Religion: X-raying the Pope

The Pontiff had taken no breakfast when, at 8 a.m., he stepped into a little, white-walled room in his Vatican apartment. Flanking an X-ray table set up for the occasion were four doctors. As the ailing Pope raised his hand in blessing, all knelt for a short prayer. Then, at last, the doctors were able to begin a task that should have been done months, if not years ago: a thorough X-ray of their patient’s intestinal tract. (Many times during his recurrent illness the Pope could not have stood the process, but some Vaticaners feel that there were plenty of opportunities between the crises when X-rays could have been taken.)

The Pope’s housekeeper, Sister Pasqualina, handed him a “barium breakfast”—a glass of gritty, ill-tasting barium sulfate which he swallowed slowly with unconcealed dislike. The Pope remained standing as the barium salt (opaque to X-rays) moved down his gullet, and the doctors made exposures to show its entrance into his recently inflamed stomach. Then the Pope lay down on the table and the X-ray camera shot more pictures showing the barium’s slow course through the stomach and into the upper intestinal tract.

All this took 70 minutes and proved exhausting to the Pope. He was glad to get back to bed while doctors waited for technicians to develop the X-rays. The pictures finally made clear, after months of guessing and rumors, just what was the matter with the Pope.

One of the first exposures showed what the doctors had been looking for. At the hiatus, where the esophagus (gullet) passes through the muscular diaphragm from the chest cavity into the abdominal cavity (see diagram), the muscle was weak and part of the upper stomach had herniated or bulged through it. How the hernia started, they could not tell (it might have been there in milder form since birth), but there was no doubt that it was the cause of much of the Pope’s recent gastritis, hiccuping and vomiting. The hernia held food like a pouch, instead of letting it pass straight into the main part of the stomach. Acid and digesting food in the pouch irritated the esophagus and diaphragm, causing hiccups and vomiting.

To be doubly sure, the doctors insisted on more X-rays late in the afternoon, when the barium had traveled to the lower intestine. But they found nothing more—certainly no sign of the malignancy they had feared. Then the question was what to do about the hernia. Operate soon to remove the hernia, advised the Pope’s new doctors, Gastroenterologist Antonio Gasbarrini and Surgeon Raffaele Paolucci di Valmaggiore. No, said Chief Papal Physician Riccardo Galeazzi-Lisi, the Pope is too old (nearing 79) and not strong enough, and he would be too upset by the inability to carry on his duties. That was also the view of Switzerland’s unorthodox Dr. Paul Niehans (TIME, Sept. 13). So the doctors decided to continue doing all that they could to cut down the acidity of the Pope’s stomach, and increase his feedings to build up his strength. By week’s end they had him out of bed for a ten-minute walk in the garden, on the chance that exercise would make the protruding piece of stomach snap back through the diaphragm and into place. Unscientific as it sounds, many doctors agree that it would be the best treatment for the Pope, since it would not drain his feeble strength.