Pope Francis died swiftly and without suffering on Thursday morning after suffering an unexpected stroke, according to his personal physician, Sergio Alfieri.

The 88-year-old pontiff’s death came as a shock, especially as he had appeared in good spirits during public Easter celebrations the previous day.

Alfieri, a senior physician at Rome’s Gemelli hospital who had overseen Pope Francis’s treatment during a recent battle with pneumonia, received an early morning call summoning him to the Vatican. He arrived within 20 minutes.

“I entered his rooms and he had his eyes open,” Alfieri told Corriere della Sera newspaper. “I checked and found no respiratory distress. I called out his name, but he did not respond. At that moment, I knew there was nothing more we could do. He was in a coma.”

In a separate interview with La Repubblica, the doctor explained that even immediate hospitalisation would not have altered the outcome. “It was one of those strokes that, within an hour, takes you away. He would have died en route,” Alfieri said, adding that while a CT scan could have offered a precise diagnosis, it would not have changed the course of events.

Despite his advanced age and fragile health, Pope Francis had returned to the Vatican on March 23 after a 38-day hospitalisation for double pneumonia. Doctors had advised him to rest for two months. Nevertheless, he continued to carry out his duties in a limited capacity, including presiding over Easter Sunday events and briefly meeting U.S. Vice President JD Vance.

“Going back to work was part of his treatment,” Alfieri noted. “He never put himself in danger. He was the pope, and being present in service was essential to him.”

Francis’s resilience and dedication were on display just a day before his death, when he greeted crowds in St. Peter’s Square from an open-top vehicle. He had also visited a Roman prison on April 17, Holy Thursday, where he met inmates—a gesture aligned with his longstanding focus on social justice and outreach.

Alfieri recounted his final meeting with the pontiff on Saturday afternoon, during which the pope appeared in good health and good spirits. “He told me, ‘I am very well, I have started working again, and I like it,’” the doctor shared, noting he had brought the pope a pie in his favourite flavour.

The physician said Pope Francis had expressed one final regret: being unable to perform the traditional Holy Thursday foot-washing ceremony. “He told me, ‘This time I couldn’t do it,’” Alfieri recalled. “That was the last thing he said to me.”

Pope Francis, born Jorge Mario Bergoglio in Buenos Aires, was elected the 266th pope of the Roman Catholic Church in 2013 and was the first pope from the Americas. His death has prompted tributes from around the world, with leaders and faithful mourning the loss of a pontiff known for his humility, reformist zeal, and compassion for the marginalized.