The surgeon who was at Pope Francis’s bedside when he died has revealed how the late pontiff approached his tragic last moments – and how doctors fulfilled one of his final wishes.
Sergio Alfieri, who performed two crucial operations on the Pope in 2021 and 2023, said he failed to respond to any stimuli from medical staff as he lay open-eyed in a coma shortly before his death.
Alfieri, the Pope’s chief surgeon who coordinated the Holy Father’s doctors at the Gemelli hospital, said the late pontiff did not appear to have any breathing problems after he visited his Santa Marta residence.
But the 88-year-old failed to answer when Alfieri called out to him and did not even respond to painful stimuli.
It was at this point that the surgeon, who fulfilled one of Pope’s final wishes in letting him die at home rather than the hospital, said there was ‘nothing more to be done’.
The revelations came as tens of thousands of mourners flooded St. Peter’s Basilica to pay their respects to the late pontiff ahead of this weekend’s funeral.
Security measures have been heightened around the Vatican as police expect large crowds for the event.
Reflecting back on the Pope’s final days, Alfieri said he saw the late pontiff on Saturday afternoon in good spirits.
Francis seemed ‘very well’ and seemed determined to carry out his papal duties less than 48 hours before his death, the surgeon said.
He even asked the surgeon to organise a meeting with the 70 staff members who had treated him during his stay at the Rome hospital for Wednesday.
Sergio Alfieri, who coordinated the Holy Father’s doctors at the Gemelli hospital, said he saw the late pontiff on Saturday afternoon in good spirits
Francis even asked Alfieri to organise a meeting with the 70 staff members who had treated him during his stay at the Rome hospital for Wednesday
Early on Monday, however, the surgeon received a call from the Pope’s personal nurse, who summoned medical figures back to Gemelli hospital
Early on Monday, however, the surgeon received a call from the Pope’s personal nurse, Massimiliano Strappetti, who warned that the pontiff’s condition was worsening and that he may need to return to Gemelli hospital.
Alfieri arrived at Casa Santa Marta, the spartan Vatican lodge Francis chose to live in for 12 years, 20 minutes later.
The surgeon, who performed two crucial operations on Francis at Gemelli Hospital in July 2021 and June 2023, told Strappetti that the pontiff’s time was likely coming to an end, however, and there was no need to transport him.
‘We risked letting him die during transport, I explained that hospitalisation would have been useless,’ he told Italian outlet Corriere Della Sera.
‘Strappetti knew that the Pope wanted to die at home, when we were at the Gemelli he always said so.
‘He passed away shortly after.
‘I remained there with Massimiliano, Andrea, the other nurses and the secretaries; then they all arrived and Cardinal Parolin asked us to pray and we recited the rosary with him. I felt privileged and now I can say that I was.
‘That morning I gave him a caress as a last farewell.’
When Alfieri first entered the Pope’s Santa Marta residence on Monday morning, he said it was ‘difficult to think that he needed to be hospitalised’.
Francis’s eyes were open and he had no breathing problems, but the surgeon said that he was not responding to any stimuli.
He added: ‘On Monday at about 5:30 Strappetti called me [saying]: “The Holy Father is very ill, we must return to Gemelli”.
‘I pre-alerted everyone and twenty minutes later I was there in Santa Marta.
‘I entered his room and his eyes were open. I noticed that he had no breathing problems and then I tried to call him but he didn’t answer.
‘He didn’t respond to stimuli, not even painful ones. At that moment I understood that there was nothing more to be done. He was in a coma.’
After being released from hospital, his final appearance in public came on Easter Sunday as he greeted thousands of people at St. Peter’s Square in his popemobile
In the weeks before his death, he told doctors he did not want artificial respiration
When Alfieri first entered the Pope’s Santa Marta residence on Monday morning, he said it was ‘difficult to think that he needed to be hospitalised’
Transporting Francis to Gemelli hospital wouldn’t have improved his chances of survival, he claimed.
‘Even doing a CT scan would have given us a more precise diagnosis, but nothing more,’ Alfieri told Italian newspaper La Repubblica.
‘It was one of those strokes that take you away in an hour.’
The late Pope was admitted to hospital on February 14 this year and was subsequently diagnosed with double pneumonia.
He was released just over a month later and started to make public appearances, including his final one on Easter Sunday as he greeted thousands of people at St. Peter’s Square in his popemobile.
In the weeks before his death, he told doctors he did not want artificial respiration, which could have prolonged his life by a few days.
On the morning he suffered a stroke, the medical staff present at the Pope’s bedside noticed something was wrong as soon as he woke up.
‘At 5am, the Holy Father woke up to drink a glass of water,’ Alfieri told La Repubblica.
‘He rolled onto his side and the nurse noticed that something was wrong.
‘He was struggling to react. The Vatican doctor on duty for resuscitation was called. They called me around 5:30 a.m. and I was on the scene within fifteen minutes. I found him with oxygen and an infusion.
‘I listened to his lungs, which were clean, without rattling. His eyes were open, but he wasn’t responding to questions or to the pain of the pinches.
‘He was already in a coma. His pulse was slowing and his breathing was becoming more and more shallow.’
He died at 7.35am local time on Monday, just over two hours after Alfieri received the worrying phone call from Strappetti.
‘He died without suffering, and at home,’ Alfieri added.
‘At the Gemelli he didn’t say: I want to go back to Santa Marta. He said: “I want to go home.”‘
The surgeon claimed that Francis had not trusted his medical team ‘much’ in the past but in ‘got closer’ to them again in his final days.
Just days before the pontiff’s death, the ailing pope told reporters he was ‘living it as best I can’ after he was plagued with health issues and reduced mobility caused in part by his advancing years and expanding waistline.
The pontiff had kept up a busy schedule until his final weeks. In September 2024, he carried out a 12-day tour across south-east Asia and Oceania that included visits to Indonesia, Papua New Guinea and Singapore.
Despite being told to rest for two months after being discharged from hospital, he wanted to thank all 70 staff that supported him at the facility in person.
He died at 7.35am local time on Monday, just over two hours after Alfieri received the worrying phone call from Strappetti
Just days before the pontiff’s death, the ailing pope told reporters he was ‘living it as best I can’ after he was plagued with health issues
But his recovery after being released was unstable, with doctors fearing that his end was nearing on multiple occasions.
Alfieri said that on one instance, the pontiff ‘surprised everyone’ by making it through a particularly bad night.
He suggested that Francis behaved as if he had a clear purpose as he approached his death.
He said: ‘Going back to work was part of the therapy and he never exposed himself to danger.
‘It’s as if, approaching the end, he decided to do everything he had to.
‘I have the clear feeling that he felt he had to do a series of things before dying.’
This included one last ride in the popemobile to greet worshippers on Sunday.
‘Do you think I can manage it?’ he had asked his personal nurse before taking the plunge, according to the Vatican News, the Holy See’s media outlet.
Strappetti, whom he had previously credited for saving his life, reassured him.
Francis then spent about 15 minutes waving at the crowd and blessing babies from his popemobile, flanked by numerous bodyguards.
In what were some of his final words, he told his personal nurse afterwards: ‘Thank you for bringing me back to the square.’
The day before, Alfieri said, the Pope looked ‘very well’ as he brought him his favourite pie.
He recounted the pontiff saying: ‘I am very well, I have started working again, and I like it.’
He regretted not to have been able to wash the feet of prison inmates he met in Rome four days before he passed away.
‘This time, I didn’t manage to do it,’ the pontiff reportedly said.
Alfieri also revealed one of Francis’s last wishes was to ‘take care of the abandoned embryos’
Pope Francis, who died on Easter Monday, pictured lying in a wooden coffin dressed in red, with rosary beads draped across his hands
Alfieri also revealed one of Francis’s last wishes was to ‘take care of the abandoned embryos’.
Throughout his tenure, the late pontiff said that there is no outcome that can justify the use or destruction of embryos for scientific purposes.
In 2017, he said: ‘No ends, even noble in themselves, such as a predicted utility for science, for other human beings or for society, can justify the destruction of human embryos.’
He reaffirmed this in January, according to Alfieri.
‘He was clear: “They are life, we cannot allow them to be used for experimentation or to be lost. It would be murder,” he said.
‘We were evaluating, also with the Ministry of Health, among the various options, how to release them for adoption but there was no time for the Pope to make his decision effective.
‘My commitment now will be, if the conditions are right, to make this wish come true.’
He said he will raise the issue with Italian Minister of Health Orazio Schillaci.
Tens of thousands of mourners are queuing around the clock to pay respects to Pope Francis after the Vatican abandoned its plan to close St. Peter’s Basilica overnight.
Huge crowds thronged St Peter’s Square in Vatican City, queuing for hours to see the late pontiff in his open coffin ahead of his funeral this weekend.
Waves of mourners stood patiently in line after Francis’s remains were transferred to St Peter’s Basilica yesterday, with the queue snaking its way through the square to the Holy Door of the building.
Almost 50,000 people have flooded the basilica ‘to pay homage to Pope Francis’ since he was laid out yesterday in an open coffin ahead of his funeral on Saturday, Vatican media said.
Huge crowds thronged St Peter’s Square in Vatican City, queuing for hours to see the late pontiff in his open coffin ahead of his funeral this weekend
Almost 50,000 people have flooded the basilica ‘to pay homage to Pope Francis’ since he was laid out yesterday in an open coffin ahead of his funeral on Saturday
Italian Prime Minister Giorgia Meloni was among those who paid their respects to Francis yesterday, with photographs showing how she solemnly approached his casket just hours after having praised him during her address to Parliament.
Meloni celebrated Francis’ ability to talk freely with anyone, despite his exalted position, praised his fortitude and courage to ‘go against the current’, and shared with lawmakers some personal advice he gave her: ‘Never lose your sense of humour.’
‘With him you were at ease, you could open up, without filters, without fear of being judged,’ she added. ‘He could see your soul, lay it bare.’
While it had been expected that St, Peter’s would close at midnight on Wednesday and Thursday, it remained open throughout the night to allow more people to pay their respects.
By late yesterday evening, the wait appeared to be three or four hours and growing. An official doing crowd management estimated that the wait was closer to five hours.
Some of those present have sparked fury, however, after taking selfies next to the late pontiff’s open casket.
On Instagram, one image saw a woman smiling at the camera as she displayed the Pope clutching his rosary around 10ft behind her.
Official images of first day from the lying-in-state showed swarms of people surrounding the simple coffin holding their phones in the air above their heads.
A sea of screens was seen floating around the Pope’s body, and some even extended selfie sticks in a bid to capture the best shot.
On Instagram, one image saw a woman smiling at the camera as she displayed the Pope clutching his rosary around 10ft behind her
Official images of first day from the lying-in-state showed swarms of people surrounding the simple coffin holding their phones in the air above their heads
A Vatican source said: ‘It would be good if people could try and remember where they are and have a little respect’
A Vatican source said: ‘It would be good if people could try and remember where they are and have a little respect but there’s little else that can be done.’
Large crowds are expected for Saturday’s funeral in St Peter’s Square, with the Prince of Wales, a future head of the Church of England, confirmed to be attending on the King’s behalf.
Prime Minister Sir Keir Starmer will also be there, alongside other global leaders and dignitaries including US President Donald Trump, French President Emmanuel Macron, Ukrainian President Volodymyr Zelensky, Irish premier Micheal Martin and Irish President Michael D Higgins.
In accordance with the late pope’s wishes, 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.