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. American-style good governance practices at play 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.