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Ever since the Pope barely survived a 1981 assassination attempt, Catholics worldwide have got used to praying for his health. Whenever John Paul II has a setback — and he's had quite a few in the past 10 years — speculation about his successor ratchets up another notch. So when the Pope was rushed to the hospital last week suffering from an inflamed windpipe, spasms of the larynx and the flu, people wondered how long he would be able to continue in office. The Vatican reported that John Paul was making a good recovery, but with the 84-year-old Pontiff increasingly debilitated by Parkinson's disease, some are asking a more immediate question: Who's running the church?

Despite his physical frailty, Vatican officials say John Paul is still mentally alert and capable of making the big decisions. And the Pope insists on appearing as often as possible in public. But even the most steadfast loyalists concede that his failing health has forced the Pope to delegate a substantial chunk of his workload. "He's still the head of the church," says one priest based in Rome who is well-connected to top Vatican officials. "But he's more of a figurehead. He's not making the day-to-day decisions anymore." That, according to one senior Vatican official, poses risks. "There's more of a chance for corruption," the official told TIME. "People start coming in and looking for a favor — sometimes with money — looking to have someone appointed or transferred to this or that diocese."

There have been no recent reported charges of priests or laypeople bribing church officials, but there have been concerns that the Holy See was lax in responding to the ongoing sexual abuse scandal in the U.S. And there have been some mixed messages coming out of Rome. Just last week, the theologian Georges Cardinal Cottier contradicted longstanding Church teachings that ban condom use, saying they could be "legitimate" to fight aids. The Vatican also seems to have been caught off guard by Spain's move to legalize gay marriage, which the church vehemently opposes.

While the Pope recuperates, many of his duties fall to some of his most trusted advisers. Secretary of State Angelo Cardinal Sodano, 77, is the man with the most administrative muscle. A veteran diplomat, Sodano is like a papal Prime Minister, responsible for the governance of the Roman Curia, headquarters of the Vatican bureaucracy. Sodano is also charged with covering for the Pope during temporary absences, such as the last week's hospitalization, and was slated to stand in for John Paul at this week's meeting in Rome with U.S. Secretary of State Condoleezza Rice. Virtually every major internal Vatican decision and document lands on Sodano's desk.

Perhaps the strongest moral voice behind the Pope is Joseph Cardinal Ratzinger, 77. The German prelate, who has headed the Congregation for the Doctrine of the Faith, which oversees moral and theological issues, since 1981, is a trusted ally, who in the past has drawn fire for cracking down on Catholic thinkers who stray from orthodoxy. Ratzinger has been unyielding in enforcing traditional doctrines and has become influential in outlining a more modern role for the papacy and the Curia.

The unrivaled gatekeeper to the power of the papacy is the Pontiff's personal secretary, Archbishop Stanislaw Dziwisz, 65, who has served with John Paul since his days as Archbishop of Krakow. Dziwisz heads the Pope's personal entourage, a group of prelates and nuns charged with setting John Paul's daily schedule. Access to the Pope is still a direct ticket to influence, and no one — not even most Cardinals — can get to John Paul without a green light from Dziwisz. According to several well-informed church watchers, Dziwisz also leads the group within the Vatican that is most opposed to a papal resignation because of ill health. Despite renewed speculation about that possibility last week, few insiders consider it likely. "If John Paul was going to resign, it would have already happened," says longtime Rome-based Jesuit priest Keith Pecklers. "He identifies with the mystery of Christ's suffering."

Keeping the world updated last week on the Pope's latest health scare was Joaquín Navarro-Valls. A former psychiatrist and journalist, the 68-year-old Spaniard has been the papal spokesman since 1984 and is in constant contact with the Holy Father. Though some veteran Vatican watchers complain that Navarro-Valls spins the world about the Pope's physical condition — he insisted that John Paul was steadily recovering last week — few believe he would deny an illness he knew could be fatal.

And since the Pope's health is itself increasingly a central issue for the church, there is another key power player to watch. Last week, when the respirator at John Paul's private apartment wasn't enough to clear his breathing, the Pontiff's longtime personal physician, Renato Buzzonetti, decided to rush him to hospital. Not even the Pope dares ignore doctor's orders.

• JEFF ISRAELY | Vatican City
• The advisers who run the church when the Pontiff is ill