In the days after the Vatican announced on Feb. 6 that Pope Francis had bronchitis and would be restricting his activities to his residence, he proceeded to hold multiple private audiences a day with groups of nuns, pilgrims and leaders of foundations.
On Feb. 9, he presided over an outdoor Mass in St. Peter’s Square, where the wind was so strong that it blew his white zucchetto off his head. He could not finish his homily, passing it to an aide and saying, “I have trouble breathing.”
Three days later, at his weekly Wednesday audience, the ailing pope had an aide read his speech. But then he shook hands with dozens of prelates, many leaning over to whisper greetings, and took photos with Spanish faithful, Milanese military recruits and nuns from Mother Teresa’s order.
Two days after that, Francis was rushed to the hospital, with what doctors said was a complex medical condition that evolved into pneumonia in both his lungs.
Many who know him said in interviews that Francis, driven by a sense of mission and a discipline born of his early training, essentially worked himself into the hospital.
He is now bedridden after weeks of ceremonies and audiences — both private and public — that only intensified with the start in December of the 2025 Jubilee, a year of faith, penance and forgiveness of sins that takes place only every quarter century.
But the pope’s grueling schedule — which would exhaust anyone, let alone an 88-year-old with a series of health issues — is in keeping with Francis’ personality and with his vision of the papacy, say doctors, biographers and Vatican observers.
“The pope cares a lot about the Church, so it’s clear he put the Church first,” Dr. Luigi Carbone, the pope’s personal physician at the Vatican, told reporters at a briefing at the hospital on Friday.
Dr. Sergio Alfieri, another one of the pope’s doctors, added that “he doesn’t hold back because he is enormously generous, so he tired himself out.”
Francis became pope late in life — he was 76 — and was determined to make the most of it because he suspected that, relatively speaking, he would not hold the position for long. A year into his papacy, he told reporters that he thought he would be pope for two or three years, then “off to the house of the Father.”
That prediction was clearly wrong. Instead, he established a schedule — waking up before 5 and at his desk by 6 to tackle a full day of work — that Nelson Castro, the author of the book “The Health of Popes,” called “crazy.” Just last September, Francis took the longest and most complicated trip of his tenure: an 11-day, four-country tour in the Asia-Pacific region.
“For Francis, it’s all or nothing,” said Austen Ivereigh, a Catholic commentator and papal biographer. In Francis’ view, it was “an essential dimension of the papacy” that people had constant access to him, and there was no time to be inaccessible for health reasons.
“His primary concern isn’t to extend his life, his primary concern is to exercise the papal ministry in the way that he believes it must be exercised, which is all in, 100 percent,” Mr. Ivereigh said.
“He has a crazy agenda,” said another biographer, the Argentine journalist, Elisabetta Piqué. Alongside his official morning schedule, he has a parallel, equally full agenda for the afternoon. “He always says, I’ll have time to rest in the next world,” she said.
Francis had a deep-seated sense of duty that was instilled in him by the boarding school he attended as a child, run by the Salesian religious congregation, and later by the Jesuit order which he joined in 1958, said Fabio Marchese Ragona, another biographer.
He said that Francis had told him that he had joined the Jesuits “above all for the discipline,” and that keeping commitments was drilled into him — as was arriving early for appointments.
Carlo Musso, who worked with Francis on “Hope,” an autobiography that was published last month, noted: “The word he used most, the exhortation I remember best, is ‘forward.’ Even when he was looking back, it was so he could move forward.”
People who know Francis say that he is resistant to taking a break, even when he should because of sciatica, a bad knee or recurrent bronchial woes. As a young man, he had the upper lobe of his right lung removed, and he has suffered bouts of influenza and bronchitis during the winter months.
“He’s so obstinate; he’s a testardo,” said Dr. Castro, using the Italian word for stubborn. And the pope has admitted to being “a very difficult patient,” he added.
The pope once told him that he liked to keep his distance from doctors, Dr. Castro said, “meaning that he wants to make the decisions” about what he can and cannot do.
Mr. Ivereigh said that Francis had admitted that one of his “big faults” was obstinacy. “He’s very strong willed and doesn’t readily listen to suggestions that he cut things back,” he said.
Mr. Musso pointed out that a few hours before he was taken to hospital, Francis held audiences with the prime minister of the Slovak Republic, the president of CNN and representatives of a charity that works in Puerto Rico. “He has an enormous capacity for work,” he said.
The pope does not go away for summer vacations, Mr. Musso added. That habit, said Ms. Piqué, is a source of chagrin for many Vatican employees. His last real vacation was in 1975, Francis himself said in his autobiography “Hope.”
John Paul II and Pope Benedict XVI summered at the papal residence in Castel Gandolfo, though the former also opted for mountain stays in northern Italy.
Francesco Antonio Grana, a Vatican reporter for the Rome daily newspaper Il Fatto Quotidiano, said it did not help that Francis surrounded himself with “yes men” who indulged the pope.
“This hospitalization could have been avoided” had someone put the brakes on the pope’s schedule, Mr. Grana said.
“I prefer a live pope than a pope who died because he kept one more commitment on his agenda,” he added. “With Donald Trump in the White House, the world needs a live and combative pope.”
The same week that he went into the hospital, Francis wrote an open letter to bishops in the United States criticizing President Trump’s policy of mass deportations of immigrants, and he has stood up to Mr. Trump on issues like climate change.
Francis’ workload was not only arduous but also brought him into contact with hundreds of people who could potentially transmit diseases, said Massimo Andreoni, professor emeritus of infectious diseases at the University of Rome Tor Vergata. “So perhaps he should be more careful when he has a cold or bronchitis and maybe slow down a little and look after himself a little more,” he added.
There are a few signs that the pope may be ready to slow down.
Francis was visited in the hospital on Wednesday by Prime Minister Giorgia Meloni of Italy. Reporting on the meeting, the Milan daily newspaper Corriere della Sera wrote that Francis complained to the prime minister: “The doctors said I have to take some time off” and that “I have to be careful with my health, otherwise I go straight to heaven.”
At a news briefing on Friday, Francis’ doctors made clear they would keep him at the hospital as long as he needed treatment that he could only receive there, rather than bring him home to his residence in Casa Santa Marta.
“We think it’s prudent,” said Dr. Alfieri. “If we brought him to Santa Marta, he’d start working like before, we know this.”
