From lying unresponsive to slipping into a coma and receiving a final caress from his trusted surgeon, Pope Francis’ last moments unfolded quietly and solemnly. Take a closer look at how the Pontiff spent his final hours.

Sergio Alfieri, Pope Francis’ personal surgeon and coordinator of his medical team during hospitalizations, recounted the Pontiff’s final moments with a heavy heart.

“His eyes were open, he didn’t answer me. There was nothing to be done,” Alfieri said of his last encounter with the Holy Father at dawn on Monday, April 21.

Director of the department of Abdominal and Endocrine Metabolic Medical and Surgical Sciences at the Gemelli hospital, professor Sergio Alfieri speaking to the media on June 7, 2023, at the hospital in Rome, Italy. | Source: Getty Images

Alfieri, head of abdominal oncology surgery at Gemelli Polyclinic, spoke openly for the first time about the details and plans that shaped a relationship “of esteem and affection” with Pope Francis, a bond that began in 2021 when he first operated on the Pontiff.

Despite the gravity of his illness, Pope Francis approached the end of his life with characteristic resolve. The Pontiff returning to work, Alfieri explained, “was part of the therapy,” and the Pope never exposed himself to danger.

His decision to engage with the public, including accepting his health care assistant Massimiliano Strappetti’s proposal to walk through the crowd in St. Peter’s Square, reflected his determination to fulfill his mission to the very end.

Alfieri last saw Pope Francis on Easter Eve, after lunch on Saturday. “I can say he was very well, he told me so himself,” Alfieri recalled. He had brought the Pontiff a dark tart, a favorite treat, and they enjoyed a brief conversation.

Pope Francis greeting soccer player Dani Alves during the launch of the Scholas Occurrentes International Movement at the Pontifical Urban University in Vatican City, on May 19, 2022 | Source: Getty Images

“I’m very well. I started working again, and I’m up for it,” Pope Francis said, excited about delivering the Urbi et Orbi blessing the next day. They agreed to meet again on Monday.

There had been no push to keep the Pope from his duties, despite Alfieri’s original prescription of 60 days’ convalescence. “It was right,” Alfieri affirmed. “He is the Pope.”

Pope Francis greets and blesses the faithful from a balcony of the Gemelli Hospital in Rome, Italy, on March 23, 2025 | Source: Getty Images

10 days earlier, the Pope had asked Alfieri to arrange a meeting with everyone who had treated him at Gemelli. Although Alfieri suggested postponing until after Easter, Pope Francis insisted, “I’m meeting them on Wednesday.”

Alfieri now believes the Pontiff felt he had important tasks to complete before his passing. Sadly, the call that changed everything came early Monday morning. “At about 5:30 a.m. I got a call from Strappetti. ‘The Holy Father is very sick, we have to go back to Gemelli,’” Alfieri recalled.

Professor Sergio Alfieri giving a press conference at the Gemelli hospital on February 21, 2025. | Source: Getty Images
Professor Sergio Alfieri giving a press conference at the Gemelli hospital on February 21, 2025. | Source: Getty Images

Within 20 minutes, he arrived at Santa Marta. Entering the Pope’s room, he found him with his eyes open but unresponsive. “He did not respond to stimuli, even painful ones,” Alfieri said. “At that moment I realized that there was nothing more I could do. He was in a coma.”

Transferring him to the hospital was ruled out, as the risk of dying in transport was too great. Knowing the Pope’s wish to die at home, Alfieri and the small group around him — including Strappetti, other nurses, and secretaries — stayed by his side until the end.

Sergio Alfieri and Pope Francis photographed at the Gemelli Hospital on June 16, 2023, in Rome, Italy. | Source: Getty Images
Sergio Alfieri and Pope Francis photographed at the Gemelli Hospital on June 16, 2023, in Rome, Italy. | Source: Getty Images

Cardinal Parolin soon arrived and led a rosary prayer. “I felt privileged and now I can say that I was,” Alfieri said. As a final farewell, he gently caressed the Pontiff.

Reflecting on their history, Alfieri remembered meeting Pope Francis for the first time in 2018 as a consultant surgeon for the Holy See. The Pope had invited the medical team to a Mass at Santa Marta, where he personally greeted everyone afterward.

Two years later, when Pope Francis began suffering from severe abdominal pain due to diverticular disease, he consulted multiple doctors before ultimately choosing Alfieri for his surgery. Alfieri believed the Pope selected him because he had the most experience in colon-rectal surgery in Italy.

Their first consultation was brief and unexpected. After reviewing the CT scan, Alfieri encountered the Pontiff leaving the Vatican clinic. A few days later, he formally informed Alfieri of his decision.

“I decided to have surgery and I chose you,” he said. Alfieri insisted the surgery be performed at Gemelli, and the Pope agreed under one condition. “I will arrive on Sunday after the Angelus. No one will have to know. If the news gets out I won’t operate anymore,” he stated.

The secrecy was successfully maintained, with the official cover story being a confidential visit from a foreign head of state. Then, just before surgery, an unforgettable moment occurred.