An American pope brings American-style governance to the Vatican, even in a health crisis

VATICAN CITY (AP) — There’s a telling anecdote from St. John Paul II's pontificate that illustrates how Pope Leo XIV and his American style of governing have changed the Vatican and the way it handles papal health crises.

The Polish pope, 84 at the time, was back at Gemelli hospital battling an acute respiratory infection, breathing problems and the worsening effects on his larynx of Parkinson’s disease, which had made speaking nearly impossible and breathing difficult.

Doctors performed a tracheotomy under anesthesia, an incision in John Paul’s windpipe, to help him breathe. And yet the next morning, his spokesman gave reporters a remarkably rosy, seemingly implausible update: John Paul had eaten his regular breakfast of coffee with milk, 10 biscuits and a yoghurt.

“Something that would suffocate anyone,” church historian Alberto Melloni recalled Friday. “But it was normal then that they told lies about the pope. Those were the rules of the game.”

Two papacies and twenty years later, Pope Leo XIV has changed the rules of the game.

Not only did history’s first American pope announce himself that he had a lung nodule that required surgery – live on television during his Sunday noon blessing from the Apostolic Palace — but Leo's doctors have been providing the medical updates for his recovery, not the Vatican.

Every day since Leo’s surgery Tuesday, Leo’s personal physician Dr. Luigi Carbone and the head of thoracic surgery at Gemelli, Dr. Stefano Margaritora, have signed the medical bulletins updating the world on Leo’s recovery. The Vatican spokesman has provided information primarily involving non-medical details: The Mass Leo celebrated, the Vatican officials who visited.

The written medical updates are spare, but provide authoritative information with a degree of accountability and transparency that has long been anathema to the Vatican.

Leo’s handling of his cancer is in many ways textbook American-style corporate good governance, applied to the Catholic Church, said Julie Rubio, a professor of Christian social ethics at the Jesuit school of theology at Santa Clara University.

“Even though it doesn’t seem all that revolutionary, ‘best practices’ of relying on experts, transparency, evaluation -- all those kinds of things are practices that are good for an institution,” she said.

She said Leo, the American math major pope, had already brought such best practices into his governing style at the Vatican, most visibly in the official rollout in May of his encyclical on artificial intelligence.

Rather than have a handful of prelates talk about the encyclical at a Vatican press conference, Leo himself presided over the presentation. To provide a spectrum of voices, perspective and experience, Leo had on the stage with him three cardinals, two lay female theologians – from Britain and Congo -- and the co-founder of AI developer Anthropic.

Rubio said the inclusive presentation was in keeping with the effort, begun by Pope Francis, to make the church less clerical and more reflective of the real world. It's a church that relies on lay expertise in the way that Leo relied on medical advice to have the nodule removed, she said.

“Those kinds of practices actually can be pretty transformative to a place,” she said. “Though obviously the transformation is a process.”

The process began to some degree under the Francis pontificate, when the Argentine pope took the reins of the Vatican communications apparatus and gave dozens of sit-down interviews over the course of 12 years, often without informing his media handlers. That level of control precluded a Vatican media operation from spinning tall tales as occurred during John Paul's reign.

But when it came to his own health and governing style, Francis was opaque, stubborn and often shunned expert advice. His go-it-alone attitude, in everything from Vatican diplomacy to communications, extended to his view of doctors. He repeatedly refused medical advice, even as his already fragile respiratory health and mobility deteriorated.

Francis had strained ligaments in his right knee that made walking difficult. But he refused to operate on it, saying he didn’t like the effects of anesthesia. Eventually he was unable to walk and had to use a wheelchair. He similarly refused to go to the hospital as his pneumonia worsened toward the end of his life, even as he swelled with the effects of cortisone and other treatments.

Melloni recalled that Francis was very much a Jesuit, a militant-style religious order and its pope a “Rambo-style” fighter who governed alone. He was, Melloni said, “a man who takes care of himself, a man who if injured fights back, a man who always had to give this proof of military-style valor.”

Leo, on the other hand, is the perfect civilian patient: He listens to expert medical advice and follows it, like most people who get sick, Melloni said. Leo moved quickly to remove the nodule, considering other cases of cancer in his family, with his brother currently being treated for blood cancer, he said.

"He knows that this disease —as is obviously the case with all diseases of that sort — is unpredictable,” he said.

Leo is making his mark on governing, even from the hospital, and showing who is in charge in other ways, too.

Late Friday, the Vatican announced he had spoken by telephone with Russian President Vladimir Putin and “expressed his deep concern about the grave humanitarian situation in the city of Oleshky, in the Kherson region, and called for a ceasefire to allow the delivery of food and medical assistance, and the voluntary and safe evacuation of the civilian population.”

The statement was significant, showing Leo was well enough to conduct official diplomatic business from the hospital, was keeping up with world events and was continuing to promote his message of peace as he recovers from surgery. The Kremlin readout of the call suggested progress had actually been made on the humanitarian front.

But the demonstration of Leo's leadership was significant also because it came as intrigue was consuming the Vatican over the fate of the secretary of state, Cardinal Pietro Parolin. The seasoned diplomat had said Leo's pontificate may have to be “adjusted” given his cancer diagnosis, a bold claim given all indications were that Leo was recovering well.

Parolin, who had been Francis' top deputy but remains in the job, was considered a leading contender in the conclave that elected Leo and was recently passed over as dean of the College of Cardinals.

Perhaps tellingly, he was not among the Vatican officials who visited Leo Friday.

Associated Press religion coverage receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content.

This picture, released by Vatican Media on Friday, Oct. 16, 2026, shows Pope Leo XIV, flanked by his personal secretary, Monsignor Edgard Iván Rimaycuna Inga, left, celebrating Mass at the Agostino Gemelli Polyclinic in Rome, where he is recovering after having cancer removed from his right lung. (Vatican Media via AP)

An image of Pope Leo XIV rests at the base of a statue of Pope St. John Paul II at the Agostino Gemelli Polyclinic, where Leo is hospitalized, in Rome, Friday, Oct. 16, 2026. (AP Photo/Andrew Medichini)

Vatican Secretary of State Pietro Parolin arrives to attend an international congress titled "Human Splendor: Preserving Fertility, Treating Infertility" at the Agostino Gemelli Polyclinic where Pope Leo XIV is hospitalised, in Rome, Friday, Oct. 16, 2026. (AP Photo/Gregorio Borgia)

This picture, released by Vatican Media on Friday, Oct. 16, 2026, shows Pope Leo XIV celebrating Mass at the Agostino Gemelli Polyclinic in Rome, where he is recovering after having cancer removed from his right lung. (Vatican Media via AP)

This picture, released by Vatican Media on Friday, Oct. 16, 2026, shows Pope Leo XIV celebrating Mass at the Agostino Gemelli Polyclinic in Rome, where he is recovering after having cancer removed from his right lung. (Vatican Media via AP)

MIAMI (AP) — Hurricane Trudy strengthened slightly Friday evening as it moved towards southwestern and west-central areas of Mexico's Pacific coast and could keep growing through Saturday, forecasters said.

The center of Trudy will approach the coast of southwestern and west-central Mexico on Saturday and pass near the coast Saturday night into Sunday. A hurricane warning was in effect from Manzanillo in Colima state to Cabo Corrientes in Jalisco.

The storm was a Category 1 hurricane with maximum sustained winds of 90 mph (150 kmh) on Friday night.

It was reported as Category 3 early Friday, but the U.S. National Hurricane Center in Miami later said satellite wind data showed it was weaker than indicated.

Trudy was about 210 miles (335 kilometers) southwest of Acapulco, in the Mexican state of Guerrero, and about 290 miles (465 kilometers) south-southeast of Manzanillo, Colima state, while moving north slightly faster, at 7 mph (11 kph), the center said.

The Mexican Navy urged the maritime community and coastal residents to exercise extreme caution due to high waves, heavy rains, and the risk of rising river levels, flooding, and landslides in vulnerable areas.

The state of Colima has said that risks are currently low, but the storm could bring significant rainfall that could have damaging effects due to the saturated ground following the successive storms that have hit the Pacific coast.

Through the weekend, Trudy is expected to produce 4 to 8 inches (10 to 20 cm) of rain, with isolated higher totals around 15 inches along and near the southwest Mexican coast in Michoacan, Colima and Jalisco.

To the northwest of Trudy, the remnants of Hurricane Simon dissipated Friday near the Southern end of South Baja California. It had 40 mph (65 kph) winds and was forecast to keep weakening.

Also in the Pacific, Tropical Storm Champi was intensifying and moving west towards Marianas, moving west at 13 mph (20 kph), with maximum sustained winds increasing to 60 mph (96 kph), according to the U.S. Weather Service and the U.S. Navy's Meteorology and Oceanography Command website.

A typhoon warning was issued for Guam and Rota along with a tropical storm warning for Tinian, Saipan and nearby areas.

This GOES-19 GeoColor satellite image provided by the National Oceanic and Atmospheric Administration (NOAA) and taken on Thursday, Oct. 15 2026, shows Hurricane Trudy in the Pacific. (NOAA via AP)