Diarmuid Pepper

“EACH TIME A pope takes ill, the winds of a conclave always feel as if they are blowing.”

These are the words of Pope Francis in his recently published memoir Hope, and the winds were certainly blowing strongly over the past few weeks.

Francis was released from Rome’s Gemelli hospital on Sunday after a period of 38 days.

He faced two “critical episodes” in hospital which put his life in imminent danger.

Francis now faces two months of recuperation at his Santa Marta residence in the Vatican.

During a brief appearance from his hospital window before returning home on Sunday, Francis appeared weak as he blessed the crowds that had gathered. 

He spoke only to praise a woman who was holding yellow flowers, flowers he left at the Basilica of Saint Mary Major during an unscheduled stop en route to the Vatican.

Pope Francis leaves in his white Fiat car after appearing at the window of the Gemelli hospital Alamy Stock Photo Alamy Stock Photo

At a press conference on Saturday announcing that Francis would be released the following day, a journalist asked if Francis was “putting pressure” on doctors to let him return to the Vatican.

“No pressure, but agreement concerning the reaction of the pope and his interest in being released from the hospital,” said the Vatican’s spokesperson Matteo Bruni.

However, it is understood that there is a concern that Francis will try to return to work too quickly, and risk impacting his health.

It has also been reported that Francis initially resisted going to hospital but was told that he risked dying if he disobeyed doctor’s orders.

Francis has a strong work ethic and was working right up until his hospitalisation.

He has said in the past that he wants to keep doctors at arm’s length.

“The doctor and I are both better off when we are in our own homes,” Francis joked in an interview published in 2021.

‘Letter of resignation’

Francis was twice at risk of death during his recent hospitalisation, but it is not the first time he had faced extended periods in hospital.

He underwent a hernia operation in June 2023, and in 2021 he underwent surgery for a type of diverticulitis, an inflammation of pockets that develop in the lining of the intestine.

“The reality is that even during the days of surgery I never thought of resigning, except to say that it is always a possibility,” wrote Francis in his memoir.

Francis said that at the moment of his election, he “delivered a letter of resignation to the camerlengo”, the Cardinal who runs the Vatican in the period between the death or resignation of a pontiff and the election of a new one.

The current camerlengo is Irish-born Cardinal Kevin Farrell.

Francis said his letter of resignation would become applicable “in the event of impediment for medical reasons”.

Pope Francis waves from the window of St Peter's Basilica's balcony after being elected the 266th pope of the Catholic Church Alamy Stock Photo Alamy Stock Photo

Francis, who was elected in 2013, also revealed that he felt his papacy would be “brief”.

“No more than three or four years, I thought. I never imagined that I would have made all those journeys to more than sixty countries.”

In 2022, rumours swirled that Francis would soon resign and call a conclave – but this was correctly dismissed as nothing more than “a cheap soap opera” by one cardinal.

However, critics of Francis might now query whether the bar he himself set for retirement, that of “impediment for medical reasons”, has been reached.

Austen Ivereigh, a papal biographer, told CNN that this is unlikely.

“I think the only circumstances under which he would consider resignation, as he has said, would be if he had a long-term degenerative or debilitating condition which prevented him from fully carrying out the papal ministry,” said Ivereigh.

And when reflecting on his health issues in his memoir, Francis writes that “the Church is governed using the head and the heart”.

At Saturday’s press conference announcing Francis would be discharged from hospital, his doctors noted that he “always remained alert and oriented” during his hospitalisation.

In 2013, Benedict XVI became the first pope in around 600 years to resign, and Francis said this removed the taboo on resigning and “opened the door” for future popes to step down.

Emeritus Pope Benedict XVI and Pope Francis meet at St Peter square, 28 September 2014 Alamy Stock Photo Alamy Stock Photo

However, the papacy is typically an office held until death and, in 2023, Francis remarked: “I believe that the pope’s ministry is ad vitam [for life].”

This was the first time Francis had stressed the “as vitam” nature of the papacy.

Looking to the future

Francis continued to work while in hospital, speaking to the Catholic parish of Gaza, publishing messages to the faithful, and appointing people to senior roles within the Vatican.

But the biggest move he made while in hospital was to extend his years-long Synod process into 2028.

For many, Francis’s laying out of plans for the global Catholic Church into 2028 underscored his intention to remain in office despite a potential long road to recovery.

Pope Francis, background center, attends second session of the Synod in the Paul VI hall at the Vatican, Saturday, 26 Oct, 2024. Alamy Stock Photo Alamy Stock Photo

Announced in 2020 and launched by Pope Francis in 2021, the Synod unfolded at the local, national, and then continental level.

It culminated in two month-long gatherings at the Vatican in October 2023 and October 2024.

It’s seen as the cornerstone of Francis’s legacy and focuses largely on how to make the Catholic Church a more welcoming and inclusive place for all of its members, especially women and laypeople.

The Synod was the first time the Vatican waded into so many contentious, contemporary social issues openly, from the place of LGBTQ Catholics to whether women should be ordained as deacons.

These topics have since been sent out to study groups to consider and they are due to report back in June.

The three-year extension of the Synod to 2028 will allow for these findings to be incorporated.

In his final address to the Synod participants last October, Francis called for a period of “discerning and evaluating” in relation to the final document arising from the Synod.

This final document called for greater involvement from lay people in decision-making, more leadership positions for women, enhanced financial transparency and protocols for abuse prevention, and new procedures for selecting and evaluating bishops 

The extension will also include an evaluation period that begins in local churches, then moving to national and international gatherings.

In June 2028, the Vatican will publish the Instrumentum Laboris, or guiding document, from this evaluation period announced by Francis, before culminating in a global gathering at the Vatican in October 2028.

This three-year period will allow the church to evaluate how global Catholic communities have implemented the recommendations from the Synod and the Vatican gathering in October 2028 is described as “consolidating the path taken so far”.

‘Try everything, don’t give up”

Meanwhile, the doctor who led the medical team that treated Francis has spoken about the pontiff’s time in hospital.

In an interview with daily Italian newspaper Corriere della Sera, Dr Sergio Alfieri said the critical episode on the afternoon of 28 February was the “worst moment”.

“For the first time I saw tears in the eyes of some of the people around him,” said Alfieri.

“We were all aware that the situation had further worsened and there was a risk that he might not make it.

“We had to choose whether to stop and let him go or force it and try all the drugs and therapies possible, running the very high risk of damaging other organs.”

Alfieri said this episode was “terrible” because Francis knew he might not survive the night.

“Try everything, don’t give up,” is what Francis is said to have told his medical team.

Alfieri added that Francis was aware of conspiracies that he had died, and that Francis “reacted with his usual irony”.

On Saturday, Francis said to his medical team: “I’m still alive, when are we going home?”

The next day, he made his brief appearance at the window of his room at the Gemelli hospital and headed home to the Vatican.