A news conference on Pope Francis' condition takes place at Rome's Gemelli hospital March 22. Participating are, from left: Dr. Luigi Carbone, the pope's personal physician; Matteo Bruni, director of the Vatican press office; and Dr. Sergio Alfieri, who has led the medical team treating Francis in the hospital. The doctors announced that Francis would be discharged and return to his residence in the Vatican the following day. (CNS/Pablo Esparza)
During a routine Vatican press briefing the day before Pope John Paul II died, the usually composed director of the Holy See Press Office was overcome with emotion.
When a German journalist asked the pope's spokesman how he was personally feeling, Joaquin Navarro-Valls hesitated before responding to the room packed with more than 100 reporters and Vatican correspondents. With an unsteady voice he said: "Personal feelings have no room in this place."
But the weight of the situation — John Paul lying in bed, struggling to breathe — proved impossible to suppress. Navarro-Valls' tears, broadcast live worldwide, conveyed the gravity of the moment more powerfully than any official statement could.
Navarro-Valls — a physician and journalist — enjoyed a close bond with John Paul from 1984 until the pope's death April 2, 2005.
That relationship allowed the papal spokesman to obtain firsthand information about John Paul's health. Then, through a well-planned communication strategy, Navarro-Valls would report to reporters from around the world who came to Rome to cover the pontiff's illness and death. This personal approach was far different from the daily bulletins released by the Vatican during Pope Francis' recent hospitalization.
Former Vatican spokesman Joaquin Navarro-Valls speaks to the media during a conference about Pope John Paul II at the Pontifical University of the Holy Cross in Rome April 1, 2011. Navarro-Valls served as director of the Vatican press office 1984-2006. He died in 2017. (CNS/Paul Haring)
As the world followed with anxiety and concern Francis' recent 38-day hospitalization for a serious lung infection, the Holy See Press Office released to the media almost daily brief medical bulletins with details about the pope's health.
In recent church history, the style of communicating information about popes' health has changed, reflecting the popes' own desires and the degree of trust and power they had towards their spokesmen and Vatican officials.
Passionist Fr. Ciro Benedettini served as vice director of the Holy See Press Office 1995-2016 during the pontificates of John Paul, Benedict XVII and Francis. He witnessed firsthand the evolution of modern papal media relations.
Benedettini said that John Paul's declining health in the 1990s fueled speculation about his condition and ability to lead the church. "During his last 10 years, his illness became increasingly evident," Benedettini said. "Journalists speculated widely because they saw the pope trembling, getting worse and worse, but we couldn't give any news. His personal secretary and doctor were terribly protective."
'Health is a political issue for men of power, and for this reason the matter is so secretive.'
—Nelson Castro
That silence ended in 1996 during a papal visit to Hungary. Navarro-Valls confirmed to the media what had long been suspected: The pope had Parkinson's disease. "The pope's doctor was angry, but at least speculation ended," Benedettini said. "Navarro-Valls suffered a lot because of these internal clashes, but the pope defended him. John Paul II had absolute esteem for him."
Navarro-Valls "was a great journalist, a great Christian, and he brought a new professionalism to the sleepy world of the Vatican," Benedettini said. "In the end, he was the only one to give news about the pope's illness and death."
The Holy See Press Office no longer has a singular, recognizable figure like Navarro-Valls, Benedettini said. Instead of citing an individual spokesperson during Francis' long hospitalization, journalists could only quote the Vatican itself, making communication less personal and, at times, less clear.
John Paul was known for his media savvy. But his successor, Benedict, was reserved and hesitant to engage directly with journalists, making access more difficult. This was one reason Navarro-Valls decided to resign as papal spokesperson in 2006, he wrote in his journal.
Structural changes and institutional reforms under Francis' pontificate also reshaped the Holy See Press Office. The office now operates under multiple directors at the Dicastery for Communication, a Vatican department for media and communications.
Unlike previous Vatican spokesmen, Navarro-Valls did not relay information only through bureaucratic channels. He regularly met with John Paul before and after papal trips, discussing key topics and reporting back on how the pope's messages were received by the press, said Valentina Alazraki, who has covered the Vatican for the Mexican broadcast TelevisaUnivision since 1978.
"When Joaquin reported something from the pope, he reported it because he had heard it from the pope himself, or from the pope's secretary at the very end when he could no longer speak to the pope," she said. His direct line to the papal apartment bypassed the usual channels of the secretariat of state, a move that granted him unparalleled insight but also created tensions within the Vatican's internal hierarchy.

The Holy See Press Office is near St. Peter's Square at the Vatican. (NCR photo/Camillo Barone)
Navarro-Valls' medical background also played a critical role, particularly in managing communications about John Paul's declining health. At the time, doctors at Rome's Gemelli Hospital frequently held press conferences, allowing a level of transparency that was unusual for the Vatican.
"Being a doctor himself, he also knew how to interpret the medical bulletins," Alazraki said.
While Francis reportedly instructed doctors to be transparent about his health since he was admitted to the hospital Feb. 14, access to direct medical explanations remained limited. Vatican correspondents from all over the world were able to speak to Francis' doctors at Gemelli only twice in 38 days.
"The fact that we don't have direct contact with the doctors, in my opinion, creates difficulties," Alazraki said. "Today's director of the Holy See Press Office is not a doctor, and rightly so he is not required to give us explanations or help us understand certain things."
Despite the brevity of official health updates, Pope Francis himself has broken new ground in discussing his personal health, said Nelson Castro, an Argentinian journalist, doctor and friend of the pope. "As if it were a contradiction, Pope Francis was the first pope in the entire history of the popes to talk about his health with the clarity with which he spoke to me," Castro said.
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Pope Francis had years earlier suggested that Castro write a book about popes' health. For Castro's 2021 book La salud de los papas (The Health of the Popes), Francis shared every detail of his personal medical and physical life. Francis even talked about his mental health — an unprecedented moment in Vatican history. "For me, it is still incredible today to have had the availability of that interview," Castro said.
In a 2019 interview with Castro, Francis said that although he is a good patient, he prefers to stay away from doctors and set limits. He disclosed that he sometimes suffers from anxious neurosis and that during the dictatorship in Argentina he saw a psychiatrist for six months. He also told Castro about the serious health problems he suffered in his lungs, colon, heart and locomotor system.
The secrecy surrounding papal health, Castro said, is not unique to the Vatican. "A person of power with an illness becomes a weak person," he said. "Health is a political issue for men of power, and for this reason the matter is so secretive."
The intense media scrutiny of popes' health exceeds that of any other world leader, and underscores his global significance, both as a religious leader and a figure of public interest, Benedettini said. "The popes' health makes many journalists lose their heads, even the more serious ones at times," he said.
The pope, Benedettini said, is "a truly important testimonial for both Christians and non-Christians — an exceptional media figure whose role must be safeguarded."