Just a day earlier, Pope Francis had thrilled the faithful by showing up on the balcony of St. Peter’s Basilica, after two brushes with death, and blessing the crowd of worshipers below on Easter Sunday. “Viva il Papa,” they cheered.

But on Monday, standing somberly behind a microphone at the Vatican, Cardinal Kevin Farrell announced that the pope had died. “At 7:35 this morning, the Bishop of Rome, Francis, returned to the house of the Father,” he said.

For the faithful who began streaming into St. Peter’s Square in tears, Francis’ death at 88 was shocking, coming at the end of a brief period in which he had seemed determined to return to his pastoral duties. He had used his final days to emphasize the themes that defined his papacy, particularly the need to defend migrants and others on the margins of society.

Recent severe illness

It was only weeks ago that Francis had seemed unlikely to survive a severe case of pneumonia in both lungs. He was hospitalized for 38 days. Twice, his doctors said, they did not think he was going to make it.

The Vatican said Monday that Pope Francis died of a stroke, followed by a coma and the collapse of his cardiovascular system. The declaration of death said Francis had Type 2 diabetes and high blood pressure, both of which can increase the risk of stroke. In a statement announcing the cause of death, the Vatican said that the stroke had led to “cardiocirculatory collapse,” which occurs when the heart and lungs can no longer function.

When he was discharged late last month, doctors told him to remain essentially isolated in the Vatican residence. But Francis wanted to “return to normality,” said one of his biographers, Fabio Marchese Ragona.

Some in the Vatican believed that his doctors had sent him to die at home. His doctor had urged the pope to take it easy. But his aides talked about a new chapter of his pontificate, even though it was clear from his public appearances that he remained weak and was struggling to breathe and to speak.

So the pope started making unexpected appearances that now look like farewell gestures.

Holy Week

He greeted the faithful who had gathered in St. Peter’s Square on Palm Sunday, and on Holy Thursday, he went to a nearby prison, where he met with about 70 inmates. He told them that he wanted “to be close to you; I pray for you and your families.” But he was unable to perform the traditional ritual of washing the feet of 12 inmates, as he had in the past.

After the visit, the Vatican released a photograph of Francis, blowing kisses to the inmates. Asked by reporters at the prison how he was doing, he said in a weak voice: “As best I can.”

On Saturday, his aides brought him into St. Peter’s Basilica in a wheelchair, stunning pilgrims and tourists alike. There he prayed in front of the main altar.

Then on Sunday, he held a brief unannounced meeting with Vice President JD Vance, who was baptized as a Catholic six years ago and was visiting Rome with his family. The meeting came after Francis had sharply criticized President Donald Trump over his administration’s immigration policy, denouncing the deportation of people fleeing hardship as a violation of the “dignity of many men and women, and of entire families.”

On Monday, Trump told reporters that Francis “loved the world, and he especially loved people that were having a hard time — and that’s good with me.” But moments later, he railed against the “millions and millions” of migrants who have entered the U.S. He also said that he and his wife, Melania, planned to attend the pope’s funeral.

After meeting with Vance on Sunday, Francis delighted worshipers in St. Peter’s Square when he appeared on the balcony of St. Peter’s Basilica in a wheelchair and raised a hand in greeting. A roar erupted from the crowd.

“Dear brothers and sisters, Happy Easter,” the pope said, his voice weak and raspy.

His final address was read aloud by a Vatican aide and amplified many of the priorities of his papacy.

After his address, he went for a final ride through the jubilant throngs in St. Peter’s Square. Ignoring his doctor’s advice to avoid young children to ward off infections, he stopped to bless a newborn baby.