A Vatican spokesman said Pope John Paul II observed Ash Wednesday in his hospital room, receiving ashes and inviting his doctors to stay for a special Mass.

The pope was visited by Cardinal Camillo Ruini, who said the pontiff looked “very well.”

A severe bout with the flu and breathing spasms sent the pope to the hospital last week. His hospitalization meant that for the first time in the 26 years of his term, John Paul was unable to lead Ash Wednesday services at the Vatican.

American Cardinal James Stafford filled in at St. Peter’s Basilica, saying the pope’s spiritual presence could be felt, while others offered prayers for John Paul’s recovery.