By THE surgeon who was at Pope Francis’s bedside when he died has revealed how the late pontiff faced his final moments — and how doctors honoured one of his last wishes.
Professor Sergio Alfieri, who performed two major operations on the Pope in 2021 and 2023, said the Holy Father failed to respond to any stimuli from medical staff and lay open-eyed in a coma shortly before his death.
Alfieri, the Pope’s chief surgeon who coordinated his medical care at the Gemelli Hospital in Rome, said the pontiff had not appeared to be in respiratory distress after he visited his residence at Santa Marta.
However, the 88-year-old did not respond when Alfieri called out to him and failed to react even to painful stimuli.
It was at this point, the surgeon said, that he knew there was “nothing more to be done”. One of Pope Francis’s final wishes — to die at home rather than in hospital — was respected.
These revelations emerged as tens of thousands of mourners filled St Peter’s Basilica to pay their respects ahead of this weekend’s funeral. Security measures have been heightened around the Vatican in anticipation of large crowds.
Reflecting on the Pope’s final days, Alfieri recalled seeing him on Saturday afternoon in good spirits.
“He seemed very well,” the surgeon said. “He was determined to continue fulfilling his papal duties, less than 48 hours before his death.”
Francis had even asked Alfieri to organise a meeting with the 70 hospital staff members who had cared for him, scheduled for the following Wednesday.
However, early on Monday morning, Alfieri received a call from the Pope’s personal nurse, Massimiliano Strappetti, alerting him that the pontiff’s condition had worsened and he may need to be returned to Gemelli Hospital.
Alfieri arrived at Casa Santa Marta, the Vatican guesthouse where Francis had chosen to live for the past 12 years, within 20 minutes.
Having performed the Pope’s previous surgeries in July 2021 and June 2023, Alfieri said he told Strappetti that the Pope’s time was likely near, and that transporting him would be futile.
“We risked letting him die during transport,” Alfieri told Corriere della Sera. “I explained that hospitalisation would have been pointless. Strappetti knew the Pope wanted to die at home — he had said so while at Gemelli.”
The Pope passed away shortly afterwards.
“I remained there with Massimiliano, Andrea, the other nurses and the secretaries. Later, everyone arrived, and Cardinal Parolin asked us to pray. We recited the rosary together. I felt privileged — and now I can truly say that I was.
“That morning, I gave him a caress as a final farewell.”
Alfieri said that upon entering the Pope’s room, it was hard to believe he required hospitalisation. Francis’s eyes were open and he had no visible breathing difficulties, but he was entirely unresponsive.
“On Monday at around 5:30 a.m., Strappetti called me: ‘The Holy Father is very ill, we must return to Gemelli.’ I pre-alerted everyone and arrived at Santa Marta within twenty minutes,” Alfieri said.
“He didn’t respond to my voice, nor to painful stimuli. At that moment, I knew there was nothing more to be done. He was in a coma.”
The Pope had suffered a stroke earlier that morning. According to Alfieri, the medical team noticed something was wrong when Francis woke up at 5 a.m. to drink a glass of water.
“He rolled onto his side, and the nurse saw he was struggling to react. The Vatican resuscitation doctor was called. They called me at around 5:30 a.m. I arrived within 15 minutes and found him with oxygen and an IV infusion.
“His lungs were clear, no rattling. His eyes were open, but he wasn’t responding to questions or pain. His pulse was slowing, and his breathing became more shallow.”
Pope Francis died at 7:35 a.m. local time, just over two hours after the initial emergency call.
“He died without suffering, and at home,” Alfieri said. “At Gemelli, he never said: ‘I want to go back to Santa Marta.’ He said: ‘I want to go home.’”
According to Alfieri, Francis had previously been distrustful of his medical team but warmed to them in his final days.
Despite suffering from multiple health issues, Francis kept a demanding schedule almost until the end. In September 2024, he embarked on a 12-day tour of southeast Asia and Oceania, visiting Indonesia, Papua New Guinea and Singapore.
He was hospitalised on 14 February this year with double pneumonia, discharged just over a month later, and resumed public engagements — including his final public appearance on Easter Sunday, when he greeted thousands at St Peter’s Square in his popemobile.
In the weeks leading up to his death, he made clear to doctors that he did not want artificial respiration, which may have extended his life by only a few days.
Alfieri said the Pope faced his final days with a clear sense of purpose.
“Returning to work was part of his therapy — and he never exposed himself to unnecessary risk. It’s as if, sensing the end, he decided to complete everything he felt he needed to.”
This included one last ride through St Peter’s Square.
“‘Do you think I can manage it?’ he asked Strappetti before the outing,” Alfieri recalled. “Strappetti reassured him. Francis then spent about 15 minutes waving to the crowd and blessing babies from his popemobile.”
Afterwards, he told Strappetti: “Thank you for bringing me back to the square.”
The day before his death, Alfieri brought the Pope his favourite pie. “I am very well,” Francis reportedly said. “I have started working again, and I like it.”
He also expressed regret that he was unable to wash the feet of prison inmates during a planned visit just four days earlier. “This time, I didn’t manage to do it,” he reportedly said.
One of Francis’s last wishes, according to Alfieri, was to “take care of the abandoned embryos.”
Throughout his papacy, he had consistently stated that no scientific purpose could justify the destruction of human embryos.
In 2017, he said: “No ends — even noble ones, such as utility for science, other human beings, or society — can justify the destruction of human embryos.”
In January, he reaffirmed this view, saying: “They are life. We cannot allow them to be used for experimentation or to be discarded. It would be murder.”
Efforts were under way to explore adoption options for these embryos, though the Pope died before action could be taken. Alfieri said he now intends to pursue this cause with the Italian Minister of Health, Orazio Schillaci.
Meanwhile, tens of thousands of mourners have queued around the clock to pay their respects after the Vatican abandoned plans to close St Peter’s Basilica overnight.
Vatican media reported that nearly 50,000 people had visited to pay homage by yesterday evening. The queue snaked through St Peter’s Square and into the basilica via the Holy Door.
Some mourners, however, drew criticism for taking selfies next to the Pope’s open casket. One image on Instagram showed a woman smiling with the Pope in the background, clutching his rosary beads.
A Vatican source remarked: “It would be good if people remembered where they are and showed a little respect — but there is little else we can do.”
Large crowds are expected for Saturday’s funeral. The Prince of Wales will attend on behalf of the King, alongside Prime Minister Sir Keir Starmer, and world leaders including US President Donald Trump, French President Emmanuel Macron, Ukrainian President Volodymyr Zelensky, and Irish leaders Micheál Martin and Michael D Higgins.
In accordance with his wishes, Pope Francis will be buried at the Basilica of St Mary Major in Rome, breaking with the tradition of papal burials in St Peter’s Basilica.
DAILY MAIL
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