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Fri Apr 1 04:02:27 PST 2005

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 Pope's Condition Remains 'Very Grave'

 By Daniel Williams

   VATICAN CITY, Apr. 1 -- Pope John Paul II struggled with death Friday, having received a communion provided to patients nearing the end, Vatican officials said.

 His condition remains "very grave," said spokesman Joaquin Navarro-Valls during a briefing at 5.30 a.m. EST. Although his condition is "stationary" and the pope is "lucid and conscious," his blood pressure "is unstable," said Navarro-Valls.

 Navarro-Valls spoke just a few hours after announcing that the pope had suffered a heart failure late Thursday while undergoing treatment for a urinary tract infection.

 The pope chose not to return to Gemelli Polyclinic hospital, where he underwent a tracheotomy in March, Navarro-Valls said this morning. He is being fed through a tube inserted in his nose and breathing through a tube inserted into his throat. 

 Despite his steady and alarming decline, the pope asked for several routine Friday religious customs to be observed. He requested the reading of the Fourteen Stations of the Cross, the steps Christ took to death and burial in Jerusalem. "He crossed himself at the reading of each station," Navarro-Valls said.

  He co-celebrated Mass at 6 a.m. as a rosy dawn broke in Rome.

  The evening before, he had received "Holy Viaticum" communion, a special service for patients near death.

  This morning, he received visits from chief aides as well, one by one. Among them were Cardinal Angelo Sodano, who is effectively the Vatican's Secretary of State, Cardinal Joseph Ratzinger, the Vatican's senior guardian of dogma, and Cardinal Camillo Ruini, his deputy as Bishop of Rome.

  Ruini described the visit to a television station: "I prayed with him for a moment, which profoundly moved me. The Pope has left himself in God's hands."

  Gingerly, Vatican officials have begun to accept that death is close on the horizon. "He is fading serenely," said Cardinal Andrzej Maria Deskur, a friend of the pope and fellow Pole.

 As word spread in Rome, pilgrims and well-wishers flocked to St. Peter's Square, where they were kept behind a barrier beneath the pope's residence. Police blocked traffic into the main artery leading to the square and St. Peter's Basilica.

 Thursday's setback followed severe throat problems that have impeded the pope's eating and breathing.

 The Vatican announcement Thursday night was issued after Apcom, an Italian news agency, reported the fever. The pope's temperature spiked about 6:45 p.m., the agency said, which was about four hours before the Vatican issued its statement. Apcom also reported that John Paul's blood pressure had dropped precipitously.

 Early Friday, the agency reported that his condition was "stable."

 "The Holy Father during the day was struck with a high fever provoked by a confirmed infection of the urinary tract," Navarro-Valls said in a statement Thursday. The statement said the pope was being treated with "an appropriate antibiotic therapy" but made no mention of a blood-pressure crisis.

 Vatican officials summoned doctors from Gemelli Polyclinic hospital to the pope's apartment, church officials said. It was unclear whether they were there to treat him or prepare him for a trip back to the medical complex in Rome, where John Paul has been treated twice this year. Italian newspapers had reported Thursday that Gemelli physicians wanted him transferred to the hospital.

 According to Navarro-Valls, the pope's treatment is in the hands of Vatican doctors. His apartment is equipped with medical equipment.

 On Wednesday, Vatican officials announced that the pope's doctors ran a plastic tube through the pontiff's nose into his stomach so he could be nourished with liquid formula. On Feb. 24, John Paul underwent surgery at Gemelli to open a hole in his throat so a tube could be placed directly into his windpipe to aid breathing.

 Throat problems are typical symptoms of advanced Parkinson's disease, an incurable neurological disorder that progressively stops muscles from working properly and makes it difficult for the victim to swallow, breathe or clear air passages. The pope can neither walk nor speak.

 The Vatican has insisted that John Paul has been regaining strength after contracting the flu in early February. The latest crisis, involving infection, raises the question of whether the methods used to provide air and nourishment to the pope might irritate the delicate passages of his throat and cause infections there. The pope has suffered recently from frequent coughing fits. He has also lost a noticeable amount of weight.

 The urinary infection might result from bladder muscle paralysis, said Michele Gallucci, a urologist in Rome. In that case, if antibiotics do not work, "it might be necessary to insert a catheter to clear any obstruction" that impedes urination, he said.

 For the first time this week, a high-ranking church official said on Thursday that the pope was facing death. "He is approaching, as far as a person can tell, the end of his life," Cardinal Christoph Schoenborn, the archbishop of Vienna, told an Austrian news agency during a visit to Jerusalem.

 Other leading prelates have limited their comments to praise for the pope's determination and his example of fighting for life while continuing his mission as head of the Roman Catholic Church. A few dissidents have said that the pope's decline, marked by periodic televised appearances at his apartment window, has become an inhumane spectacle.

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