Pope Francis’ final moments unfolded quietly and sorrowfully, from being unresponsive to slipping into a coma, all the way to receiving a final, tender gesture from his trusted surgeon. Here’s a closer look at how the Pontiff spent his last hours.
Sergio Alfieri, Pope Francis’ personal surgeon and the leader of his medical team during hospital visits, shared with deep emotion the details of the Pope’s final hours. “His eyes were open, but he didn’t respond to me. There was nothing more to be done,” Alfieri said, reflecting on his last interaction with the Holy Father on the morning of April 21.
Alfieri, who is also the head of abdominal oncology surgery at Gemelli Polyclinic, spoke for the first time about the bond he formed with Pope Francis, which began in 2021 when Alfieri performed the Pope’s first surgery.
Despite his serious illness, Pope Francis faced his final days with his usual determination. Alfieri explained that returning to his duties “was part of the therapy,” with the Pope taking every measure to avoid unnecessary risks.
The Pontiff’s commitment to his role was evident when he chose to engage with the public, even agreeing to walk through St. Peter’s Square, as suggested by his healthcare assistant Massimiliano Strappetti.
Alfieri recalled seeing the Pope on Easter Eve after lunch on Saturday, noting that Pope Francis appeared in good spirits. “I’m very well. I’ve started working again, and I’m up for it,” the Pope had said, eager for the Urbi et Orbi blessing the following day. The two planned to meet again on Monday.
Alfieri had originally recommended 60 days of convalescence, but Pope Francis had no intention of stepping back from his duties. “He is the Pope,” Alfieri affirmed, acknowledging that the Pope’s desire to fulfill his responsibilities was unwavering.
Just days before, the Pope had asked Alfieri to arrange a meeting with those who had cared for him during his previous hospitalizations. Despite Alfieri suggesting a delay until after Easter, Pope Francis insisted, saying, “I’m meeting them on Wednesday.”
Alfieri now believes the Pope felt he had important work left to do before his death. The unexpected shift came early on Monday morning. “At about 5:30 a.m., I got a call from Strappetti. ‘The Holy Father is very sick, we need to get him to Gemelli,'” Alfieri recalled.
When he arrived at Santa Marta within 20 minutes, he found the Pope unresponsive, his eyes open but showing no reaction, even to painful stimuli. “At that moment, I realized there was nothing more I could do. He was in a coma,” Alfieri said. The decision was made not to transfer him due to the risks involved, and Alfieri and his team stayed by the Pope’s side, respecting his wish to remain at home.
Cardinal Parolin arrived shortly after to lead a rosary prayer. Alfieri, deeply moved, described it as a privilege to be present in those final moments, gently caressing the Pope as a farewell.
Reflecting on their years of working together, Alfieri recalled their first encounter in 2018 when he served as a consultant surgeon for the Holy See. Their relationship grew stronger after Pope Francis chose Alfieri for surgery to address his painful diverticular condition in 2021. Despite the secrecy surrounding the operation, Pope Francis remained deeply committed to public health and Catholic hospitals.
Alfieri also shared a memorable moment before the surgery when the Pope blessed his hands, a gesture that symbolized the Pope’s encouragement to work with both skill and heart.
As the years passed, Alfieri’s bond with the Pope grew. During his recovery, Pope Francis hosted a small pizza dinner for the medical team, another gesture of gratitude and camaraderie.
In his final days, the Pope’s commitment to his mission was clear. Alfieri recalled nights when they feared the worst, but Pope Francis’ resolve never wavered. “We knew he wanted to be Pope until the last moment. And he did not disappoint us,” Alfieri reflected.
The Pope’s last moments were marked by simple but profound words and gestures. His final known words were spoken to Strappetti, the nurse who had been with him throughout his illnesses: “Thank you for bringing me back to the Square.” These words, just before Pope Francis passed, underscored his deep connection to the people.
Strappetti had been by the Pope’s side during his final hospitalizations, including his last public appearance during the Urbi et Orbi blessing on Easter Sunday. Although the Pope had planned to make one last ride in the popemobile, he hesitated and asked Strappetti for his opinion before deciding to proceed. “Do you think I can manage it?” he asked, before delighting in the crowd, particularly the children. This was his final public appearance and his last ride in the popemobile.
That evening, Pope Francis shared a quiet meal and retired to bed. The next morning, he suddenly fell into a coma, and after an hour of medical intervention, he passed away.
According to his doctors, the cause of death was a stroke followed by a cardiocirculatory collapse. Pope Francis had also been struggling with bronchiectasis, high blood pressure, type 2 diabetes, and severe respiratory failure due to pneumonia.
Pope Francis died on Easter Monday, April 21, 2025, at the age of 88 in his residence at the Vatican’s Casa Santa Marta. His death, though sudden, was consistent with his private attitude toward his health. Throughout his life, he remained steadfast in his vow to travel with God’s people, and he fulfilled that vow until the very end.
