Pope in 'Very Grave' Condition After Suffering a Heart Attack

Published: April 1, 2005
http://www.nytimes.com/2005/04/01/international/europe/01pope.html?th&emc=th  (must register to view original article)

ROME, April 1 - The condition of Pope John Paul II was "very grave," the Vatican said on Friday morning, and he had been given last rites after suffering heart failure on Thursday.

But the pope, 84, whose health has taken a steep dive in the last two months, had decided himself not to go to the hospital, and on Friday morning he was still "conscious, lucid and tranquil," his chief spokesman, Dr. Joaquin Navarro-Valls, said in a statement.

This latest health crisis - only a day after doctors fitted him with a feeding tube - was set off on Thursday by a urinary tract infection. That infection, the Vatican said on Thursday, caused a high fever in the already frail and weakened pope, who has suffered for more than a decade from Parkinson's disease.

Doctors began treating him with antibiotics at his apartment in the Vatican, and Vatican Radio reported overnight that the pope was responding well and that his condition appeared to have stabilized.

But the new Vatican announcement on Friday morning made it clear that the John Paul II, the 264th pope and one of the longest serving in history, was close to death.

It said that he had suffered "septic shock with cardiovascular collapse." The statement added that the pope "co-celebrated" mass at 6 P.M. on Thursday with the Vatican secretary of state, Cardinal Angelo Sodano and others.

The last time he is known to have been administered last rites was on May 13, 1981, after he was shot by a would-be assassin in St. Peter's Square, almost three years after he was chosen pope.

Rumors of another serious health crisis began circulating late on Thursday afternoon, and by this morning, the pitch of worry around the Vatican and among the faithful was high, after a Holy Week in which he was too sick to attend any of the ceremonies except for mass on Easter Sunday. Even then he was so weak that no words came out of his mouth when he tried to deliver his traditional blessing from the window of his apartment of St. Peter's Square.

Late on Thursday, as news spread that pope's life may be in danger, pilgrims began flowing to St. Peter's Square, at once worried about his condition but relieved for him too that his long suffering and illness might soon be over.

"He'll finally be at peace," said James Butler, 16, part of group of students from Dublin visiting Rome, who arrived at the Vatican just after midnight on Thursday to pay their respects.

On Wednesday, in his most recent public appearance, he again tried to speak, but also failed. Hours later, the Vatican announced that doctors had threaded a feeding tube through his nose and into his stomach to ensure that he was properly nourished. The news came in the first medical statement from the Vatican in more than two weeks and, unlike a string of earlier, more upbeat reports, it characterized the pope's recovery as "slow."

After months of what seemed relatively stable health, the pope's condition has declined since Feb. 1, when he was admitted to Gemelli hospital suffering from flu, fever and spasms of the throat that caused severe problems breathing. He was discharged on Feb. 10, but was taken back to the hospital two weeks later with similar symptoms. That night, doctors performed a tracheotomy to assist his breathing.

Doctors said that urinary tract infections are usually treatable, but that the pope's age and advanced illness could present complications.

Dr. Harry Fisch, professor of clinical urology at Columbia University Medical Center in New York, said such infections in men the pope's age typically come from the prostate "and they can be severe."

"These infections tend to be readily treatable with antibiotics," Dr. Fisch said. "They are normally not life-threatening, but in the elderly and debilitated, they can be. The fever won't drop immediately. It can take a day."

Dr. Fisch said that a catheter - a tube inserted into the bladder of bed-bound patients to drain urine - can make such infections worse. The Vatican has not said whether the pope has a catheter.

Doctors said that infections often caused a drop in blood pressure - and several unconfirmed news reports said that the pope was in fact suffering from a drop in blood pressure, a development doctors said could lead to decreased levels of consciousness.

Just after midnight, the entrance to St. Peter's Square was ringed by dozens of television cameras and journalists, as well as pilgrims and tourists peering up to the window of the papal apartments, where John Paul II made his most recent, pained appearances.

The light in the apartment was shut off around 11 p.m., later than the pope's usual bedtime. But a light in a room with medical equipment remained on past midnight.

Unlike in other recent health crises, Italian television switched its programming to extensive coverage not only of the status of the pope's health, but of his life and legacy.

Elisabeth Rosenthal of The International Herald Tribune and Jason Horowitz contributed reporting for this article.