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He spent his final hours in his Vatican apartment, surrounded by nine members of his mainly Polish inner circle. Three doctors were present, but no elaborate hospital technology to help prolong his life.

Just before the end, the pope's longtime secretary celebrated Mass and began to anoint the pope's hands with oil, according to one account. John Paul gripped his secretary's hand, an apparent farewell gesture to a faithful aide who helped the pontiff fulfill his wish to die unencumbered by tubes and machines. It was 9:37 p.m. Saturday.

The cause of death was septic shock and irreversible heart failure, according to the death certificate made public Sunday by the Vatican. John Paul's decision last week not to return to the Gemelli Polyclinic hospital where he had spent so much time in recent years mirrored decisions made every day by severely ill patients and their families.