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‘I can understand that, Lorenzo. After all, the Holy Father’s faculties are still quite sharp.’ The Papal Physician kept his fears that the Pope’s condition was far more serious to himself.

‘Yes, and he is determined to bear the burden of his debilitating condition until the end. Between you and me, Vincenzo, the Church’s greatest nightmare would be for a reigning Pope to become unconscious for any prolonged period. I don’t mean any disrespect to your profession but, in the case of a Pope, modern medicine brings mixed blessings. A hundred years ago the physician’s remedy was often more dangerous than the affliction, now we keep people alive for a very long time. To the ordinary man that can either be a comfort or a curse. A Pope is different. If he slips into a coma, the Holy Church slips into a coma with him. I can run the day-to-day business here, but unless His Holiness delegates specific authority, bishops can’t be appointed and major policy decisions can’t be made. A Pope on life-support can spell serious trouble for the Church.’

‘And who amongst the Curial Cardinals will have the courage to turn off the life support of a Pope,’ Professor Martines mused. It was a statement rather than a question. Vincenzo Martines again reflected on his diagnosis of Petroni and the cardinal’s judicious use of charm, manipulation and intimidation to achieve total control. Martines wondered if that would stretch to violence should the need arise. There was a coldness about this Prince of the Church that was the antipathy of Christ, along with a ruthless ambition that hid what Martines suspected was an inner insecurity. But it was not his role in life to make judgements on the fitness or otherwise of a candidate for the Keys to Peter. His task was to brief the Curial Cardinals on His Holiness’ condition, although he was under no illusions as to what was driving Cardinal Lorenzo Petroni.

‘Who indeed, Vincenzo. Perhaps it is time my Curial colleagues were given all the facts. Shall we?’

‘I know you all have busy schedules,’ Petroni began when he and Professor Martines had taken their places at the heavy polished table in the Borgia Chamber, ‘and I am grateful to each of you for your valuable time.’ It was a vintage Petroni opening. He knew full well that not one of the Vatican’s Cardinal Prefects would have dared miss such a meeting. In the secret mazes of the Curial bureaucracy, knowledge was power, and as always, Petroni’s own ruthless power was paramount but it was masked with a velvet glove of courtesy and silken diplomacy.

‘I have asked Professor Martines to join us this evening because I think the time has come for you all to be given a forthright assessment of his Holiness’ condition. As this is an informal meeting and not a consistory, no notes will be taken. It goes without saying that what is said here tonight is to remain in this room.’ Cardinal Petroni nodded politely towards the Papal Physician. ‘Professor Martines, we are indebted to you.’

Professor Martines cleared his throat and adjusted a pair of horn-rimmed glasses on his large aquiline nose.

‘I am happy to be of service, Eminence; I only wish it was under better circumstances,’ he said, looking out at the sea of scarlet around the table.

‘As you know, Eminences, the Pope has been suffering from Parkinson’s for some years, and as you are also aware, Parkinson’s is a progressively degenerative neurological disorder that affects the control of body movements.’

‘Is there a cure?’ The question came from Cardinal Castiglione, one of the longest serving of the Curial Cardinals and Prefect of the Congregation for the Causes of Saints. Giulio Castiglione came from the old school. He was already past the normal retiring age of seventy-five, and when he turned eighty in two years time, he would no longer be eligible to vote. The Holy Father had extended him in his appointment and no one present at the meeting tonight was in any doubt where his loyalties lay. The ‘old bull’ was clearly not happy.

‘Unfortunately not.’ Professor Martines confirmed what most already knew. ‘There is an enormous amount of research being conducted, but the present treatment is restricted to reducing the effects of the disease, not to alleviating the disease itself.’

‘I thought there was some promising research coming out of the United States.’ This time the question came from Cardinal Rinato Fiore, Cardinal Prefect of the Congregation for Bishops.

‘Eminence, I assume you are referring to some work done at the University of Colorado and the Columbian University where they are assessing whether or not cell transplants can restore the dopamine function.’ Professor Martines chose his words carefully. ‘Medical scientists in the United States have shown that dopamine-producing cells can take root, survive and function after a transplant. That gives us some useful clues for further research, but I’m afraid that while the work has shown some promise, implanted cells cannot be fully controlled. An overproduction of some chemicals can trigger involuntary movements which can be quite disturbing.’

‘And the Holy Father’s present condition?’ asked Cardinal Fumagalli, Prefect of the Congregation for the Clergy.

‘You will appreciate, Eminence, that the Holy Father has been on medication for a very long time. One of the characteristics of Parkinson’s is that over time, its effects become commensurately more severe. His Holiness’ stooped posture is, I’m afraid, just one symptom of that. As the illness progresses, more and more medication is required and unfortunately the side-effects become more pronounced.’

‘I understand that in time, Professor Martines, medication might no longer be effective?’ Petroni’s interjection was designed to ultimately force the direction of a decision in his favour.

‘Sadly, we are probably close to that point now, Eminence. To be blunt, apart from his problems with movement and writing, and sometimes with speech, His Holiness is suffering increasingly from nausea and vomiting. He is not sleeping and he is becoming progressively more tired as his dosage of levodopa is increased. There will come a time when the drugs will no longer be effective and appearances in public may be difficult, if not impossible.’

‘And what of the Holy Father’s mental state?’ Cardinal Fiore had ventured where no one else had so far dared, but this was too much for Castiglione.

‘Someone should rule that question out of order!’ Castiglione spluttered, looking directly at Cardinal Petroni. ‘It is not up to us as cardinals to sit here and discuss the Holy Father’s mental capacity as if he were some priest we’re considering putting in a home.’

‘I can understand that some of us, all of us, find this distasteful,’ the Secretary of State responded calmly, ‘but it is not the first time that the Church has had to face this sort of difficulty.’ The Secretary of State turned to face Cardinal Castiglione. ‘There is a lot of experience around this table and none of us have more than you, Eminence, but if the stewardship of the Church should pass into our hands, we need to be prepared.’

‘You make it sound as if His Holiness is half-dead already,’ Castiglione snapped.

‘Forgive me, Eminence, I don’t mean to. Please continue, Professor Martines,’ Petroni said, coldness creeping into his voice.

‘If you are asking me whether or not His Holiness comprehends what is going on around him, the answer is unequivocally yes. His mind is still very sharp. However,’ Professor Martines warned, ‘some patients have difficulty with short-term memory and, for some, complex issues are increasingly more difficult to grasp. His Holiness has been accustomed to a very full working day, which is no longer possible. This is causing him a degree of stress which further lessens the effectiveness of the pharmacological intervention.’

Petroni scanned the faces of his fellow cardinals. The reality was that modern medicine could not provide a recovery, nor could it provide a peaceful death. In a way, the cardinals were also refusing to face their own mortality, grimly hanging on to the old inflexible Church they loved. Petroni was determined to press them for a decision on the Pope’s resignation, but tonight was not the time.