The Sat Report: Making sense of the Pope's clinical situation
Pope Francis needs our prayers
I wanted to share my thoughts and professional opinion on the Holy Father’s health with the respect to the information we received yesterday at the Press Conference delivered by the two doctors with knowledge of his clinical situation, but first an update on the current health situation of the Holy Father, whose condition has deteriorated over the course of today, and has been described by the Vatican as “critical.”
In a statement to journalists this evening, Saturday February 22, the Holy See Press Office said that the Pope’s condition is critical with the prognosis “reserved”, medicalese used when there is not enough information yet to make a judgment about likely outcomes. This morning the Pope suffered a prolonged acute asthmatic attack, which required high-flow oxygen. [As an aside, the morning note from the press office made no note that Pope Francis ate breakfast this morning, the first time this had been omitted, which raised some suspicions that something was a miss]. Additionally, blood tests today showed that the Holy Father was both thrombocytopaenia and anaemia (low platelets and haemoglobin), which required the administration of blood transfusions. Again we don’t know the absolute values, though I suspect this was a prophylactic measure to prevent bleeding. Of more concern for his medical team will be the cause of his thrombocytopaenia, and is the reason why the prognosis is reserved. There is a big difference between thrombocytopaenia as a result of sepsis and as a result of the medications the Holy Father is on. The situation is delicate, and today illustrated how precarious the Holy Father’s health is at this moment.
Which brings me to yesterday’s Press Conference. I would describe it as bizarre, for a number of reasons. Firstly, the doctors at the briefing, Professor Sergio Alfieri, a world leading colorectal surgeon and Clinical lead of the Gemelli University Hospital, and Dr. Luigi Carbone, the Pope’s personal physician and head of the Health department of the Vatican City State, both of whom aren’t actually part of the hospital medical team directly responsible for the health of Pope Francis. Secondly, apparently there were audio and visual issues for the first 10 minutes of the press conference so only those present on the ground could actually see and hear what was being said. Thirdly, the Press Briefing was being held at the behest of Pope Francis himself.
One can speculate as why the Pope felt the need to have this press conference, but from the prepared statements by the doctors, it was to send a message to the Cardinals. The Conclave can wait. Dr. Carbone said “he is not in danger of death at this time.” This was the Pope telling the Cardinals that he was not in danger of death, which when I heard it yesterday, I thought was naïve and foolish at best, because when pushed by the journalists later, Professor Alfieri admitted, quite rightly that although Pope Francis is “not sick aside from the infection” and his condition could deteriorate, as it sadly did today.
Also rather telling was the fact that they emphasised on numerous occasions, that the Pope was still working, and signing documents in the hospital. It is clear that the Pope wanted to portray, for whatever reason, that he is still very much is charge, is working and will eventually return to the Vatican.
Vatican News for its part said the press conference “dispelled all the fake news that unfortunately some media outlets have been circulating in recent days regarding the health conditions of the Pontiff.” We also learnt yesterday, that the twice daily press releases issued so far by the Vatican Press Office were prepared and agreed upon with the doctors who are treating Francis. It was emphasized the press releases gave all the useful and necessary information, without ever hiding anything, as these are wishes of the Pope. So it is the Pope who wants us to know that he is reading newspapers, having breakfast and receiving Holy Communion daily, as well as the now rather infamous line of “having passed the night well.”
Rumours were swirling in the Italian press, and were even broadcast on Rai News, the national public broadcaster of Italy, that the Pope met with Cardinals Parolin and Ghirlanda to discuss his resignation. The Vatican released a statement denying that any such meeting took place. Pope Francis will never resign, despite admitting that a letter to such an effect has been drafted in the case of incapacity, but he hasn’t signed it. How exactly is he supposed to sign it in the event that he, God forbid, becomes incapacitated? Utterly pointless.
We also learnt more about the events that led up to the Pope admission, with his personal nurse at the Vatican, Massimiliano Strappetti, praised as "an extraordinary person who has been taking care of the Holy Father for many years", raising the alarm that the Pope’s breathing had deteriorated, and I assume his oxygen saturations fell, as a result of a viral infection, that required a step up in care that was only available in a hospital.
The press conference also reiterated what had been published a few days earlier, namely that the Pope has longstanding “bronchiectasis, with an asthmatic bronchitis that can have phases of exacerbation. This is to explain that, at his age, it is a condition that makes him by definition a fragile patient.” It was also implied that the Pope has a chronic fungal infection in his lung, with a hospital acquired bacterial infection superimposed causing his pneumonia. It is unknown whether the Pope has been on long-term steroid treatment, thought that would explain his facies of late, as well as the fungal infection. Both Prof. Alfieri and Dr. Carbone made clear that the Pope’s chronic lung diseases cannot be cured but are being managed.
Both were keen to stress that the Holy Father was on the “appropriate and correct treatment,” and that use of steroids was necessary, despite the effects “lowering the immune system, raising blood sugar levels and this is a breeding ground for infections; you have to use certain medications and scale back others: our job is not easy. So, if the question is: is he out of danger? No.”
Like I said it was a strange press conference, one minute Prof. Alfieri declared in English, “the Pope is fine now. He is fine. He is just old”, the next Dr. Carbone is saying “His heart is strong”, but “when we say that the Pope is fragile, at the same time we say that he is a very strong patient. He is being looked after very well.”
Prof. Alfieri said that although he has a body of a 88 year old, “his head is still that of a sixty-year-old,” with the Pope having not lost his sense of humour, an example of this being when addressed as Holy Father, the Pope greets the doctor back as "Holy Son." They also said that the Pope is a good and cooperative patient, and will remain in hospital at least all of next week. The hospitalization will last as long as necessary, “He will only be discharged when he is well.”
On the advice of the medical staff, the Pope does not meet anyone apart from two or three close collaborators. We don’t know who they are. It is not Antonio Spadaro. The Holy Father is not attached to any machine, though he receives supplemental oxygen when he desaturates. His breathing is spontaneous, and he is feeding himself. He is not bedridden, moves to the arm chair, and is taken by wheelchair to the nearby chapel. There are no photos because it would be undignified to see the Pope in “pyjamas”. He is under the care of three teams; microbiology, led by Prof. Carlo Torti, respiratory led by Prof. Richeldi, and the gastroenterology team led by Prof. Gasbarrini.
Although, as of yesterday, the Pope is much better than when he arrived, “things could change in a day, an imbalance is always a danger.” That is what today brought. The Holy Father needs our prayers. May tomorrow be a better day. The great risk is that the bacteria passes into the bloodstream. If sepsis were to arise, it could be really difficult to survive at his age and with his respiratory problems.
Pray for the good health of Our Holy Father.
Oremus pro Pontifice nostro Francisco. Dominus conservet eum, et vivificet eum, et beatum faciat eum in terra, et non tradat eum in animam inimicorum eius.