOs, editors ... and can’t be defined by a single industry."

• Morrell told me he likes Teneo's integrated approach because reputation problems are often rooted in deeper business issues.

At a preview of the Consumer Electronics Show in Vegas, which formally kicks off tomorrow, Bird Buddy showed off a smart bird feeder that takes snapshots of feathered friends as they fly in for treats.

• The startup says its AI can recognize 1,000+ species, allowing users to share photos through an app, AP reports.

"We try to kind of gamify the collection so it's ... like a real-life Pokémon Go — with real animals and wildlife in your backyard," said Kyle Buzzard, a Bird Buddy co-founder.

• The company, which began as a Kickstarter project in 2020, started shipping bird feeders in September and has sold all 100,000 in its inventory. The basic feeder is $199.

Axios' running post of CES highlights.