When hope goes dark, what’s a heaven for?

Italy long ago backed away from Catholicism as its state religion, but the faith remains fundamentally important, even in the practice of medicine. And Italian medical culture can differ so dramatically from that which is standard in Anglo-Saxon nations as to seem a universe apart.

Take my own case. I suffer from two insidious diseases, one of which leads almost invariably to blindness. That disease, glaucoma, is incurable, and once it attaches itself to the eye, it grows like a nefarious wall vine, eventually blotting out the wall itself.

In despair, I recently begged my long-time ophthalmologist, who in the United States would be labeled a health care professional, if he knew of any remedies, any antidotes, all the while knowing none exist. Visually, I am and have been for a longtime a dead man walking.

But he did not refuse to answer or speak sparingly, fearing a lawsuit for negligence, an action now common in the Anglo-Saxon world yet still rare in Italy. Instead, he told me, verbatim: “Go home to your room, turn off the lights, close your eyes, and pray.”

As an American child of secular roots, I could not take the centerpiece of his advice. The darkened room I could manage, but not the prayer.

And yet I have received a goodly amount of such advice over the years, usually in passing, never as orders from a pulpit.

An esteemed teaching oncologist once told me almost off-handedly that I should not allow my maladies to hold me hostage. If the mortal body was an old and battered Fiat, eternal life promised a Rolls-Royce. This of course thanks to a God in whom, despite his ample assembly-line gifts, I do not believe.

No matter.

Nor did my doctor stint of providing me with excellent worldly care. His was merely a bit of reassurance, in the vein of darkened rooms and prayer.

I try to imagine one of my American physicians walking down this road and laugh out loud — though one, an oncologist, was known to hold revival sessions in his den. But this of course he never said aloud.

My eye doctor, he of the prayer advice, behaves in a way not uncommon in Italian medical circles. He diagnoses illness and operates, never mentioning faith, but attends Mass several times a week and always on Sunday. There are no images of Christ in his office, and yet something about the furnishings is austere and deferential, as if a higher power would be unhappy with the ostentatious, such as plaques, diplomas, and award certificates on the wall. Call it inner piety.

With me, he dares to speak as he does because we have become friends and he has many times made house calls, another relic, at least in the urban portion of the non-Latin world. He also visits other patients at home, especially those who have already lost their sight. They were once his active patients, and he feels a moral obligation to stay close because, in his words, he failed them.

But at the very least my doctor suggests a direction, a road, albeit one I do not wish to walk.

But most of these men and women adhere to prayer. That I do not does not so much vex him as sadden him, as he wishes to give me a source of comfort. Having failed medical repair, or better said, having failed to curb a rampant illness, he seeks to open a door to the greatest cure of all, and one that both lasts and transcends all that meager humans can provide. Although I cannot adhere to his faith, I feel its zeal and am at times moved by his credence.

Secular Americans, hearing this, might say, all well and good that your doctor is a Catholic who believes deeply in God, but what does that do for your failing vision? Where is the repair? Where is the cure? Where is tangible medical hope? It is of course nowhere, which is precisely why I was dispatched to a blacked-out room to pray, to me a form of devoted begging.

But at the very least my doctor suggests a direction, a road, albeit one I do not wish to walk. He cares enough to invite me into “his” world, still the world of many in Italy — although Rome, where I live, is often called the most pagan Catholic city on Earth, a place where, not withstanding the Pope and holy balconies, and indeed maybe because of them, many Masses go on almost insultingly semi-deserted.

And yet.

And yet.

One day, in the worst of times, I told the building superintendent where I live that I had run out of hope and that I might one day take my own life.

He was not alarmed but dumbstruck.

“You cannot take your own life,” he said. “It is not yours to take. Only one entity has that right, and until He decides there is no recourse . . .”

But what until then, I ask myself.

A dark room and prayer.