Notwithstanding reports from the Vatican that his condition is “slightly improving,” millions of Roman Catholics remain in fervent prayer for Pope Francis as the ailing 88-year-old Vicar of Christ on earth struggles with double pneumonia on his sickbed at the Agostino Gemelli University Policlinic, Rome’s largest hospital and a world leader in medical technology.

Hospitalized since 14 February, not a few are wondering what process would ensue if the Bishop of Rome vacates the Papacy for health reasons, like Pope Benedict XVI, whom he succeeded, or worse, if he passes away. For certain, this Pope, who ushered in a new era of leadership in the Church when he was elected Supreme Pontiff of the Universal Church in 2013, would be a tough act to follow.

Francis, who had a reputation for humility, was the first pope to come from South America — Archbishop of Buenos Aires since 1998, he was made Cardinal by Pope John Paul II in 2001 — and the first for a Jesuit. He brought many significant reforms to the Church, urging the faithful to address the climate crisis; championing the poor and the oppressed was at the core of his Papacy; and he promoted a broad ministry that included not only non-Catholic Christians, but even non-Christians.

In March 2016, he issued his exhortation, “Amoris laetitia” (The Joy of Love), wherein he urged priests and bishops to be more welcoming and less judgmental about single parents, the divorced who had remarried and hadn’t obtained an annulment, and gay people, even as he reaffirmed the Roman Catholic Church’s rejection of contraception and same-sex marriage.

He renounced the pomp and isolation of living in the traditional papal apartments within the Apostolic Palace, choosing instead to stay with a small community in a modest Vatican City guest house.

Fearlessly challenging the status quo, he reformed the Roman Curia — the central body for the administration of the Roman Catholic Church — and initiated an investigation of the Vatican Bank which had long been linked to money laundering and tax evasion.

Under his watch, the secretive private bank, also known as the Institute for the Works of Religion founded by Pope Pius XII in 1942, complied with international banking standards and other transparency rules. Francis went farther than the reforms started by his predecessor, Pope Benedict XVI, by replacing many of the bank’s top advisers.

Just a year after he was elected Pope in 2013, the bank’s profits rose from $3.9 million to $75.5 million. Also, the bank’s average return on its holdings and its profit margin on interest-bearing assets climbed, with its so-called Tier 1 capital ratio — for regulators, the most important measure of a lender’s financial strength — rising over time.

He opened the doors of the Church wide open to ecumenism and reached out to other denominations and religions. Francis was the first Head of the Holy See to visit the Arabian Peninsula, the birthplace of Islam, in a journey aimed at forging peace and fraternity with faiths outside the Roman Catholic Church.

Attending a global conference on human fraternity in Abu Dhabi, he met with and embraced the Grand Imam Ahmed al-Tayeb, head of Cairo’s Al-Azhar Mosque and one of the highest Sunni Islam authorities.

He broke tradition when he washed the feet of women (including a Muslim) — this never happened before — during a traditional Maundy Thursday reenactment of the washing of the feet of the 12 Apostles.

In an unprecedented letter in 2018, Francis begged for forgiveness following a report that detailed the sexual abuse of some 1,000 children by “predator priests” in Pennsylvania and, in 2022, during a tour of Canada, he again apologized for the “evil” of clergy sexual abuse, vowing that the Catholic Church would never again allow such atrocities to happen.

At the height of the Covid-19 pandemic, Francis stepped out of the Vatican and walked on foot through the streets of Rome to the Basilica of Santa Maria Maggiore to worship before a statue of the Blessed Virgin Mary and on to the Church of San Marcello al Corso to pray before a crucifix that had been carried in a procession through Rome in 1522 to end a devastating plague.

A fervent devotee of the Virgin Mary, he expressed in December 2023 his wish to be buried in the Basilica of Santa Maria Maggiore rather than at the Vatican when he passes away; when that happens Francis will be the first pontiff to be buried there since Clement X in 1669.

Hopefully that inevitability doesn’t occur soon, and some time will pass before a new face will appear on the central balcony of St. Peter’s Basilica to a cheering crowd gathered at St. Peter’s Square, with the protodeacon of the College of Cardinals announcing, “Annuntio vobis gaudium magnum: Habemus Papam!”