The doctor who treated Pope Francis recently detailed the heartbreaking final hours leading up to the death of the 88-year-old pontiff, who despite his frailty, managed to check off his list “a series of things he felt he had to do before dying” on April 21.
Behind the Vatican walls in February, a battle unfolded as Pope Francis was taken to Gemelli Hospital with life-threatening double pneumonia.
While most people recover from pneumonia within a few weeks, the illness can become life-threatening under certain conditions.
For the 88-year-old pontiff, the risk was even more acute. When he was 21, he suffered from pleurisy, a serious lung infection that led to the surgical removal of part of one lung, the BBC reports. This history of compromised lung function made him particularly susceptible to recurrent pulmonary infections, including pneumonia, turning what is often a recoverable illness into a potential health crisis.
At the heart of this five-week medical journey was Dr. Sergio Alfieri, who in 2021 became the surgeon for His Holiness when he needed treatment for diverticulitis, a condition described by the Mayo Clinic as “ inflammation of irregular bulging pouches in the wall of the large intestine.”
“He had a big sweet-tooth and sometimes would go to the kitchen at the Santa Marta hotel for a midnight snack. He put on a [nearly 30 pounds] too many. At times I came off as too rigorous, because he told me, ‘Remember to live with irony,’” Alfieri told the Rome daily La Repubblica, through AP.
‘Found him in good shape’
But after the pontiff suffered severe respiratory crises during his hospitalization – episodes that demanded swift and life-saving intervention – the doctor, who guided the pope’s care, shared a sobering realization: “We knew he wouldn’t return to his former condition, and that the infection had left another scar on his lungs.”
Yet, “he improved with physical therapy. I saw him on Saturday, and I found him in good shape. I didn’t think it would be the last meeting,” the doctor added.
‘Series of things’ before death
Despite his fragile health, Pope Francis couldn’t resist the call of his people. On Easter Sunday, just weeks after returning from the hospital, he made a surprise appearance in St. Peter’s Square, where 50,000 worshippers gathered in celebration. Riding through the cheering crowd in the popemobile, he made several heartfelt stops – most memorably, to bless the children held up to him by hopeful parents.
Also, against medical advice that recommended waiting until the end of his convalescence in June, the pope invited the health care team from Gemelli hospital – the very professionals who had cared for him – to visit the Vatican before Easter.
“I have the clear sensation now that there were a series of things he felt he had to do before dying″ Alfieri told Milan daily Corriere della Sera, through AP. “We knew he wanted to return home to be pope until the last instant, and he didn’t disappoint us.”
‘Nothing more to do’
On April 21 about 5:30 a.m., Massimiliano Strappetti, the pope’s health assistant, noticed something was wrong and alerted Alfieri, who rushed to the Vatican within 20 minutes.
“I went into his room, and he had his eyes open. I noted that he did not have respiratory issues, so I tried to call him, but he did not respond,” Alfieri told Corriere, adding that the pope was receiving supplemental oxygen and that his lungs were clear. “He also did not respond to stimuli, even painful ones. In that moment I understood there was nothing more to do. He was in a coma.”
The doctor then explained that it was too risky to transport the pontiff to Gemelli hospital, where he was previously treated.
Only two hours later, the pope died, having suffered cardiac arrest and a cerebral stroke.
“He died without suffering, at home,” Alfieri told Repubblica.
After Pope Francis was gone, the papal household staff gathered in the room while Cardinal Pietro Parolin said the rosary over his body.
“I gave him a caress, as a farewell,’’ the doctor told Corriere.
Vatican News later revealed that before falling into a coma, Pope Francis, from his bed on the second floor of Casa Santa Marta, raised his hand in a gentle gesture of farewell to his trusted aide and friend, Strappetti.
The passing of Pope Francis marks the end of an era of humility, reform, and unwavering spiritual guidance. His last weeks remind us not only of his mortality but of his humanity.
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