When Cardinal Bernard Law flew from Boston to the Vatican at the weekend, he left an archdiocese that had not only just revealed more cases of sexual abuse by priests, but is also threatening to declare bankruptcy.
His time at the Holy See will be no less troubling. The cardinal's "consultations" with Vatican officials will cover how to settle litigation by victims - as well as the possibility of his resignation over his failure to act more forcefully against guilty priests.
Boston may just be the most egregious case of a growing international crisis for the Catholic Church, with cases of paedophile priests and allegations of official cover-ups raging from London to Sydney, via Dublin and Hong Kong.
No one is predicting an early resolution to a crisis that is sapping the Church's moral and financial resources. In the US, civil suits by victims are estimated to total $1bn (£635m), and in the past year more than 300 of the nation's 46,000 priests have resigned or been removed because of sex-abuse claims.
Tensions between liberals and orthodox Catholics have been revived, with no common agreement as to the cause of the crisis or its solution.
Conservative Catholics led by senior Vatican prelates argue that the issue of clerical child abuse has been stirred up by the media, and that it is only of concern in English-speaking countries.
But child sexual abuse involving members of the clergy has been reported in at least 20 countries, just eight of which are English-speaking. In traditionally Catholic Spain, the leading newspaper El Pais last March denounced the local media's near-silence on sex offences against children, especially where the cases involved officials or church members.
Nevertheless, it is in the US and the UK where a sense of crisis over the issue has become a subject of public debate, leading the international Catholic weekly The Tablet to editorialise in its current issue: "The Catholic Church . . . cannot make any excuses. It has to come out with its hands up, as it were, and show transparency in its response to criticisms."
In the UK, the Cardinal Archbishop of Westminster Cormac Murphy O'Connor rejected calls for his resignation and instead asked in a BBC TV interview to be given the chance to focus on a child protection programme recommended by an independent committee he had set up.
But questions about his future remain, with police studying allegations about his failure to act against paedophile priests in the 1980s and 1990s, and victims planning compensation claims.
A parish priest in the UK who asked to remain anonymous said: "Week in and week out we hear of paedophile priests, internet porn, mishandling by bishops in the UK, the US, Australia, Ireland. It does no help that paedophilia occurs in ordinary homes, in child care homes, among other professions too. The Catholic Church is our community. We feel ashamed and vulnerable."
A growing number of lay Catholics are in revolt, arguing that the abuse scandals are the product of a secretive hierarchical organisation that prefers to cover up its misdemeanours than engage in a true spirit of faith with the victims.
In the US, the gap between Rome and Catholic lay people seems to be widening, and the repercussions for the institution could be profound. Al-though no measures have been made public, many priests complain of lower church attendance and empty offering plates. And seminaries, suffering from a shortage of future priests, face closure.
About 400 Catholics and priest abuse victims protested outside Cardinal Law's church in Boston over the weekend. The Voice of the Faithful, an influential Catholic lay organisation, drafted a resolution calling for his resignation.
A national review board set up by US bishops in June to monitor charges of sexual abuse by priests has been flooded by claims that bishops have failed to submit abuse records. Fresh law suits could follow. Last week, Californian bishops warned priests to brace for an onslaught of sexual abuse lawsuits.
The Vatican is reportedly confused by all the fuss, convinced the sexual abuse charges were a result of American liberalism in the 1960s and hinting darkly that what is needed is a clamp down on homosexuality in seminaries.
Yet last week's revelations in Boston renewed outrage over the church's tolerance for sexual abusers. Perhaps most shocking, documents revealed that abusers continued to head parishes even after the scandals broke this year.
One bizarre story told of a priest who repeatedly sexually assaulted trainee nuns in the belief that he was the "second coming of Christ". Another priest traded cocaine for sex.
The scandal first broke early this year in Boston, where it was revealed that the church had shuffled known abusers between parishes. Soon lawsuits were being filed.
The crisis led to US bishops drafting a zero-tolerance sexual abuse policy for priests. In November, the policy was toned down by the Vatican, which rejected a measure that would have censured bishops who protected abusive priests.
Many Americans point the finger at the Vatican for being out of touch with what happens in the church. "They don't have a clue what's going on," says David Clohessy, executive director of the US Survivors' Network for Abused Priests. If that is the case, Cardinal Law's meetings at the Vatican may come as a rather unpleasant revelation.