POPE JOHN PAUL II is not the vigorous, indefatigable man he once was.
But, then, why would he be? He's been pope now for nearly 17 years, more than double the papal average, and, in his case, the distance between middle and old age.
So when the pontiff arrives in the United States, accommodations will be made to both his age and his physical limitations.
His hosts in Baltimore and elsewhere have been asked to minimize the number of stairs the pope has to climb. Some chairs for his use will be raised or have unusually high seats so he won't have to crouch deeply. Rest times will be built into his schedule. Local doctors have been asked to be available at all locations where he passes. And Pope John Paul is unlikely to bow down when he arrives and kiss the tarmac, once a staple during his trips. Instead, a bowl of dirt will be raised to him.
The pope's years in the papacy have not been easy. When he was elected in 1978, he was 58, a famously energetic man with an appetite for mountain climbing, hiking and skiing.
Since then, there have been two bullet wounds from a 1981 assassination attempt and surgeries for colon cancer and a hip replacement. There also have been two serious falls, resulting in a dislocated shoulder and a broken thigh. At 75, the pope now has white hair, a pronounced stoop in his shoulders and a decidedly slow gait.
On his most recent trip, a visit to Africa last month, reporters frequently commented upon the pope's apparent frailty and rare displays of animation. Since he canceled his visit to Baltimore and New York last year because of his slow recovery from the hip replacement surgery, there has been speculation that his health is far more precarious than the Vatican was revealing. Observers have noted that his left hand shakes involuntarily, provoking rumors that he is suffering from cancer, Parkinson's disease or any number of other life-threatening illnesses.
While the Vatican vigorously denies such rumors, it also has a history of being less than candid when it comes to the health of popes. "They have a saying in Rome that the pope is not officially sick until he is dead," said the Rev. Vincent O'Keefe, the superior of the Jesuit community in New York who served for many years in Rome.
Father O'Keefe recalled the official Vatican newspaper denying reports that Pope Paul VI was about to undergo surgery. The next day, he was in surgery. Similarly, while rumors were flying that Pope John XXIII was dying in 1963, the Vatican announced he was going on retreat. Two days later, he was dead of cancer.
No such subterfuge is unfolding now, the Vatican says. It acknowledges that the pope's rehabilitation from his hip replacement surgery in April 1994 has gone slowly. He has had a noticeable limp and for a time had to use a cane.
The official explanation is that the pope, because of his insistence on maintaining his strenuous travel schedule, has given inadequate attention to rehabilitation and physical therapy.
Dr. David S. Hungerford, professor of orthopedic surgery at the Johns Hopkins University, said that the Vatican's explanation is consistent with reporters' observations of him. "Following a fracture and surgery, if the muscles are not strengthened, the person might limp," Dr. Hungerford said. "If people rehab the muscle, they can get rid of the limp."
According to Dr. Hungerford, patients the same age as the pope usually bounce back well from hip replacement surgeries. While he said he recommends against running or other vigorous activities, most people are able to resume normal physical activities after a period of rehabilitation.
As for the trembling in the pope's hand, the Vatican attributes that to nerve damage the pontiff suffered as a result of the assassination attempt.
No matter the speculation, the pope seems to be making no concessions to age or infirmity when it comes to making plans. For some time, he has spoken about his desire to lead the Catholic church into the next millennium, into the 21st century.
He has expressed a desire to assemble the world's religious leaders in Israel then, perhaps even on Mount Sinai.
"He's talked about it almost ever since he became pope," Father O'Keefe said. "He is quite obviously a man on a mission."