Behind the towering walls of the Vatican, a private battle unfolded in February when Pope Francis was rushed to Gemelli Hospital with life-threatening double pneumonia. For most people, pneumonia can be a recoverable illness, but for the 88-year-old pontiff, the risks were far greater. Having lost part of a lung to pleurisy at the age of 21, his compromised respiratory system left him particularly vulnerable to severe complications. This latest infection would leave a deeper scar than before, one his body would not recover from.

At the center of the Pope’s medical journey was Dr. Sergio Alfieri, who had been a trusted figure since 2021, when he operated on Francis for diverticulitis. Their relationship had grown close, built on trust, humor, and the Pope’s gentle defiance. Alfieri recalled how Francis, despite stern medical advice, loved sneaking down to the kitchen at Casa Santa Marta for midnight snacks, putting on nearly 30 extra pounds over time. “At times I came off as too rigorous,” Alfieri admitted to La Repubblica, recounting the Pope’s reminder to him: “Remember to live with irony.”

Despite serious respiratory crises that required urgent interventions, the Pope showed remarkable resilience. Alfieri noted that Francis had made progress with physical therapy after his hospital stay. When Alfieri visited him on Saturday, two days before his passing, the Pope appeared in good spirits. “I found him in good shape,” the doctor said. “I didn’t think it would be the last meeting.”

But in retrospect, Alfieri now believes that Pope Francis, sensing the end was near, was determined to complete a series of acts before his final moments. One of them was a surprise Easter appearance in St. Peter’s Square, where he rode through a crowd of 50,000 worshippers, blessing children and connecting with the faithful. Another was the invitation he extended to his Gemelli Hospital healthcare team, bringing them to the Vatican just before Easter—a gesture against medical advice, but deeply meaningful to him. “I have the clear sensation now that there were a series of things he felt he had to do before dying,” Alfieri shared with Corriere della Sera. “He wanted to return home to be pope until the last instant, and he didn’t disappoint us.”

On the morning of April 21, around 5:30 a.m., the Pope’s health assistant, Massimiliano Strappetti, noticed something was wrong and urgently called Alfieri. The doctor arrived within 20 minutes. “I went into his room, and he had his eyes open,” Alfieri recalled. There were no immediate signs of respiratory distress, but when he called out to him, Francis did not respond. “He also did not respond to stimuli, even painful ones,” Alfieri added. “In that moment, I understood there was nothing more to do. He was in a coma.”

Given the severity of the situation, it was quickly decided that transporting the Pope back to Gemelli Hospital was too risky. Alfieri said plainly, “He would have died on the way.” Within two hours, Pope Francis suffered cardiac arrest following a cerebral stroke. “He died without suffering, at home,” Alfieri told La Repubblica.

After his passing, the papal household staff gathered quietly in his room while Cardinal Pietro Parolin led a rosary over his body. Dr. Alfieri stayed by his side, offering a final farewell. “I gave him a caress,” he said simply.

Before slipping into a coma, Vatican News later reported, Pope Francis raised his hand from his bed at Casa Santa Marta in a final, gentle gesture of farewell to Strappetti, the aide who had been with him through countless hospitalizations and recoveries.

The death of Pope Francis closes a remarkable chapter defined by humility, reform, and a deep, unwavering commitment to the people he served. His last weeks were a testament not only to his faith but to his humanity, reminding the world that even the greatest spiritual leaders meet their end with quiet grace.