As he did on Sunday, Francis participated in the retreat remotely from the Rome hospital where he is being treated. He could see and hear the Rev. Roberto Pasolini, preacher of the papal household, but the priests, bishops and cardinals gathered for the retreat in the Vatican auditorium could not see or hear him.

With Pope Francis entering his fourth week in hospital, those working in the Apostolic Palace are grappling with the continuing uncertainty over the pope’s health. The same is true for everyone in the Vatican.

On Thursday, the Vatican will mark the 12th anniversary of Francis' election, the first with the pope out of sight but still in charge.