Monaco on Death Watch for Prince Rainier

MONACO – Hooked to a respirator, Prince Rainier III (search) of Monaco was being treated for cardiac and kidney failure at a seaside clinic in the tiny Mediterranean enclave that he transformed into a glitzy resort for the rich.

Throughout Monaco, Rainier's subjects braced for what they feared could be the final days of a man many revere as a father figure. On Thursday, Rainier was spending his third day in intensive care at a hospital with a view of his hilltop palace.

"Monaco became Monaco thanks to him. I think of him like a second grandfather," said Sandrine Negre, 22, out strolling with friends near the hospital. "This really hurts me."

Rainier's heir, Crown Prince Albert (search), 47, was seen entering the hospital Thursday for a visit. Rainier's two daughters, Princess Caroline (search), 48, and Princess Stephanie (search), 40, also were seen paying calls.

A medical bulletin from the royal palace Wednesday described the ailing prince's condition as "stable." The prince's entourage said Thursday there had been no change, but no official medical bulletin was released.

The 81-year-old prince, whose movie-star wife, Grace Kelly (search), died in a 1982 car crash, was hospitalized more than two weeks ago with a chest infection. After a marked improvement, the prince's health suddenly worsened.

Rainier was transferred to the intensive care unit at Monaco's Cardio-Thoracic Center Tuesday after developing a sudden respiratory infection "with cardiac and kidney failure," Wednesday's statement said. "Breathing difficulties made the installation of artificial respiration indispensable," it added.

Outside the hospital, daily life continued as normal in this tiny Riviera principality wedged between the mountains and the Mediterranean. But the prince's fragile state was close to many. Some watched the palace — and its flagpole — for signs.

"Monaco prays for Prince Rainier," read the main headline of Monaco Matin newspaper, with a photo of people lighting candles for him at church.

Rainier, who assumed the throne in 1949, is beloved in Monaco for having transformed a state smaller than New York's Central Park into a modern and elegant magnet for jet-setters.

"This country is Prince Rainier," said Patricia Vermeulen, a 53-year-old retired school teacher who lives near the royal palace. "This fabulous adventure that is Monaco, he created it."

Speaking his name drew tears to her eyes.

"We've known about his bad health for a long time. But each new time I feel the deepest sadness, as if it were my father," said Vermeulen, setting down grocery bags to dab her eyes. "It's like a knife in my heart each time."

"He's not gone," she paused. "Not yet."

In 2002, the constitution was revised to allow the unmarried Albert to succeed his father, despite his lack of heirs.

Archbishop Bernard Barsi of Monaco visited the hospital Tuesday evening, an official close to the prelate said. On Wednesday morning, the Rev. Philippe Blanc, the local curé, was seen entering the hospital.

The visits were a somber note to what has been a high-flying lifestyle for the Grimaldi family and their playground for the rich, a tiny land that has become synonymous with casinos, Formula One races and tax breaks.

Rainier's two daughters for years have been the focus of paparazzi, who fed off their rocky love lives. Stephanie, known as the wild child, had three children out of wedlock, then married a circus acrobat.

Rainier has been in and out of the hospital recently. He has a history of heart problems and has lately been plagued by recurring ailments linked to his respiratory tract.

Infections can bring on congestive heart failure, which can lower blood pressure and ultimately lead to kidney failure. Heart failure also depresses the respiratory system, making breathing difficult.

Doctors often use respirators, and dialysis machines, to lighten the workload of the body while healing from an infection. Once the infection is cleared, the machines can be disconnected and the body can resume its normal function, said Dr. James Underberg, an internist at New York University Medical Center (search).

However, respiratory infections in the elderly can be deadly, Underberg added.

"It could go either way. This could be a temporary thing where they just support his body while they aggressively treat the infection with antibiotics and he recovers, or it could be the beginning of a downward spiral," he said.