This marked Pope Francis’ first public appearance since February 14, following his hospitalization for double pneumonia and other complications.

Pope Francis made a brief yet emotional appearance on the Gemelli hospital balcony before his discharge on Sunday, March 23. He was smiling and waving to well-wishers who had gathered to see him. Photos and videos of him circulated online, prompting a flurry of reactions from concerned fans.

A wheelchair carried Pope Francis to the balcony, and under his white cassock, bandages were visible on both arms. Despite his frail condition, the 88-year-old pontiff greeted the crowd, his voice noticeably weak.

Among the well-wishers was 79-year-old Carmela Vittoria Mancuso, who had visited the hospital daily during the pope’s treatment. Holding a bouquet of yellow flowers, she was visibly moved when Pope Francis acknowledged her, later sharing that her heart “was bursting” at the moment.

After greeting the crowd from the balcony, the pontiff left Rome’s Gemelli hospital around noon on Sunday. His car, escorted by police, made a brief stop at the Basilica of Saint Mary Major in Rome, where he left flowers as a gesture of devotion.

Pope Francis had been admitted for five weeks whilst battling double pneumonia and other complications. This is the most serious health crisis he has faced in his 12-year papacy.

His first public appearance since February 14 sparked a wave of online reactions as fans commented on his changed appearance. Some struggled to recognize him, with one asking, “It is him?” and another person remarking, “He looks very different.”

Other people insisted, “That is not the same person” with more concurring, “That’s not him.” His well-being also sparked worry, with one person commenting, “Looks exhausted,” while another netizen sympathized, “Poor man. He’s so frail.” Many individuals simply wished him well, with one pleading, “Omg…let him rest!”

Though the pope is back at the Vatican, his doctors have advised that his recovery will take time. They have recommended two months of rest and cautioned against large or strenuous gatherings. With his schedule uncertain, it remains to be seen how much activity Pope Francis will resume in the coming months.

While he was breathing on his own during his recent appearance, he used a small oxygen hose under his nose while traveling in his car. Furthermore, his health condition had been so serious that he had been receiving oxygen to help him breathe throughout his hospital stay.

During his hospital stay, Pope Francis was only seen publicly once in a Vatican-released photo showing him praying in a hospital chapel. As his health declined, the Vatican faced mounting questions about what would happen next as it came to light that the pontiff quietly signed a resignation letter to be enacted if he ever became incapacitated.

Pope Francis signed the resignation letter in 2013, leading to lots of questions. What does the letter mean? How severe was the Pope’s condition? What would happen if he stepped down or passed away? And how was the Vatican preparing for such a historic moment?

Pope Francis’ resignation letter was intended to be enacted in the event of incapacitation, a move with little precedent in modern papal history.

While his recent hospitalization and frail condition raised speculation about whether this letter might soon take effect, reports indicated that the Pope had accepted that “the end of his earthly life is very close,” making a formal resignation seem unnecessary.

The Vatican did not confirm any plans to invoke the resignation letter, but if it had happened, it would have set in motion a highly structured process.

According to The Australian’s chief leader writer, Tess Livingstone, the first steps following a papal resignation or death would include the destruction of the Pope’s ring and seal of office to prevent misuse.

Nine days of mourning, known as novendiales, would follow, accompanied by masses for the repose of his soul.

Pope Francis, however, has opted to be buried not in the Vatican but in the Basilica of St. Mary Major, a historic and revered church dedicated to the Virgin Mary, located just outside the Vatican’s walls.

In a December 12, 2023 interview with Mexican news outlet N+, the Pope, in good spirits, openly discussed his funeral plans. He revealed that he had already spoken with Archbishop Diego Giovanni Ravelli, his master of liturgical ceremonies, about the arrangements.

“We simplified them quite a bit,” he said before jokingly adding, “I will premiere the new ritual.” This decision marked a significant departure from tradition.

Historically, popes have been buried in the Vatican Grottoes beneath St. Peter’s Basilica. The last pontiff to break this custom was Pope Leo XIII, who died in 1903 and was interred at the Basilica of St. John Lateran.

As for St. Mary Major, six popes have been buried there, but the most recent was Pope Clement IX in 1669. Pope Francis’ reasoning for his choice was deeply personal.

“It’s my great devotion,” he said, explaining that before becoming pope, he would visit the basilica on Sunday mornings whenever he traveled to Rome.

The site houses the revered Byzantine-style icon known as Salus Populi Romani (Salvation of the People of Rome), which depicts the Virgin Mary holding the infant Jesus.

The Pope has long expressed a special connection to this image, often praying before it after returning from his papal trips. His preference for a final resting place outside the Vatican aligns with his broader emphasis on humility and simplicity.

By November 2024, he had revised the funeral rites that would be used upon his death, streamlining the rituals to highlight his role as a bishop rather than an exalted figure.

The Vatican newspaper L’Osservatore Romano reported that he approved the updated liturgical book on April 29, replacing the previous version last updated in 2000.

The decision to revise these rites came in the wake of Pope Benedict XVI’s death on December 31, 2022. As the first retired pope in 600 years, Benedict’s funeral posed unique challenges for the Vatican, prompting Pope Francis to work with Monsignor Ravelli to simplify the traditional ceremonies.

In the event of Pope Francis’ passing behind the scenes, cardinals would prepare for what could be a historic transition. “Around the world, about 200 cardinals would be getting ready to fly to Rome,” Livingstone explained.

“I’m quite sure that would be the case. Quite a few — probably about 50— live in Rome as it is,” she added. A conclave, the closed-door assembly of cardinals responsible for electing a new pope, would then be convened.

Among them, 138 cardinals under the age of 80 would be eligible to vote, while senior cardinals over 80 would participate in pre-conclave discussions. “That promises to be extremely lively this time around,” Livingstone noted.

Given the Pope’s history of selecting cardinals from diverse backgrounds who are largely unfamiliar with one another, some speculate that the upcoming conclave may be particularly unpredictable.

When questioned in 2022 about whether his diverse appointments would make the process more challenging, Pope Francis responded, “Of course, from the human point of view. But it is the Holy Spirit who works there.”

Despite his health, the pontiff continued working from the hospital, reportedly making governmental decisions and approving new appointments.

He also met with his second-in-command, Cardinal Pietro Parolin, and the Vatican’s chief of staff to discuss the canonization of five new saints.

Additionally, Pope Francis called for a consistory — a formal gathering of all cardinals — to determine when these saints will be officially recognized.

However, some within the Church, including priests in Rome, speculate that the consistory could serve a dual purpose, possibly signaling more significant developments within the Vatican.

Speculation surrounding Pope Francis’ resignation persisted in part due to his own remarks in the past. The Pope had previously stated that he would consider stepping down if his health severely limited his ability to fulfill his duties, following the precedent set by Pope Benedict XVI.

In the 2022 interview, he confirmed that he had already prepared for such a possibility. “I have already signed my resignation,” he stated, revealing that he handed the document to then-Secretary of State Tarcisio Bertone.

“I signed it and I told him, ‘In case of impediment for medical reasons or what do I know, here is my resignation. You have it,'” he added.

When asked about the whereabouts of the letter today, the Pope speculated that Bertone likely passed it to his successor, Cardinal Parolin.

He is not the first pope to take this precautionary step. “Paul VI also left in writing his resignation in case of permanent impediment,” Pope Francis was told during the same interview.

“That’s right, and Pius XII, I think he did too,” he responded. However, unlike Pope Benedict XVI, who became the first pope in nearly 600 years to resign voluntarily, Pope Francis has never openly expressed an imminent intention to step down.

In recent weeks, the Pope was reportedly preoccupied with ensuring his legacy and finalizing key decisions. Sources close to the Vatican suggest that he was deeply concerned about his health and was rushing to complete unfinished matters, particularly regarding Church leadership and reforms.

According to two individuals who were familiar with the situation, the Pope was in severe pain and had privately expressed certainty that he would not recover this time.

In response, he was moved to secure the future direction of the Church by appointing key figures to influential positions, continuing his progressive agenda amid ongoing ideological divisions within the Vatican.