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Q&A: Sorting out the pope's health

By Times Staff Writer
Published February 5, 2005

Why was the pope admitted to the hospital this week?

Pope John Paul II is suffering from flu and acute laryngeal tracheitis (inflammation of the windpipe), which caused a breathing crisis Tuesday night. The Vatican described the problem as a "larynx spasm crisis" (the larynx is the upper part of the trachea). His health continues to improve and he has begun eating, the Vatican said Friday, but it would not say if the pope would give his weekly Sunday address from the hospital.

How serious is his illness?

Influenza can be dangerous if complications (most commonly pneumonia) develop. The pope's age and Parkinson's disease, which makes muscle control difficult, increase his chances of developing complications. But officials say his heart and respiration are normal.

How is his general health?

The pope is 84 years old and has become frail. He has undergone nine operations, including a hip replacement. However, before this week, he had not missed a scheduled weekly audience because of illness in more than 16 months. He appeared healthier last year, a change attributed to better medicines and a less taxing schedule. He has shown symptoms of Parkinson's disease since 1988. He has difficulty speaking clearly, sometimes stops for breath during an address and has trembling hands. He needs help with walking because of Parkinson's disease and arthritis in his legs. Over the years, he has had several serious medical problems (see chronology).

Was this current illness caused by his poor health?

Flu has been sweeping through Italy since December, and Rome was hit hard. The Vatican declined to say whether the pontiff had a flu shot, but all employees were offered them.

Who's in charge when a pope is ill?

Most things can be taken care of by the Curia, the bureaucracy that runs the Vatican. Problems would arise only when significant changes that fall to the pope need to be made, such as the appointment of bishops or policy revisions. If Pope John Paul became incapacitated, trusted aides could take on more responsibility. They include Cardinal Joseph Ratzinger, head of the Congregation for the Doctrine of the Faith; Secretary of State Cardinal Angelo Sodano, whose role roughly corresponds to prime minister in a parliamentary democracy; and Archbishop Stanislaw Dziwisz, the pope's personal secretary. Popes cannot delegate some things, including their ability to pronounce with infallibility on matters of doctrine.

What if the pope is in a coma or incapable of decisions?

Matters requiring his approval would have to wait. While the church has elaborate rules for papal elections, it has virtually no provisions for determining how, or under what circumstances, a living pope might be deemed mentally incapable.

Can a pope resign for health reasons?

Only a handful of popes have resigned or abdicated in the past millennium, and none of them for reasons of health or age. While it is rumored that Pope John Paul has prepared a resignation letter to be used if he ever becomes incapacitated, the Vatican has never corroborated that.

Is there any clear successor to Pope John Paul?

After 26 years in the papacy, he has outlived many of the men once considered possible successors. Cardinals entering a conclave will consider factors including age, nationality and potential programs. They may be looking for a so-called transitional pope after such a lengthy papacy; a pope with Vatican experience or a "pastoral figure" who can please crowds and feel comfortable with them; a firm conservative in Pope John Paul's mold; or someone open to change. He almost certainly would not be American (too much political baggage) but may come from the developing world. Nearly 65 percent of Catholics live in Africa, Asia and, especially, Latin America.

Is Pope John Paul's string of illnesses unusual?

"The pope is never sick until he's dead," goes an old Roman saying. Openness about a pontiff's health has never been a hallmark of the Vatican. When commentators reported in August 1914 that Pope Pius X had a cold, the official Vatican newspaper issued a denial. Less than 24 hours later, Pope Pius was dead. Pope Pius XI (1922-39) suffered for 10 years from diabetes and heart disease. He was an invalid through the period of the rise of Adolf Hitler but remained highly focused until his death in 1939. Pope Pius XII (1939-58) had teams of specialists and was given to unconventional medications, sometimes administered by an unqualified doctor; one left the pope with constant hiccups. Pope John XXIII (1958-63) had stomach cancer but died in full possession of his faculties in 1963. Pope Paul VI (1963-78) suffered from prostate disease and continued his duties with a catheter until undergoing an operation inside the Vatican. He died of a massive heart attack in 1978. Pope John Paul I, John Paul II's predecessor, was a frail man who died of a heart attack or a pulmonary embolism in 1978 after 33 days in office.

Associated Press, Washington Post, Cox News Service, Sunday Times, Newsday

[Last modified February 5, 2005, 00:57:15]