Inside the Pope's Illness

It took the Vatican a decade to confirm what the world had long been witnessing with its own eyes. It was in the early 1990s that Pope John Paul II first showed symptoms of Parkinson's disease, with the trembling of his hands, stiffening of facial muscles and slurring speech progressively worsening over the years. But Vatican officials confirmed the diagnosis only recently, a sign of just how sensitive — some would say hypersensitive — the Holy See is when the subject is John Paul's health.

Still, there is little reason to doubt the basics of the latest medical concern that created, then rather quickly seems to have dispelled, the biggest scare for the faithful in years. The Pope was hoarse but in high spirits at Sunday's traditional Angelus prayer in St. Peter's Square. Less than 24 hours later, papal spokesman Joaquin Navarro-Valls released a statement canceling all of John Paul's appointments for Monday because of what was described as a mild case of the flu. The plugged-in Italian press corps took a light approach to the story by noting that the 84-year-old Pope had caught the same flu bug that had already bitten half of Rome. Tuesday morning another statement cleared the Pope's calendar for the next two days, but confirmed that there was nothing serious about his condition. But when the Italian newswire ANSA flashed word just after 11 p.m. local Rome time on Tuesday that the Pontiff had been rushed to Gemelli hospital, there was a worldwide fear that the worst could be happening.

Around midnight, Navarro-Valls, who is a medical doctor, confirmed that there were complications to the flu and the pope had suffered acute laryngeal tracheitis and experienced a "larynx spasm crisis," a clinical way to say he'd had difficulty breathing. The cynical among the Vatican press corps believed that the "flu" that had been reported in the official bulletins was in fact a cover for something much worse. Sources at the Vatican discount that scenario, noting both the Pope's relatively robust appearance Sunday and the fact that the basic details about his condition were being released at regular intervals. Navarro-Valls and others who manage the flow of information in the Roman Curia would have nothing to gain from telling the world's one billion Catholics not to worry if they knew that tomorrow would bring bad news. Still, one well-placed Vatican official told TIME that the situation Tuesday night was most likely more grave than the official word that the hospitalization was simply "precautionary."

"Put two and two together" said the Vatican official. "The papal apartment is equipped to respond to respiratory problems. He's had trouble breathing other times in the past. This was obviously more serious." But rather rapidly the Pope's condition appears to have stablized. On Wednesday morning, he held Mass from his hospital bed after a light breakfast and coffee. And Navarro-Valls told reporters jammed in the Gemelli lobby: "There is no cause for alarm."

But even if the Pope is released from the hospital in the coming days, concern over his health will inevitably multiply. No one denies that the Pope is mentally alert, and able to carry on meaningful discussions. Still the Parkinson's is progressing, not only adding a risk to any related breathing problems, but steadily stripping the Pope of his ability to preach to his followers. What were once 17-hour papal work days are now a fraction of that with the Pope confined to a wheelchair and in need of ever more rest. Talk of retirement that surfaced three years ago has effectively been stifled, leaving Vatican observers with a nagging question: Who is really running the show at the Holy See? Rome's influential Cardinals no doubt are having their say. Conservative German stalwart Joseph Ratzinger who heads the office that oversees all moral and theological issues and Secretary of State Angelo Sodano whose role is traditionally that of a de facto Prime Minister are largely given free reign to run their respective dicasteries. Many insiders note that ultimately groundshifting decisions must get a Papal green light, which means John Paul's trusted personal secretary, Archbishop Stanislaw Dziwisz (pronounced Geevish), perhaps wields more power than any of the big-shot Cardinals. Dziwisz — who started working for the future Pope in 1966 when he was Archbishop of Cracow — sleeps next door to the Pontiff and is by his side virtually every waking moment of the day.

One power that would be denied to Dziwisz, 65, who was recently elevated to Archbishop status, is a say in choosing John Paul's successor. That will be done by the some 120 Cardinals under 80 years of age, who will vote in a secret, closed-door Conclave for the next Pope whenever John Paul's health does eventually fail him. Ratzinger has recently re-emerged as the top papal candidate from within the Vatican hierarchy, joining other front runners such as Dionigi Tettamanzi of Milan and Claudio Hummes of Sao Paolo. Vatican sources have told TIME that the length of the current papacy — now more than 26 years — may prompt the Cardinals to seek a shorter-term "transitional" figure. Ratzinger, 77, may fill that bill. His reputation as a hardline doctrinaire has given way to a sense that he knows how to balance old-school tradition and modern pragmatism.

Still, the faithful say they have much to learn from the current Pope. Susan Addinall, a high school teacher from Sydney leading a pilgrimage of 43 students, came to pray for the Pontiff outside Gemelli hospital on Wednesday. "He is still our spiritual advisor," she told TIME. "Now he teaches us how much love and peace and hope can come out of suffering — and that death is not something to be feared."