VATICAN CITY — Pulmonary adenocarcinoma: two words that struck the Catholic world like a thunderbolt at 10 p.m.

“The operation was completed successfully, within the expected time frame and according to plan. The Holy Father has returned to his room and is expected to remain hospitalized for a week,” the Vatican announced at 8 p.m.

The malignant tumor affecting Robert Francis Prevost is a serious blow to the Holy See’s diplomatic efforts, particularly in war zones. Yet the “Prevost method” is expected to remain the guiding principle of the Vatican’s commitment to peace through the difficult months ahead.

Seven hours earlier, Leo XIV had arrived at Gemelli Hospital looking calm and smiling, visibly moved and surprised by the outpouring of affection from the crowds of faithful, patients, hospital residents and family members who had gathered to greet him.

Accompanied by the prefect of the Papal Household, Archbishop Petar Rajic, and his Second Secretary, Father Marco Belleri, the Pope pulled into the hospital entrance plaza with his car window lowered, raising his hand in greeting. He then got out unassisted and was immediately met by his personal physician, Luigi Carbone.

He appeared confident. But as his face disappeared behind his security detail as they entered the elevator, a shadow of unmistakable emotion crossed it. He had entered the hospital as Pontiff, but in an instant he had also become an ordinary patient.

The applause broke the suspended silence that settles over anyone crossing the threshold of a hospital, a feeling that Leo himself was immediately swept into.

During Mass, the hospital Chaplain, Father Nunzio Currao, invited the congregation to pray for the Pope. Waiting for Prevost on the 10th floor, in the private-patient wing where he was admitted, were his First Secretary, Father Edgar, and the nuns who serve the papal household. The room assigned to him is adjacent to the papal apartment, which is currently being renovated.

What unites the Pope’s aides and ordinary people is a shared sense of empathy for a Pontiff who, too, has discovered his own vulnerability.

Meanwhile, inside the Vatican’s sacred palaces, the apparent lull in activity is deceptive. Before his hospitalization, Leo XIV made key appointments in the Vatican’s governing structure, accelerating decisions he considered crucial to the institution’s future.

“We were all struck by the serenity with which the Pope announced the operation, and we hope that the problem can be resolved as soon as possible. We are confident, and we accompany him with our prayers,” said Cardinal Pietro Parolin, the Vatican Secretary of State.

Speaking about their conversation Monday evening, Parolin said, “We spoke very calmly. I am concerned because I did not expect anything like this. It was a bolt from the blue for the Holy See, too. Nobody saw it coming.”

“The nodule is something that, thank God, was detected immediately. And when these things are caught in time, they can be treated successfully. As the Pope said, these are God’s surprises.”

The world’s attention is fixed on what Karol Wojtyla, Pope John Paul II, used to call the “third Vatican.”

Inside Gemelli Hospital, the Pope was undergoing surgery. Beneath the windows of the 10th floor, the faithful prayed for his recovery.

“Leo followed his doctors’ instructions and underwent surgery promptly, leaving Cardinal Luis Tagle, the newly appointed dean, to preside over the liturgical closing of the meeting of episcopal conferences,” said Bishop Domenico Mogavero.

“Leo entered the hospital calmly, reassuring those worried about this unexpected situation with smiles and handshakes,” Mogavero added. “He has always weighed every decision carefully. The key appointments made shortly before his hospitalization, although not urgent, show that he wanted to put the Curia in order in preparation for any eventuality.”

Under both John Paul II and Pope Francis, there had been fears that illness might limit a pontiff’s effectiveness or weaken his ability to govern. Those fears, Mogavero noted, had not ultimately materialized.

“By personally disclosing the nature of his medical problem, the Pope is preparing public opinion for his hospital stay,” the bishop said.

Father Filippo Di Giacomo, a canon lawyer, sees Prevost’s response as consistent with his methodical, reassuring style and his Anglo-Saxon preference for discretion, maintained even during a medical emergency. He also pointed to the unwelcome reappearance at the bedside of prominent figures from previous Vatican administrations, whose presence contrasts with the new direction.

“Without allowing himself to be distracted by supposed advisers suddenly resurfacing from the past, the Pontiff has meticulously planned the timing of his operation and hospitalization, maximizing the chances of sticking to his South American travel schedule, including the stop in Cusco, Peru, at an altitude of 11,155 feet,” Di Giacomo said.

“Already during his trip to France, Leo knew he would have to deal with this setback. He accelerated certain decisions so that he could manage a delicate period both for himself and for his ministry. The rest is idle talk.”

The Pope had been considering surgery for several days.

At St. Peter’s Square, Cardinal Tagle will preside today over the Mass concluding the summit with the presidents of episcopal conferences, taking the Pope’s place.

The position of dean of the College of Cardinals is more than ceremonial. As primus inter pares — first among equals — the dean presides over the conclave if he is younger than 80.

Meanwhile, Archbishop Vittorio Viola has been appointed the Vatican’s Vicar, and Sister Mary Teresa Barron has been named Secretary of the Dicastery for Evangelization, historically known as Propaganda Fide.

The hardest part for the Curia begins now: managing the Pope’s absence, reshaping his schedule and maintaining the Vatican’s geopolitical role.

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