The popes of the 20th and 21st centuries have faced many different health-related challenges, and some died suddenly or under suspicious circumstances.

From Leo XIII in 1903 to John Paul II in 2005, the end of the reigning popes’ lives has always aroused great emotion and intense media coverage. Here is a look back at sometimes little-known and surprising historical episodes, recounted in the book by the Argentine doctor and journalist Nelson Castro, The Health of the Popes (“La salud de los Papas,” 2021).

Leo XIII: the extraordinary longevity of the “illustrious invalid”

Elected in 1878 at the already venerable age of 69, Vincenzo Gioacchino Pecci was tipped to be a transitional pope. Leo XIII would in fact live another 25 years, dying in 1903 at the age of 93, a quite exceptional fact for the time. As an indication, the average life expectancy in Italy at the beginning of the 20th century was no more than 43 years.

In the 1890s, rumors of illness and even death circulated on numerous occasions. This prompted the Vatican to make what were then spectacular innovations in terms of communication. In 1896, in order to counter rumors of illness, Leo XIII became the first pope to be filmed. The video shows the then 86-year-old pope rather alert and amused by these new tools.

During his final days in July 1903, regular reports were published in L’Osservatore Romano. On July 5, the Holy See newspaper reported that the Pope was suffering from “senile pulmonary hepatisation,” adding that “given the age of the illustrious patient, the situation is serious but, for the moment, not alarming.”

Three days later, with greater emphasis, L’Osservatore Romano prepared people for the prospect of the Pope’s death.

“In a corner of the Vatican, the 256th successor of Saint Peter is fighting against the harshness of the illness, and we all wish to know the circumstances of this struggle, not out of curiosity but out of reverence for the anguish of the giant who is fighting against the danger of the ultimate earthly destination reserved for man.”

The oldest reigning pope of modern times died on July 20, 1903. Only Benedict XVI would live past the age of 93, but after his retirement. He died at age 95.

Pius X, the “first victim” of the Great War

“The Holy Father, who was not an easy patient, called his doctors tyrants and accused them of wanting to waste his time. He therefore often disobeyed their orders to rest, and spent his time working or arranging his schedule to organize meetings,” says Nelson Castro about Pope Pius X, who was elected against his will in 1903.

In 1913, the Pope fell ill with bronchitis, giving rise to medical reports of almost shocking clinical precision with regard to current criteria for respect for privacy and intimacy. “His Holiness remained standing for an hour without showing any sign of exhaustion. He had slight abdominal pain due to flatulence. Greyish expectoration. Respiration: 22 [per minute]. Pulse: 88. Temperature 36.6ºC. Clear and abundant urine,” as stated in the bulletin of April 21. The Pope would eventually overcome this difficult episode.

Much more dramatically, in the summer of 1914, the outbreak of the First World War caused Pius X to suffer intense stress and psychological depression that would quickly take hold. “I feel that this war will be the death of me,” he sadly said to those around him.

He suffered a new bout of bronchitis, and died at the age of 79 on August 20. It was the day of the first massive military engagement of that world conflict: the Battle of Morhange, in Lorraine.

Two days later, Dr. Ettore Marchiafava, a member of the medical team surrounding the Pope, said in an interview with Corriere della Sera that the Pope’s death was linked to his depression due to the shock of the war.

“I want to say that the Pope has suffered greatly in recent weeks because of the war that is bleeding Europe (…). His body would certainly have been more resistant if circumstances had not dealt him such a blow to his morale. While he was in this state of mind, the illness struck quickly and hard, like a bolt from the blue,” the doctor revealed.

“Pius X was a pope who wept for the Great War, of which he was remembered as the first victim,” Pope Francis would write in 2024 in the preface of a book about this pope, whom he particularly admired.

Benedict XV: the early death of a forgotten pope

While the advanced age of Leo XIII had falsely predicted a short pontificate, the relative youth of Benedict XV falsely predicted a long pontificate. Elected in 1914 at the age of 59 and with a wealth of diplomatic experience, Giacomo della Chiesa seemed the right man to deal with the geopolitical upheaval of the First World War. But his attempts at mediation were rejected by all parties, and the Holy See found itself completely marginalized during the major negotiations that followed the conflict, particularly the Treaty of Versailles.

The end of Benedict XV’s life is quite surprising. According to an account in Nelson Castro’s book, the pontiff caught a chill on the night of November 27, 1921. He had found the door closed when he went to St. Peter’s Basilica at 5 a.m. “Waiting firmly despite the bad weather for the door to be opened, he is said to have caught a bad cold from which he struggled to recover,” it says.

“Despite the persistent cough he inherited from this cold — regularly forcing him to interrupt his conversations — the pope continued his pastoral office until his health began to seriously decline in the first days of 1922, to the point that on January 22, at 5 a.m., he fell into a deep coma from which he would never recover, since he died an hour later,” says Nelson Castro in his book.

The Pope of the First World War thus passed away, quite suddenly, at the age of only 67. He certainly remains one of the least known popes in history, even if, in 2005, the name of Pope Benedict XVI led to the rediscovery of this predecessor.

Pius XI: suspected assassination

Achille Ratti, elected in 1922, had a pontificate marked by the re-establishment of the sovereignty of the Vatican City State with the Lateran Accords of 1929. But it also coincided with the rise of totalitarianism in Italy, in the form of fascism. In a way that may seem paradoxical, Mussolini was both a partner, in the context of the 1929 agreements, and an enemy, insofar as fascism ended up taking on the dimension of an alternative religion and permeating all aspects of social life.

It was in this very particular context that Pius XI died on February 10, 1939. It was the day before a speech in which the aged and ailing pontiff was to commemorate the Lateran Accords with a sharp criticism of Mussolini’s regime.

“In the pages of his speech, the draft of which he left on his desk and which he intended to read in public on February 12, 1939, His Holiness violently condemned fascism and Nazism,” recalls Nelson Castro.

This death, which was practically providential for the regime, gave rise to many questions about a possible assassination — especially since one of his doctors, Dr. Francesco Petacci, was none other than the father of Clara Petacci, Mussolini’s mistress.

The case was never solved. Pius XI had been suffering from diabetes and cardiovascular problems for two years, and his death at almost 82 years of age seemed imminent. But in 1972, speaking about the death of Pius XI as he was dying himself, Cardinal Eugène Tisserant, who was then one of the last direct witnesses of that period, reportedly said, “They eliminated him, they murdered him.”

Pius XII: from imaginary illness to real illness

Eugenio Pacelli, elected in 1939 at the age of 63, lived through the Second World War and the post-war period with the image of a robust man who paid attention to his physical well-being.

But his health deteriorated sharply from 1953 onwards, the year in which his doctor, Riccardo Galeazzi-Lisi, believed the pope had developed stomach cancer. The following year, this doctor with a poor reputation drew up a dizzying inventory of the pontiff’s pathologies: “Pneumonia, severe asthenia, rhinitis, tracheobronchitis, gastritis with digestive disorders and heartburn, (…) toothache, hiccups, depression, osteoarthritis with paralysis of the right arm, colitis, prostatitis, abdominal distension.”

Deeply hypochondriacal and stressed by multiple phobias, Pius XII seems to have gradually fallen under the influence of charlatans. He strangely obeyed the advice of a dentist prescribing chromic acid, a dangerous substance used for dyeing leather. This could have damaged his esophagus, contributing to the hiccups that would handicap him during the last years of his pontificate.

According to Nelson Castro, the pope even served as a kind of guinea pig for dubious treatments developed by the Swiss doctor Paul Niehans, who devised injections derived from live fetuses of sheep and monkeys. In 1956, Pius XII’s stomach problems led him to consider resigning, but his doctor dissuaded him.

The Pope died in Castel Gandolfo on October 9, 1958, and Dr. Galeazzi-Lisi caused a worldwide scandal by photographing him on his deathbed, which led to his expulsion from the Vatican and the Italian Medical Association. During his last moments, Pius XII surprised those around him by uttering, during a brief moment of awakening: “To work! Registers! Documents! Back to work!” Father Peter Gumpel, Jesuit and postulator of his beatification cause, says that the then 82-year-old pope remained lucid until he went into a coma.

John XXIII: death at the height of his popularity

Angelo Roncalli was already very old when he was elected pope in 1958, at the age of 78. The Patriarch of Venice was a cheerful and original character, far removed from the infighting that had shaken the Vatican in the last years of Pius XII’s pontificate. He offered a more relaxed image of the papal office.

“John XXIII, whose eating habits were frugal, was the first pope to be seen smoking a cigarette — two a day: one after lunch and another after dinner — despite the ban on smoking imposed by his predecessor Pius XII,” Nelson Castro writes in his book.

City of Boston Archives-(CC BY 2.0)

A few months after his election, John XXIII surprised the world by convening a new Council. Unfortunately, he would only live to see the first session, in the fall of 1962. During this period of effervescence at the beginning of the Council, a digestive hemorrhage led doctors to diagnose a stomach tumor.

“Holy Father, we have done everything in our power, but we must admit defeat,” one of the members of the medical team, Professor Valdoni, painfully admitted to him, explaining the incurable nature of the tumor.

“Don’t worry, my bags are always packed. Forgive me for taking up your time. I must confess something to you: While you were busy caring for my body, I was thinking of your souls,” replied John XXIII, with the sense of repartee that still makes him very popular in Italy today.

The “Papa buono” continued his activities until his death in June 1963. “He had the courage to continue working, to keep his commitments and even to publish his last encyclical, Pacem in Terris, which marked an important turning point in international papal policy,” Nelson Castro recalls in his book.

His death caused great emotion around the world, even in the USSR.

Paul VI: a long Way of the Cross

Giovanni Battista Montini appeared in 1963 as the natural candidate to succeed John XXIII, and his election at the age of 65 was part of a dynamic of continuity. An open-minded intellectual but with a more traditional personality than his predecessor, he was a former collaborator of Pius XII.

However, he was also a delicate man with fragile health, who had been, moreover, exempted from seminary in his youth due to his physical frailties.

After a spectacular start marked by his attendance of the Second Vatican Council and his journey to the Holy Land, which was the first time a pope had traveled by plane, his pontificate went into decline from 1970 onwards, with Paul VI no longer publishing any encyclicals or traveling abroad.

SLIDE FIVE: Holy See Mission: 60 years presence at the UN - Pope Paul VI addresses the General Assembly of the UN - Oct 4, 1965

UN Photo | Yutaka-Nagata

Suffering from arthritis, Paul VI was less and less able to move around, and he was regularly forced to use a sedan chair during audiences. Despite a certain rebound in his popularity during the Jubilee of 1975, the last years of his pontificate resembled a Way of the Cross, as the profound upheavals in society were accompanied by numerous defections in the clergy.

In 1978, the kidnapping and assassination of former head of government Aldo Moro by the Red Brigades affected the Italian pontiff very deeply. He had been personally close to this historic leader of the Christian Democrats. The newspaper El Pais reported that Paul VI was so shocked that he “fainted upon hearing the news.”

Completely exhausted, Paul VI went to Castel Gandolfo in July 1978, where he died on August 5, at the age of 80, in the same room where Pius XII had died 20 years earlier. At the time, the idea of the pope being hospitalized or spending time in intensive care still seemed unimaginable. In fact, 11 years earlier, in 1967, it was in the very heart of the Vatican Apostolic Palace that he underwent a prostate operation requiring a complex surgical device.

John Paul I: an unexpected death surrounded by grey areas

Cardinal Albino Luciani was elected on August 26, 1978. He was a man known for his kindness, his level-headedness, and a certain shyness.

“Having as pastor of the universal Church a man of such kindness and such luminous faith was the guarantee that all would be well. He himself was surprised and had to come to terms with the weight of his responsibilities. It was clear that he had suffered a little because of this. He did not expect to be elected. He was not a man who sought a career,” Cardinal Joseph Ratzinger would write 25 years later.

Beatification-mass-of-late-Pope-John-Paul-I-Antoine-Mekary-ALETEIA

Antoine Mekary | ALETEIA

Elected at the age of 65, John Paul I appeared relatively young, promising a pontificate potentially lasting 15 or 20 years — or even longer. The Catholic world was therefore shaken to its core when it learned, 33 days later, of the death of this recently elected pope.

The pontiff was found dead in his bed, officially of natural causes due to his fragile heart. Rumors of assassination circulated over the following years, but this short-lived pontiff had himself mentioned his health problems.

“The Pope before you has been hospitalized eight times and has undergone four operations,” he said bluntly at a public audience.

In 2006, his brother Eduardo Luciani revealed in an interview with the popular Italian magazine Chi that his brother had sensed his death.

“Albino behaved as if he sensed misfortune. […] After his election, he kept alluding to the fact that he would be leaving soon. As if he knew exactly what was going to happen.”

It should also be noted that his brief pontificate was marked by the sudden death of the Orthodox Metropolitan of Leningrad, Nicodemus, on September 5, in the middle of a papal audience. The Bishop of Rome was shaken by this, especially since, in the context of the Cold War, the arrival at the Vatican of an ecclesiastical leader from the Soviet Union was a considerable event.

John Paul II: agony on world TV

The Polish pontiff, elected in 1978 at the age of 58, was a sportsman, passionate about skiing and hiking, and in a reassuringly good physical condition for cardinals tired by the convening of two successive conclaves.

However, the assassination attempt on May 13, 1981, marked a turning point: targeted by Mehmet Ali Agça, the pope was shot in the abdomen, and another bullet grazed his elbow and fractured his index finger. The transfer of the Polish pope to the Gemelli Hospital took place in incredible circumstances, in the midst of Roman traffic jams. He thus became the first pope to be hospitalized.

When the bullet was removed, the doctors saw that it hadn’t damaged any vital organs, and the pope’s life was saved. However, due to the emergency blood transfusions he received, the pope contracted cytomegalovirus. This left him very weakened and led to him being hospitalized again in the summer of 1981, for a longer period of time.

This assassination attempt can also be considered as an indirect cause of the subsequent ailments that would weaken him from the 1990s onwards, and lead certain media to speculate on his imminent death. “The Pope is dying,” was the headline in Courrier International in … 1994. After having to interrupt his speech due to feeling unwell during the Urbi et Orbi Christmas blessing on December 25, 1995, the pope finally underwent surgery in October 1996 for appendicitis, which had caused him to suffer greatly for many months.

The tremors and problems with mobility and speech weakened John Paul II considerably over the years. Still, there was not an official diagnosis of Parkinson’s disease, even if the symptoms were obvious. They were especially notable starting in 1993, when he fell heavily at the end of an audience with members of the FAO.

Despite his suffering, the pope showed great resilience and humor, ironically renaming Gemelli Hospital “Vatican III” because of his frequent stays; he spent more than 120 nights there in total. He joked that to find out about his own health, all he had to do was “read the papers…”

Poświęcenie sanktuarium Bożego Miłosierdzia w Krakowie — Pope John Paul II during the dedicated ceremony in the church of Lagiewniki in Krakow August 17, 2002.

AFP

From February 1 to 10, 2005, John Paul II was hospitalized at Gemelli for laryngitis. He returned there on February 24, after receiving the sacrament of the sick from the Ukrainian Cardinal Marian Jaworski, and underwent a tracheotomy.

The Pope’s final return to the Vatican on March 13 ushered in a final, trying period. On March 20th (Wednesday), 27th (Easter Sunday), and 30th (Wednesday), the Pope was unable to express himself verbally. Shaken by painful spasms, he blessed the crowd from the window of the papal apartments.

After a slow last agony under the eyes of the whole world, John Paul II passed away on Saturday, April 2, 2005, on the eve of Divine Mercy Sunday, a feast day he had instituted five years earlier.

Pope Francis during his weekly general audience in Paul VI Hall at the Vatican on February 12, 2025

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