Pope starts to receive nutrition through a nasal feeding tube

ROME - Acknowledging that the pontiff's recovery has been slow, the Vatican said yesterday that Pope John Paul II is now receiving nutrition through a feeding tube in his nose to give him strength.

Public audiences with the pope will be canceled until further notice, the Vatican said.

It was the Vatican's first public statement on the frail pope's health in nearly three weeks, amid growing concern over his ability to continue his papal duties. The announcement came shortly after Pope John Paul appeared at his apartment window above St. Peter's Square and, for the second time in four days, failed in an attempt to speak to the crowd below.

Since his release from the hospital March 13, the pope has made a handful of short appearances at his window but has not been able to utter even the briefest of blessings. For the first time in his papacy, he was sidelined throughout this month's celebrations of the Easter holiday, the holiest period in the Christian calendar.

The pope has looked gaunt since leaving the hospital, where he was confined twice in the past two months for a total of 28 days and where on Feb. 24 he underwent an emergency tracheostomy to help him breathe. Italian news media reported this week that his doctors were considering readmitting him to the hospital for a new operation to insert a feeding tube in his stomach and that he was having trouble eating solid foods. The 84-year-old pope also suffers from Parkinson's disease, which makes swallowing difficult.

Instead, Vatican spokesman Dr. Joaquin Navarro-Valls said in a statement that the pope was receiving nutrition through a nasogastric tube as a way to "improve his caloric intake and promote an efficient recovery of his strength."

A nasogastric tube is common in people requiring supplemental nutrition. The tube is threaded down the nose and throat into the stomach, and liquid food is fed through it. While the process is uncomfortable, no sedation or surgery is required. The patient can eat and speak with the tube in place.

It was not clear when the tube was attached, but the implication was that a return to the hospital was not necessary for now. The feeding tube was not visible during his appearance earlier yesterday.

"The Holy Father continues his slow and progressive convalescence," Navarro-Valls said.

The spokesman added that the pope spends several hours a day in an armchair, celebrates Mass in his private chapel and is conferring with his aides on church business.

Navarro-Valls' comments, his first on the pope's health since March 10, were an attempt to allay the mounting doubts over whether Pope John Paul will have a visible role in the leadership of the world's 1 billion Roman Catholics.

"The Silence of the Pope; the Anxiety of the Faithful," proclaimed a front-page headline yesterday in the newspaper Il Messaggero.

The pope still has a tube in his windpipe, which further curtails his movements.

"Reducing the vital perimeter of Wojtyla to his private apartment also effectively restricts his exercise of power," Vatican expert Luigi Accattoli noted in Italy's leading daily, Corriere della Sera, using the pope's surname.

"If the man emerges from this convalescence, and in the Vatican they're confident he will because they've seen him win so many battles, then what we will have is a pope who is lucid but an invalid, who will not be able to give speeches and who will be limited to a few words to communicate his will," Accattoli said.

The pope has said he considers it "morally obligatory" to provide "basic health care," including water and food, to critically ill people, including those in a vegetative state. His comments a year ago seemed to widen the criteria for when extra measures should be taken to sustain life medically.

The Los Angeles Times is a Tribune Publishing newspaper. The Associated Press contributed to this article.