Former New York City Mayor Rudy Giuliani came out of a coma Monday and was talking, alert, and breathing on his own at a Florida hospital, according to close friend and billionaire John Catsimatidis, who said he received the update from a former aide to the 81-year-old ex-mayor.
The news marked a sharp turn from Sunday, when Giuliani's spokesman disclosed only that the former mayor was in critical but stable condition with an ailment that had not yet been publicly identified. By Monday, spokesman Ted Goodman confirmed Giuliani was battling pneumonia, complicated, Goodman said, by a restrictive airway disease tied to Giuliani's time at Ground Zero on September 11, 2001.
Giuliani's hospitalization drew well wishes from President Trump, former New York Governor George Pataki, and even the city's current left-leaning mayor, Zohran Mamdani. But behind the bipartisan concern lies a grim medical reality: the man once celebrated as "America's mayor" for his leadership after the worst terrorist attack on U.S. soil is still paying a physical price for running toward the towers that day.
Tom von Essen, Giuliani's business partner and the city's fire commissioner during 9/11, told the New York Post that Giuliani had "a tough weekend" after being stricken with a respiratory illness. Von Essen called Monday "an important day" in terms of Giuliani's recovery.
Goodman filled in more of the medical picture. He said Giuliani's restrictive airway disease, a direct consequence of his exposure at the World Trade Center site, added complications to an emerging respiratory infection.
"This disease adds complications to any emerging respiratory issue, and the virus quickly overwhelmed his body, requiring mechanical ventilation to maintain his blood pressure."
Goodman did not specify which virus triggered the crisis. AP News reported that the spokesman had initially declined to disclose what sent Giuliani to the hospital, how long he had been there, or his prognosis. The wire service noted that Giuliani had recently sounded hoarse on his online show, telling viewers, "My voice is a little under the weather, so I won't be able to speak as loudly as I usually do."
That hoarseness, in hindsight, may have been an early warning sign.
Catsimatidis, the supermarket and media mogul who owns WABC radio, said he learned of Giuliani's improvement Monday afternoon from a close former aide to the ex-mayor. The billionaire, visibly relieved, spoke at a media scrum alongside WABC radio host Dominic Carter.
"He's talking, he's alert. To me, that's great news."
Catsimatidis described a bond that stretches back decades. "Friends for 40 years, brothers for 40 years," he said. "Do brothers have arguments? Of course, we did. We kissed and made up."
Another source close to the former mayor offered a cautiously optimistic assessment: "He's alert and breathing on his own. Today was a good day and tomorrow should be even better, barring any unforeseen setbacks."
Maria Ryan, described as Giuliani's doctor and primary care provider, spoke to Fox News and called Giuliani a "fighter." She disclosed that the situation had been grave enough that a priest was summoned.
"He did have a priest come anoint him. And all the prayers from around, it's like a miracle. This guy's got 9 lives, today he's doing much better."
That a priest administered the anointing of the sick, a Catholic sacrament often given when death is feared imminent, tells you how close this came. The fact that Giuliani was conscious and talking hours later tells you something else about the man.
Goodman drew a direct line from Giuliani's current fight to his actions more than two decades ago. "On September 11th, Mayor Giuliani ran toward the towers to help those in need, which led to a restrictive airway disease diagnosis," the spokesman said. Thousands of first responders, recovery workers, and Lower Manhattan residents have suffered chronic respiratory conditions linked to the toxic dust cloud that engulfed the area after the towers collapsed. Giuliani's case, his team says, belongs in that category.
It is a reminder that the costs of that day did not end when the rubble was cleared. They continue in hospital rooms and doctor's offices across the country, often far from the public eye. In recent months, Washington has grappled with security failures of a different kind, including glaring gaps exposed during the White House Correspondents' Dinner shooting, but the long tail of September 11 remains one of the most consequential security events in American history, and its victims still need attention.
Breitbart reported Sunday that Giuliani had been admitted to a Florida hospital in critical but stable condition, with his spokesman confirming the hospitalization but offering no specifics at the time. The initial silence about the nature of the illness fueled widespread concern.
President Trump led what Giuliani's circle described as a chorus of well-wishers. The two men have been close allies for years, with Giuliani serving as a prominent adviser and personal attorney during Trump's first term.
Pataki, the former governor who worked alongside Giuliani during and after 9/11, told the Post he had expected to see Giuliani at a charity event scheduled for Thursday. The news of the hospitalization caught him off guard.
"It was just a shock. You just take for granted that figures that have such a large profile in our state and our country will be around for a long time."
Pataki reflected on their partnership. "We were great partners for the city and the state for seven years together, and we were able to just do a tremendous amount to make the city and state a better place by working together," he said. "So obviously now we just hope he gets better."
The security challenges facing public officials remain a live concern. Just weeks ago, a man was tackled by the Secret Service after attempting to scale the White House perimeter fence, underscoring the persistent threats that surround those in and around public life.
Even Mamdani, the progressive New York City mayor whose politics sit at a vast distance from Giuliani's, offered warm words at an unrelated press conference.
"I think former Mayor Giuliani is someone that we, as New Yorkers, know well, and he's been a fixture in our city's politics and public life for so many years, and I know that many New Yorkers are concerned by reports he is in critical condition and so we do keep him and his family in our prayers at this time."
Mamdani added that he was "wishing strength and recovery to former Mayor Rudy Giuliani and his loved ones during this difficult time."
Carter, the veteran WABC radio host and longtime city journalist, offered perhaps the most forceful tribute at the media scrum with Catsimatidis. "History is going to judge him as the greatest mayor of New York City ever," Carter said.
That claim will be debated. What cannot be debated is that Giuliani's actions on September 11, 2001, earned him a place in the national memory that few mayors of any city have ever occupied. He walked through the dust when others ran from it. His spokesman says his lungs have never fully recovered.
The political and legal storms that have surrounded Giuliani in recent years are well known. But none of that changes what happened on that Tuesday morning in Lower Manhattan, or the physical toll it continues to exact. The chaos and confusion of major public emergencies, whether on the streets of New York or during evacuations in Washington, test people in ways that only become clear years later.
Goodman framed the current battle in terms consistent with the rest of Giuliani's public life. "Mayor Giuliani is the ultimate fighter, as he has demonstrated throughout his life, and he is winning this battle," the spokesman said. He noted that Giuliani was with his family and his primary medical provider.
Several details remain unclear. The name of the Florida hospital has not been disclosed. The specific virus that triggered the respiratory crisis has not been identified publicly. How long Giuliani was in a coma before Monday's improvement has not been stated. And whether he remains in critical condition or has been upgraded is unknown based on available statements.
What is known is that an 81-year-old man with documented lung damage from Ground Zero was sick enough to need mechanical ventilation and a priest, and that by Monday afternoon, he was awake, talking, and breathing without a machine.
The people who ran toward the towers that day earned whatever prayers the rest of us can spare. Giuliani was one of them, and he is still paying the bill.
