As more women testified, even more came forward.
More than 150 sexual assault survivors described feeling confusion and shame after having been sexually assaulted by a Michigan State University and Olympic sports doctor, who was under suspicion for more than 20 years.
The survivors, calling themselves a "sisterhood" and "army of survivors," lined up in a Lansing, Michigan, court during the past several days to recount the details of how physician Larry Nassar had sexually violated them under the guise of "treatment" for back, hip and other problems.
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"As I look at you today, I feel nauseous," said a distraught Kaylee Lorincz, who said Nassar first treated her when she was 11. "I was confused and afraid of what you were doing to me. You assaulted me again and again. I never felt so dirty."
The youngest victim was 6 at the time of her assault, testimony revealed. Some are college students now. Others are married with children. One victim committed suicide. So did another victim's father, overcome with guilt and grief, the victim testified.
Most of the 168 who gave victim impact statements testified that based on Nassar's sterling reputation as a sports medicine doctor, they were thrilled to be seen by him. Initial visits, they said, were warm and friendly, saying Nassar was charming and trustworthy.
"We went from being his friends ... his athletes," said Amanda McGeachie of British Columbia, Canada, who served on the varsity rowing team at Michigan State University until 2011, "to being his victims." Nassar told her, after assaulting her when she was a teenager, that she would never have children because her pelvis was too small to deliver them, she said.
Why no penalty?
Many of the women who testified said that as children and teenagers, they were confused as to how a powerful and well-liked doctor could assault them, their friends and teammates, and not suffer exposure or penalty.
"We were told we were all wrong," testified Rachael Denhollander, who tasked Michigan State, USA Gymnastics and other officials who received reports of abuse from victims with explaining why they collaborated in a network of protection and suppression.
Denhollander is credited with bringing the case to light after telling her story to The Indianapolis Star, which conducted an investigation into victims' allegations. Denhollander testified that she was harassed and ridiculed for coming forward and naming the popular physician as an abuser.
"This is the way to handle cases of sexual assault at MSU?" Denhollander asked.
"I feel ashamed to have represented a school that will not take responsibility," McGeachie said.
Critics are looking to President Lou Anna Simon for answers about why the doctor was allowed to treat young female patients alone or out of eyesight amid years of suspicions. Several state legislators have called for her dismissal.
Many of the victims accused the university of mishandling past complaints about Nassar, who worked at Michigan State as a doctor. Some of his victims were athletes at the school.
Hours after Nassar was sentenced Wednesday, Simon submitted her resignation, apologizing to Nassar’s victims in the first paragraph of her resignation letter.
Michigan State officials have denied accusations the school covered up misconduct by school administrators. The university says reviews by campus police, the FBI and the U.S. attorney's office have not resulted in criminal charges against anyone at the university other than Nassar, who was fired in September 2016.
Tuesday, the National Collegiate Athletic Association sent a letter to MSU saying it would be looking into the issue, according to The New York Times.
MSU Athletic Director Mark Hollis responded Wednesday, "Since my first day on the job as athletic director, my focus has always been on student-athletes. ... Our first priority has always been and will always be their health and safety."
Prosecutor says system failed
Several other coaches and officials have been named as participating in what victims said was a cover-up of the popular physician's behavior. Angela Povilaitis, a Michigan assistant attorney general, said investigative journalism succeeded where law enforcement had failed.
"Without that first Indianapolis Star story in 2016, [Nassar] would still be practicing medicine, treating athletes and abusing kids. ... He'd be at his office ... not far from this courtroom on the campus of Michigan State University, abusing athletes."
She called on "police and prosecutors [to] take on hard cases regardless of who the offender is, or his position in the community. They cannot victim-blame, and wait until they have dozens of victims come forward."
Nassar also was named by Olympic gymnasts and medalists McKayla Maroney and Aly Raisman as having sexually abused them when he was USA Gymnastics' team physician.
Most of the women who testified thanked Judge Rosemarie Aquilina. Victims said their healing was hastened by Aquilina's affording them a platform to speak about the abuse. She allowed their testimony to be entered into the record over seven days, some of which was graphic and gut-wrenching.
Aquilina also read from a letter to the court penned by Nassar, who wept during parts of victim testimony. In his letter, he accused the victims of "seeking media attention" and money and called their testimony "fabricated."
"What I did was medical, not sexual," Nassar wrote. "I was a good doctor."
Nassar, who in November pleaded guilty to 10 counts of first-degree sexual assault, was sentenced to up to 175 years in prison. He was already serving a 60-year term for child pornography convictions.
Lorincz, who at first was in tears when she took to the microphone, ended her testimony forcefully.
"Ultimately, Larry, you made a critical mistake," she said, looking at Nassar. "You underestimated the mind, power, and will of your victims."
The Associated Press contributed to this report.