Vatican Grapples with Uncertainty as Pope Francis Remains Hospitalized

The Apostolic Palace in the Vatican serves as the headquarters of the Holy See’s Secretariat of State, the core of the Catholic Church’s central administration. As one steps into the offices on the third floor of this Renaissance-era palace, they pass frescoes depicting some of the earliest world maps, highlighting the church’s long-standing global vision and influence, predating modern globalization.

Currently, as Pope Francis enters his fourth week in the hospital, officials within the Apostolic Palace and across the Vatican are navigating the uncertainty surrounding his health.

Two key figures in the Secretariat of State—Cardinal Pietro Parolin, the Secretary of State, and Archbishop Edgar Peña Parra, the “sostituto” or “substitute”—have visited the pope at least twice in the hospital. Typically, both have individual weekly audiences with Francis and remain in close contact with him.

Parolin, a reserved yet perceptive diplomat from northern Italy, plays a crucial role in the Vatican’s geopolitical affairs and was instrumental in negotiating the Holy See’s agreement with China. Some speculate he could be a future pope. It was Parolin who led the initial prayer session in St. Peter’s Square for Francis’ recovery.

Peña Parra, a Venezuelan church diplomat responsible for overseeing the Roman Curia—the Vatican’s central administration—has demonstrated resilience in challenging situations. Last summer, he faced rigorous questioning in a London court case regarding a Vatican real estate deal. The judge ultimately ruled in favor of the Vatican and Peña Parra on key issues.

With Francis still in the hospital, these two officials are managing much of the church’s daily governance. The Roman Curia consists of various departments, or dicasteries, housed in different Vatican and Rome-based offices. These departments, including those responsible for appointing bishops, continue their operations, albeit at a slower pace.

Meetings with foreign heads of state and visiting bishops have been put on hold, and significant events that typically revolve around the pope’s presence have been postponed. This has led to a tense atmosphere within the Vatican, marked by anxiety and uncertainty.

“It’s always difficult when the head, for whatever reason, disappears because the Holy Father is a very hands-on person with regards to management of the curia and of his interest in the work of all the dicasteries,” said Cardinal Arthur Roche, head of the Vatican’s liturgy department, in an interview with CNN.

“(We are) very used to him suddenly ringing for an opinion or to share some observation that he’s made. So, in that sense, things have gone very quiet.”

Roche, who hails from the United Kingdom, acknowledged that while the church’s work continues, this period remains filled with uncertainty and heightened concern.

“But we are hopeful that the good Lord will help him along and restore his health,” he said. “And if not, we can at least back him up by our prayers in sustaining his health at a moment when he needs our support. He’s always willing… to help us and it’s a wonderful opportunity for us to help him when he’s in need.”

Despite his hospitalization, the 88-year-old pope has continued to exercise authority over the church. Even while battling pneumonia in both lungs, Francis has signed documents from his hospital room at the Gemelli hospital, approved the appointment of bishops, and even named a NASA scientist as a member of the Pontifical Academy for Sciences. He has also reached out to a Catholic parish in Gaza.

It was Francis himself who directed doctors and Vatican communications to release detailed daily health updates. On Thursday night, for the first time since his hospitalization, his voice was heard publicly. Though struggling due to his respiratory issues, the pope made a significant effort to thank those gathered in St. Peter’s Square for their prayers.

Each evening, cardinals and senior Vatican officials convene in St. Peter’s Square to pray for the pope. These gatherings have been marked by a solemn and subdued atmosphere.

Anthony Ekpo, a Vatican official and author of The Roman Curia: History, Theology, and Organization, emphasized that the Curia’s role has now shifted toward “prayerful support for the pope” while also ensuring “continuing the task of assisting him in the work of governing the Universal Church.”

Francis’ hospitalization has also reshaped the Catholic Church’s jubilee year, a special pilgrimage-focused event held once every 25 years. The pope had been scheduled to participate in a series of celebrations, but in his absence, senior cardinals have taken on leadership roles for these events.

This situation has led to speculation reminiscent of a pre-conclave atmosphere. Vatican observers are closely monitoring how cardinals stepping in for Francis carry out their responsibilities, assessing whether any might be “papabile”—that is, a potential future pope.

The interest in papal succession has been heightened by the popularity of the film Conclave, which many senior church figures have watched.

Although Francis has faced physical difficulties, he has remained mentally sharp and has taken steps to ensure that no single figure wields excessive influence in his absence.

The pope has two personal secretaries assisting him at the hospital, both priests, but they have largely remained out of public view. Throughout his papacy, Francis has rotated his secretaries, opted against appointing a personal spokesman, and avoided allowing any individual to emerge as a “deputy.”

This approach contrasts with the power structures that emerged during the long illnesses of previous popes. When John Paul II experienced extended periods of ill health, a power vacuum developed within the Vatican, allowing key officials to exert control over major decisions. His private secretary, now Cardinal Stanisław Dziwisz, became an influential gatekeeper. Similarly, Benedict XVI’s close aide, Archbishop Georg Gänswein, played a similar role.

Currently, there is no clear timeline for Francis’ discharge, and Vatican sources describe the prognosis of his complex health condition as “reserved.”

Friends of the pope say he is eager to leave the hospital and return to Casa Santa Marta, his residence since the 2013 conclave. This location also serves as lodging for cardinals during a conclave. Given the seriousness of his condition, his recovery could take weeks, fueling speculation about whether he might consider resigning.

From March 9 to 14, the leaders of the Roman Curia will participate in spiritual exercises in observance of Lent, this year focusing on “the hope of eternal life.” This period is traditionally marked by deep prayer, fasting, and almsgiving as believers prepare for Easter.

For the Vatican, however, Lent in 2025 is unfolding in an atmosphere of uncertainty. As the pope’s health remains precarious, church officials and faithful alike are holding onto hope—and prayer—that a clear path forward will emerge.