Pope Francis marks 12 years of papacy on 28th day in hospital

Serious health challenges remain for the 88-year-old, who is one of history's oldest popes. Francis has still not fully recovered from pneumonia and doctors describe his overall medical picture as complex. 

Even before his hospitalization, Francis had limited mobility — regularly relying on a wheelchair and experiencing breathing difficulty. Doctors have yet to say when he might be released from the hospital and return to his residence at the Casa Santa Marta — the Vatican guesthouse where he has lived since 2013.

Since at least March 3, Francis has received mechanical ventilation throughout the night and high-flow oxygen therapy via nasal tubes during the day to assist with breathing.

Yet the determined pope — who has been undeterred by restricted mobility — has said that "One governs with the head, not the knee." The same might also be about his voice. 

On March 6, the Vatican released the pope's first audio message since his hospitalization began. Francis' weak voice made clear that it will be some time before he is able to deliver long speeches or homilies. 

As pilgrims gathered in St. Peter's Square for the nightly rosary vigils for the pontiff's recovery, it was a mixed blessing to hear his voice once again fill the square: It reminded the world that he was still here, but it also illustrated his suffering. 

But as Francis' longtime close collaborator and fellow Jesuit, Fr. Antonio Spadaro, said on Italian television a day later, the decision to release the audio — unfiltered and without enhancements — came from the pope alone. 

"In the world today, the powerful yell. He whispers," Spadaro said. 

During the final years of Pope John Paul II's nearly 27-year papacy, the incapacitated pontiff was surrounded by strong aides. His powerful secretary of state, Cardinal Angelo Sodano, and his longtime secretary, (now Cardinal) Stanisław Dziwisz, effectively served as vice popes. 

"[John Paul II] lived but was not governing because he was incapable," said Austen Ivereigh, a biographer and collaborator of Francis. 

In an interview with the National Catholic Reporter, Ivereigh said that Pope Benedict XVI's longtime secretary, Archbishop Georg Ganswein, made clear in his memoir that Benedict resigned to avoid a repeat scenario — what some have termed an "impeded see," referring to the church's government.

"I think it's been very clear from the communiques that we do not have an impeded see," Ivereigh said of the pope's monthlong hospitalization. "The pope has been working, signing documents and receiving senior Vatican officials." 

"The pope is governing, the pope is in charge," Ivereigh said. "And as long as there isn't an impeded see, there's no immediate need for a resignation." 

Around the Vatican, business continues more or less as usual — just without its central figure. 

Spanish Vatican journalist Javier Martínez-Brocal wrote that the day-to-day business of the Roman Curia, the Vatican's central bureaucracy, is being carried out "ad mentem Papam" — in the mind of the pope. 

During the week of March 3, members of the Vatican's Dicastery for Bishops — the office responsible for advising the pope on the appointment of bishops — held their regular meeting and sent a new slate of names to Francis for consideration. 

And from his suite on the 10th floor of Rome's Gemelli Hospital, Francis has signed letters to the Vatican's Pontifical Academy for Life, attendees at a liturgical conference at the Pontifical Athenaeum of Sant'Anselmo and launched a special commission to solicit donations to the Vatican to help with its fundraising efforts. 

Francis, Ivereigh said, "is a man of governance who understands authority and understands very well that at times of uncertainty it is easy for authority to drain away and he will be very conscious of that." 

Yet the pope's prolonged hospitalization and an unclear timeline for his recovery has cast a shadow over a Jubilee Year that is expected to draw some 30 million pilgrims to Rome, many of whom are motivated to travel by a desire to see the pope in person. 

April's calendar includes a highly anticipated visit by Britain's King Charles, and Holy Week and the lead-up to Easter is the busiest time of the year in the liturgical calendar. In May, Francis hopes to travel to Turkey for an historic ecumenical gathering to mark the anniversary of the Council of Nicaea in the year 325.

All these plans would have to be reconfigured without the presence of the pope. 

Even so, Jesuit Cardinal Michael Czerny — who served as Francis' delegate last weekend during the Jubilee activities — described another recent moment where life seemed to grind to a halt and uncertainty loomed large. 

"On March 20, 2020, Pope Francis, alone in St. Peter's Square, prayed for the whole world threatened with COVID," Czerny said. "Now the whole world gathers — also in St Peter's Square — to pray for Pope Francis to recover." 

Czerny said: "And now we pray as Jubilee pilgrims of hope, hoping for him and for our very suffering world."