But the conduct of the leaders of the institution he has served his entire life, many of them friends and a few, former bosses, has pushed his forbearance to the limit. "The patience of the people of God is exhausted with the episcopal and clerical culture that puts itself first," he said.

That was the final line he spoke at the end of a Feb. 2 news conference following two days of discussions of the clergy sex abuse crisis organized here by the Leadership Roundtable, a group of lay, religious and clergy founded to promote best management practices within the church. At the meeting were more than 200 people at more than 20 tables of participants, including Cardinals Sean O'Malley of Boston, Joseph Tobin of Newark, New Jersey, and Blase Cupich of Chicago. Joining them were 12 bishops, along with theologians, canon lawyers, abuse survivors, assorted experts from across the country, the papal nuncio and Jesuit Fr. Hans Zollner, the head of the office of child protection at the Vatican. Such a collection of people was perhaps a sign that the patience had run out and that something significant needs to be done. 

During the news conference Carr offered up a self-assessment that gives expression to the feelings of many other Catholics rocked by the revelations of the past year. "I'm different," he said. "You know the talk I gave today I would not have given 18 months ago."

In those 18 months, of course, the jarring news that former Cardinal Theodore McCarrick, a long-time Carr friend whose early support had stamped a kind of imprimatur on the initiative, had not only engaged inappropriately with seminarians, as had been rumored for years, but also had been credibly accused of sexually abusing children.

The news about McCarrick, said Carr in a subsequent interview, "was crushing." That was the same assessment given by Dr. Kimberely Smolik, CEO of the Roundtable, during a Feb. 5 interview about the conference. 

McCarrick, for many in Catholic leadership roles, was the official face of the church that walked seamlessly amid levels of the church, including its loftiest quarters, and amid levels of secular power and influence. He raised enormous sums of money for a variety of Catholic activities, was a Catholic ambassador to the world, an international presence who seemed to be everywhere. He was also someone, as cardinal and former archbishop of Washington, whose endorsement lent unimpeachable credibility to any endeavor.

"The patience of the people of God is exhausted with the episcopal and clerical culture that puts itself first." — John Carr

The question of "why did we get here?" underlies the second crisis. The scandal, said Dubik, "did not arise from nowhere, so let's look deeper into the root causes and then once we understand all of them, start with long term reform: management practices, leadership practices and improved collaboration practices." 

Bishop Shawn McKnight of the Diocese of Jefferson City, Missouri, who has spoken forcefully on the need for reform and a greater role for laity in confronting the abuse crisis, raised the culture specter, saying, "What was repeated over and over again was an awareness of the need for both the cultural mindset conversion as well as specific norms and processes. We need to commit to having a study, foundational research, to understand the root causes of the problem we're in."

Dubik, in answer to a reporter's question, defined cultural change as "merely behavioral change sustained over time." Such behavioral changes as releasing lists of priests and "enablers" and extending the existing charter and its sanctions for priests and bishops will change the culture over time, he said.

During the two-day event at Georgetown, each table included someone designated as scribe who used a computer connected to a central location to record the comments and suggestions from each of the groups. 

Three topic areas were discussed during the proceedings:

• Defining the root causes of the twin crises and the culture change required to address it
• Emerging best practices in bishop accountability and co-responsibility
• Emerging best practices for responding to sexual abuse

The information gathered from the three sessions will form the basis of a list of recommendations that will be distributed, along with three "narrative" documents, to all bishops, leaders of religious communities and the public at large later this month, just ahead of the Feb. 21 meeting in Rome of the heads of episcopal conferences from around the globe.

What remains unknown is what the meeting in Rome will produce and whether attitudes have changed enough within the clerical culture to enact widespread reform. Pope Francis in recent comments attempted to lower expectations of what might result from the Rome gathering.

"It's worth pointing out two things about the Rome meeting," said Carr in the interview. "One, it should have happened a long time ago. And it's a miracle that it's happening. It's never happened before."

Never on the extreme of any of the hot-button issues, Carr self-describes as part of the "middle," his term for the group he also calls "the heart and soul the church." And he and the rest of the middle, he said, have lost their patience. 

It's taken Carr a long time to reach that point. The founder of the Georgetown initiative, he has worked for bishops most of his life as former director of the Department of Justice, Peace and Human Development at the United States Conference of Catholic Bishops and before that as secretary for social concerns for the Archdiocese of Washington. He has spent endless hours lobbying on Capitol Hill for church interests, and he was deep in the trenches at the bishops' conference devising and defending programs that, in the end, aided millions of poor and disenfranchised.

In September, Carr made the first public disclosure of having been sexually harassed and abused as a high school seminarian during a wrenching panel discussion organized by the institute on the subject of the church's self-made "catastrophe." Asked what made him finally disclose that episode, he said: "I want to be clear. I was not raped. I did not experience the horrors described in the Pennsylvania Grand Jury report. I was harassed, I was groomed, I was touched."

His decision to go public was prompted by the conversations he had had with journalists and others throughout the course of the scandal. "I heard myself saying that silence and secrecy were at the core of the problem. And then I realized I had been silent and I had my own secrets."

He prefers to be considered a survivor rather than victim. But most of all, he said, "I am a believer." 

His loss of patience, he said, is partly personal, partly stems from "hearing from priests who feel they are bearing the burden for the failure of their leaders." A third element of the exhaustion is the realization that the voice of the church "which needs to be heard on undocumented people, the unborn, the poor, has been compromised, and that's a terrible cost."

What would he tell a member of that exhausted middle who is ready to leave altogether?

He would say that none of us has done enough to confront the problem. He would put "the Gospel and the sacraments" first in his consideration to stay.

"Secondly, we have a message the world needs more than ever. If people give up and leave, it reduces the chance for renewal and reform. It's going to take all of us, so I encourage people to hang in there for the good of their souls, but also for the good of the church."