Pope Suffers Relapse, Undergoes Surgery to Assist His Breathing

Struggling to breathe, Pope John Paul II underwent an urgent tracheostomy late Thursday after being rushed to a hospital for the second time in less than a month.

The half-hour surgery, in which doctors inserted a tube through a small hole cut in the pope’s neck to ease his respiratory crisis, was termed a success by a Vatican official. The pontiff was recovering in a 10th-floor suite of hospital rooms.

John Paul suffered serious difficulties in breathing as a complication from a relapse of the flu that sent him to the hospital earlier this month for nine days, said the official, reading a statement issued by Vatican spokesman Joaquin Navarro-Valls.

The relapse was especially troubling because it raised concern that the frail, 84-year-old pontiff might develop a more dangerous illness such as pneumonia, doctors not involved in his treatment said. The pope also suffers from Parkinson’s disease, a degenerative neurological disorder that further complicates breathing.

The Vatican official noted that the tracheostomy was an elective procedure.

Notoriously secretive when it comes to the pope’s health, the Vatican dispatched the official to read a brief statement in the lobby of the Gemelli Polyclinic, where the pope was hospitalized. He took no questions.

Gianni Letta, a top aide to Italian Prime Minister Silvio Berlusconi, visited the pope late Thursday after the surgery and said he was “reassured” about John Paul’s condition. He said the pope managed a weak wave but could not speak.

The pope was breathing with the help of a respirator, the Italian news agency ANSA reported.

The looming question in John Paul’s recovery will be the extent to which he will regain his already weakened voice. Communicating with the faithful has always been a cherished aspect of his ministry.

News of the rehospitalization Thursday sent alarm through Italy and much of the Roman Catholic world.

Earlier in the day, Navarro-Valls issued a two-sentence statement announcing that the pope had fallen ill Wednesday afternoon with the same “flu syndrome with which he had been affected in the preceding weeks.”

About 10:45 a.m. Thursday, John Paul was readmitted to the Gemelli Polyclinic on the northern outskirts of Rome “for the appropriate specialized care and further tests,” Navarro-Valls said. The pope had a fever and trouble breathing, the same symptoms that sent him to the emergency room Feb. 1, church officials said.

The pope was conscious Thursday when he was wheeled into the hospital on a stretcher through a regular entrance instead of the emergency room, ANSA reported.

Even though the Vatican downplayed the seriousness of the pope’s condition, concern built anew among the world’s 1 billion Roman Catholics that the third-longest papacy in history was nearing an end.

“Everybody seems to be awaiting the inevitable, and with an older person who is sick it could be any day,” said lawyer Kevin Doherty, a tourist visiting from Chicago who was among a few hundred people milling about a gray, cold St. Peter’s Square on Thursday as news of the pope’s relapse spread. “We have to be grateful for the opportunities we can still have to be with him.”

Senior church prelates did not hide their worry, either.

“Let us pray for the health of the Holy Father,” Cardinal Joseph Ratzinger, one of the pope’s closest confidants, said in Milan after the funeral of the Rev. Luigi Giussani, founder of the conservative religious movement Communion and Liberation, who died Tuesday of pneumonia at the age of 82.

The decision to hospitalize John Paul came even though his quarters at the Vatican have been outfitted with sophisticated medical equipment.

“The fact that they can’t handle it with the equipment they have says to me this is fairly serious,” said the Rev. Keith Pecklers, a professor at the Jesuit-run Pontifical Gregorian University in Rome who often serves as a commentator on Vatican affairs.

The pope’s initial bad bout of the flu early this month triggered severe inflammation of the trachea and made it extremely difficult for him to breathe. He was discharged from the hospital Feb. 10 and made a high-profile trip home to the Vatican that night, riding through the streets of Rome in his glass “popemobile” and waving to crowds. The Vatican clearly wanted to send the signal that the Catholic leader was healed.

Since then, John Paul has been convalescing and slowly easing back into routine activities. On Feb. 16, he missed the Ash Wednesday Mass that opens the penitential season of Lent. However, on Tuesday he received the prime minister of Croatia, his first official visitor since returning to the Vatican.

Wednesday dawned in Rome with hailstorms and frigid rain, and the pope’s staff decided to keep him away from the window from which he normally greets crowds during a weekly appearance. Instead, a video hookup broadcast images of him to the crowd in St. Peter’s Square for a nearly half-hour Mass, during which he read a message and issued greetings in six languages.

All told, he seemed to be recovering. But Thursday morning, he did not appear for a meeting to canonize five new saints, even as a delegation of cardinals sat awaiting him. Instead, he dispatched Cardinal Angelo Sodano, the No. 2 prelate in the Vatican, to preside over the ceremony, and a short time later, an ambulance took John Paul to the hospital.

Elderly people who have suffered from a bad flu and then are relatively sedentary are susceptible to additional and sometimes more grave illness, doctors say. The patients don’t move enough to aerate their lungs, dislodge mucus and stave off germs.

“The concern with a relapse is that this time it won’t be an influenza but will be another problem like some sort of secondary infection,” said Dr. James Abbott, a general practitioner based in Milan. “The question now is whether this develops into pneumonia.”

The pope’s precarious condition is exacerbated by Parkinson’s disease, which he has had for more than a decade. A neurological illness, Parkinson’s causes the deterioration of the muscles and inhibits voluntary and involuntary muscular and nerve movement, said Dr. Paul Maestrone of the American Parkinson’s Disease Assn.

The patient has difficulty swallowing and taking the deep breaths that can clear the lungs. The condition also allows food or saliva to enter the lungs, which in turn can cause pneumonia. All of this is worsened by the pope’s stooped, contorted body, a product in part of his crippling arthritis, which also makes breathing difficult. “Not much can be done, expect for physiotherapy for those muscles,” Maestrone said from New York.

The pope’s illness early this month renewed the debate over whether the once vigorous but increasingly debilitated pontiff should retire. Sodano fueled the debate when he seemingly left open the possibility, by saying the decision was up to the pope’s conscience.

But John Paul, in his 27th year on St. Peter’s throne, has insisted that he will serve until his “last breath.”

The pope sees his role as being the father of the world’s Catholics and a representative of God and says one cannot step down from such positions.

Though some Catholics argue that they need a strong leader at a time when the church is confronted with declining membership, sex abuse scandals and challenges in the Islamic and Protestant world, John Paul sees his public suffering as an affirmation of the value of human life.

Writing this week to the Pontifical Academy for Life, the pope seemed to reiterate his determination to soldier on.

Human dignity “endures in every moment of life, from the first instant of conception up to natural death,” he said. “Consequently, man must be recognized and respected in any condition of health, illness or disability.”