VATICAN CITY - Pope John Paul II was near death Saturday, his breathing shallow and his heart and kidneys failing, the Vatican said. Millions of faithful around the world knelt, crawled on their knees, bowed their heads and lit candles to pray for the 84-year-old pontiff.
"This evening or this night, Christ opens the door to the pope," Angelo Comastri, the pope's vicar general for Vatican City, told a crowd at St. Peter's Square, where up to 70,000 people prayed and stood vigil in the chilly night. Wrapping themselves in blankets, many tearfully gazed at John Paul's third-floor windows, where the lights remained on early Saturday.
The Vatican said Friday morning that John Paul was in "very grave" condition after suffering blood poisoning from a urinary tract infection the previous night, but that he was "fully conscious and extraordinarily serene" and declined to be hospitalized.
By Friday night, the pope's condition had worsened further, and he was suffering from kidney failure and shortness of breath but had not lost consciousness as of 9:30 p.m., the Vatican said.
The pope "is on the verge of death," Cardinal Javier Lozano Barragan, head of the Vatican's health care office, told the Mexican television network Televisa. "I talked to the doctors and they told me there is no more hope."
As word of his condition spread across the globe, special Masses celebrated the pope for transforming the Roman Catholic Church during his 26-year papacy and for his example in fearlessly confronting death.
In Wadowice, Poland, people left school and work early and headed to church to pray for their native son.
"I want him to hold on, but it is all in God's hands now," said 64-year-old Elzbieta Galuszko at the church where the pope was baptized. "We can only pray for him so he can pull through these difficult moments."
In the Philippines, tears streamed down the face of Linda Nicol as she and her husband asked God to grant John Paul "a longer life."
At the Church of the Assumption in Lagos, sub-Saharan Africa's most populous city of over 13 million, about 200 Nigerians in Western clothes and bright traditional African robes sat on wooden benches, offering prayers for the pope at a midday Mass.
In Washington, Cardinal Theodore McCarrick said he had heard from Rome that the pope was "sinking." McCarrick said he prayed that God will "take him peacefully."
The White House said President Bush and his wife were praying for the pope and that the world's concern was "a testimony to his greatness."
By afternoon, a steady stream of pilgrims jammed the Via della Conciliazione, the main avenue leading to St. Peter's. Some carried candles, while others held rosaries. Some looked through binoculars or camera lenses at the window of John Paul's apartment.
By midnight, police estimated the crowed had swelled to 70,000. The two windows of John Paul's apartment lit up an otherwise darkened Apostolic Palace. Most people in the square stood still and silent after the prayers ended.
"We are near to him in prayer so that he can go to heaven, welcomed by the Lord and the other saints," said Rossella Longo, a young woman distributing rosaries to the crowd.
Tripp McLaughlin, a 20-year-old American in Rome, said "it would be a blessing if he passed on."
"You see video of him when he became pope, he was so alive, so excited to be here. Now to see him break down is just really sad," McLaughlin said.
Among those at the square in the morning was Rome's chief rabbi, Riccardo Di Segni, who said he came "to pray here in the piazza as a sign of sharing in the grief of our brothers for their concerns and as a sign of warmth for this pope and for all that he has done."
During the morning, John Paul had participated in Mass and received some top aides at his bedside, Vatican spokesman Joaquin Navarro-Valls said. The pope declined to be hospitalized.
Cardinal Marcio Francesco Pompedda, a high-ranking Vatican administrator, visited the pope Friday morning and said he opened his eyes and smiled.
"I understood he recognized me. It was a wonderful smile - I'll remember it forever. It was a benevolent smile - a father-like smile," Pompedda told RAI television. "I also noticed that he wanted to tell me something but he could not. ... But what impressed me very much was his expression of serenity."
Hospitalized twice last month after breathing crises, and fitted with a breathing tube and a feeding tube, John Paul has become a picture of suffering. His papacy has been marked by its call to value the aged and to respect the sick, subjects the pope has turned to as he battles Parkinson's disease and crippling knee and hip ailments.
It is not clear who would be empowered to make medical decisions for an unconscious pope. The Vatican has declined to say whether John Paul has left written instructions.
John Paul's health declined sharply Thursday when he developed a high fever brought on by the infection. The pope suffered septic shock and heart problems during treatment for the infection, the Vatican said.
Septic shock involves both bacteria in the blood and a consequent over-relaxing of the blood vessels. The vessels, which are normally narrow and taut, get floppy in reaction to the bacteria and can't sustain any pressure. That loss of blood pressure is catastrophic, making the heart work hard to compensate for the collapse.
Even the fittest patients need special care and medicine to survive.
"The chances of an elderly person in this condition with septic shock surviving 24 to 48 hours are slim - about 10-20 percent, but that would be in an intensive care unit with very aggressive treatment," said Dr. Gianni Angelini, a professor of cardiac surgery at Bristol University in England.
Dr. Peter Salgo, associate director of the intensive care unit at New York Presbyterian/Columbia University Medical Center, said the pope's shallow breathing "is totally consistent with severe failure of the blood vessels to provide blood to all the key organs. Eventually you run out of reserve."
The pontiff was treated by the Vatican medical team and provided with "all the appropriate therapeutic provisions and cardio-respiratory assistance," the Holy See said. It said the pope was being helped by his personal doctor, two intensive care doctors, a cardiologist, an ear, nose and throat specialist and two nurses.
On Friday morning, John Paul asked aides to read him the biblical passage describing the 14 stations of the Way of the Cross, the path that Christ took to his Crucifixion and burial, Navarro-Valls told reporters. The pope followed attentively and made the sign of the cross, he said.
John Paul also asked that scripture of the so-called "Third Hour" be read to him. The passage is significant because according to tradition, Christ died at three o'clock in the afternoon.
"This is surely an image I have never seen in these 26 years," the usually unflappable Navarro-Valls said.
Choking up, he walked out of the room.