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Colleen DulleJune 15, 2023
A statue of St. John Paul II is seen outside of Rome's Gemelli hospital June 10, 2023, where Pope Francis is staying after undergoing surgery to treat a hernia June 7. (CNS photo/Lola Gomez)

When Pope Francis was spotted entering Rome’s Gemelli Hospital for some medical tests on Tuesday, June 7, the Vatican did not confirm that he had been there until more than two hours had passed. The following day, after two Italian news outlets had broken the news that Pope Francis was to have an operation, the Vatican sent out a press release mistakenly announcing that the pope had already gone to the hospital for a planned surgery even before he had finished his Wednesday general audience at the Vatican.

That evening, after the surgery, the Vatican took a more proactive approach, arranging a press conference with Pope Francis’ surgeon, Sergio Alfieri.

What accounts for the Vatican’s change in tactics, and how does the Vatican’s communication strategy around this current papal hospitalization stack up against past medical events?

An effort to avoid speculation

John Thavis, a longtime Catholic News Service Rome bureau chief and author of The Vatican Diaries: A Behind-the-Scenes Look at the Power, Personalities, and Politics at the Heart of the Catholic Church, said different strategies reflect different levels of certainty regarding the pope’s health. “In general, over the last three pontificates, the Vatican has been pretty open about medical issues when it comes to the clinical details—by that I mean doctors’ diagnoses, test results, surgeries, even prognoses,” Mr. Thavis said. “They’re comfortable dealing with information when they feel they have answers. They have not been as transparent when it comes to how any of these physical ailments cumulatively can impact the ability of a pope to do his job.”

What accounts for the Vatican’s change in tactics, and how does the Vatican’s communication strategy around this current papal hospitalization stack up against past medical events?

“When the Vatican and the doctors don’t have answers yet, they’re very cautious about how much they say,” he added. “If the Vatican simply says, ‘It looks like the pope is going to need surgery; we’ll let you know more in a few days,’ can you imagine the media speculation? They want to avoid that, so they downplay it until they have results, answers, prognoses.”

This strategy was apparent in the press conferences that the Vatican has hosted during Pope Francis’ hospitalization this month. The pope’s surgeon, Dr. Alfieri, directly confronted two rumors that have circulated around the pope’s health in recent years: one that he had cancer and another that he had suffered a heart attack. Dr. Alfieri said that having examined the pope closely, he could confirm that these stories were fake.

Still, the Vatican’s hesitancy to share details until the pope’s doctors have definite answers has proven frustrating for some covering the Vatican. One crisis communications expert, who works often with various Vatican bodies and spoke on the condition of anonymity, expressed relief that Dr. Alfieri had taken questions from reporters at a press conference on Wednesday night after the pope’s surgery. “That’s a huge step forward. I’m just—like a lot of us—amazed it took them so long,” the source said.

A lack of clarity, a lack of transparency?

The crisis communications expert also expressed frustration at the medical jargon used in the brief updates that the Vatican has issued once or twice per day outside of Dr. Alfieri’s press conferences. The Vatican’s first update, for example, issued before the surgery, said that the pope would undergo a “laparotomy and plastic surgery on the abdominal wall with prosthesis under general anesthesia” and that the surgery “was necessary because of an incarcerated laparocele that is causing recurrent, painful and worsening sub-occlusive syndromes.”

“We all had to Google all of it. What’s a lacerated incision, and what’s subocclusive, and how is subocclusive different from occlusive? I’ve never heard of that. I didn’t know it was a syndrome. And how painful is recurrently painful, and worsening as related to what? It’s gobbledygook,” the source said. “And so what does that come to? It means a lack of transparency.”

“If the Vatican simply says, ‘It looks like the pope is going to need surgery; we’ll let you know more in a few days,’ can you imagine the media speculation?”

Mr. Thavis recalled a similar lack of transparency on the Vatican’s part during Pope John Paul II’s struggle with Parkinson’s disease. “Where reporters sometimes felt the Vatican fell short was, for example, when John Paul II was visibly weakened by Parkinson’s disease later in life and the Vatican had never uttered the word Parkinson’s disease. They used this term ‘extra-pyramidal disease,’” Mr. Thavis recalled, acknowledging that the difficulty of specifically diagnosing Parkinson’s disease may have accounted for this choice of terminology.

The lack of transparency was not limited to terminology, he said. On papal trips, “there were times when the pope would just disappear, and we would wonder what was going on and never be told. So, the day-to-day impact of how [an illness] affects the ability of a pope to be pope, that’s where they don’t want to get into the details,” Mr. Thavis said.

The pope’s medical privacy

At the heart of the question of how to communicate about popes’ medical concerns is the balance between the public’s expectation of accurate information regarding public figures and the pope’s expectation of a reasonable amount of privacy.

The crisis communications expert believes that the Vatican has not sufficiently met the public’s need for accurate information regarding the pope’s health. “I’ve been getting messages from friends of mine across the world: How’s the Holy Father? We’re praying for him. Is he going to be O.K.? Is this the end? That’s not fair. It’s not fair on those people who love him and care for him,” the source said. “Yes, of course, he has a right to privacy. I don’t need to know what color pajamas he was wearing [in the hospital], but I do need to know exactly why he’s there, what was wrong, and if he is going to be O.K.”

According to Dr. Alfieri’s updates, Pope Francis is going to be O.K. But historical examples of the Vatican withholding medical information about the pope has led some to be skeptical about the honesty of the Vatican’s communications. Mr. Thavis recalled that he was in the Vatican when Paul VI died in 1978. “I remember the day before his death, the Vatican said, ‘Well, he’s taking a few days’ rest for arthritis. No cause for alarm.’”

The crisis communications expert believes that the Vatican has not sufficiently met the public’s need for accurate information regarding the pope’s health.

A few weeks later, John Paul I died of a heart attack after only 33 days as pope. “Only after he died did the Vatican release medical information that showed he had serious blood circulation problems, and he was actually awaiting medication to arrive from Venice [when he died],” Mr. Thavis said. “It was a classic case where he did not get the proper attention in time. And not only that, the cardinals who had elected him a month earlier had no clue about this. So I think at the highest levels, there was a recognition that, not only do we have to be more transparent with the public, we have to be more transparent with each other. I think that really did change a lot of people’s minds.”

Mr. Thavis also believes that the institution turned a decisive corner in 1992.

That year, Pope John Paul II had a tumor the size of an orange removed from his intestine. “That’s when we saw the Vatican begin issuing very detailed medical bulletins and bringing out doctors for press conferences. They got into biopsies, they got into whether any cells were malignant or not, the details that reporters wanted. And that transparency was largely credited to the papal spokesman at the time, Joaquin Navarro-Valls, who is himself a medical doctor and believed that unless the Vatican provided medical details, the press would simply speculate about things they didn’t know,” Mr. Thavis said.

Both Mr. Thavis and the crisis communications expert spoke admiringly of Mr. Navarro-Valls, saying that although there was often some measure of positive spin added to his comments on the pope’s condition, he was easily reached by reporters, communicated clearly and was credible because he spoke directly with the pope often.

“Navarro had to fight some internal battles with the old guard at the Vatican who thought it was unseemly and an invasion of people’s privacy to broadcast medical specifics like biopsy reports,” Mr. Thavis said. “I really do think John Paul II [and] Navarro-Valls set up the model for communicating on health issues.”

The crisis communication expert added that he does not see a similar dynamic at play between Pope Francis and the current Vatican spokesman, Matteo Bruni, or the Vatican’s communications dicastery as a whole. “Joaquin Navarro-Valls was in the room with John Paul II all the time. It was one-on-one: What do you want me to say? How much do we need to know? [Vatican spokesman] Frederico Lombardi had very much the same with Benedict; they spoke German together. Again it was one-on-one: What do you need me to say? What do we want to do? There is nothing like that right now.”

The expert cited as an example how forthcoming Pope Francis has been in interviews about his health, in contrast with the brief statements from the Vatican.

The crisis communication expert, who has worked extensively with the Vatican, said he believes this can be attributed to the internal dynamics in the Vatican’s communication structure. The current papal spokesman, Matteo Bruni, “can’t say anything until his superiors give him the green light. And they won’t give him the green light until they’ve heard from the Secretary of State. And so on and so forth. It’s simply dysfunctional.”

Mr. Thavis did not go so far as to call the internal dynamics of the Vatican dysfunctional, but, he said: “Very often the way things happen at the Vatican depend very much on who’s in charge that day, who won the argument over, ‘How transparent shall we be?’ It’s not like they have a policy set in stone; it’s not part of canon law. It depends very much on the personalities involved and the personality of the pope.”

Listen next: How the Vatican talks about the health of the pope

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