Dozens of victims began testifying Jan. 16 at the sentencing hearing of Michigan sports doctor Larry Nassar, who has pleaded guilty to criminal sexual conduct. (Reuters)

The courtroom door swung open just after 9 a.m. and in shuffled the man who, before September 2016, was known throughout the region as the Michigan State University sports physician who also treated America’s best gymnasts, the personable father of three who happily chatted with mothers about his Catholic faith and Olympic travels while he performed unusual treatments he warned their daughters might find a bit uncomfortable at first.

Gaunt and haggard, he wore a dark blue jumpsuit, orange slippers and thin-framed glasses he periodically removed throughout the week, as dozens of young women stepped up to a microphone a few feet away and confronted him with accounts of what he did to them behind closed doors — at Michigan State, at local gymnastics centers, and in his home — and how irrevocably it changed their lives.

Nearly a year and a half after one woman filed a police report and contacted a newspaper, the criminal cases against Larry Nassar are nearing an end this week with a marathon sentencing hearing — 105 of the more than 130 girls and women who’ve accused Nassar of abuse are expected to speak — that began Tuesday and will likely stretch into next week, before a judge levies a sentence for seven sex crimes Nassar has admitted to as part of a plea deal.

The specifics of the pending sentence have caused little anxiety in the courtroom: With the 54-year-old already facing a 60-year federal term for child pornography crimes and a 25-year minimum as part of this plea deal, the judge has said she expects Nassar to spend the rest of his life in prison.

Rather than the sentence, the focus of this sentencing hearing has been the victims, many speaking publicly for the first time. Their accounts have been harrowing and heart-rending, but also, at times, victorious and cathartic. They have described the devastating toll Nassar’s crimes have taken, not just on those he abused, but also on parents and coaches wracked by guilt, or possessed with rage, about warning signs missed and complaints ignored.

Four-time Olympic gold medalist Simone Biles has accused her former USA team physician, Larry Nassar, of sexually abusing her. (Reuters)

A projector screen has displayed photographs of victims taken at the time of their abuse, an array of girls in gymnastics leotards and school class portraits. The first photos projected Tuesday were of a smiling brown-haired girl named Kyle Stephens — in one she was about 5 or 6, in the other she’s a few years older, with braces — who is now 26. A former family friend of Nassar’s, Stephens had been known in court filings before this week as “Victim ZA.”

Stephens’s family often spent Sundays with the Nassars, the mothers cooking dinner while Nassar played with the children. Stephens was 6 the first time a game of hide-and-seek took a detour into the boiler room, she said, and 12 when she decided to tell her parents what Nassar was doing to her.

Standing a few feet behind her, Stephens’s mother wept Tuesday as her daughter explained what happened next: Nassar said their daughter was lying, and the parents believed him. They made Stephens apologize. As a teenager, she said, she began to detach from her parents, often telling people she had no family.

“Larry Nassar wedged himself between myself and my family, and used his leverage as a family friend to pry us apart until we fractured,” she said.

Her father committed suicide in 2016, Stephens believes, in part because of the realization his daughter had been telling the truth.

“I’ve been coming for you for a long time,” Stephens told Nassar. “Perhaps you have figured it out by now, but little girls don’t stay little forever. They turn into strong women, who have come back to destroy your world.”

Larry Nassar wipes his eye as he listens to Carrie Hogan deliver a victim impact statement at his sentencing hearing Wednesday. (Scott Olson/Getty Images)

A few minutes later, a photo of a beaming girl in a leotard appeared on the screen, as her mother, Donna Markham, stepped to the microphone. Her daughter, Chelsea, was 10 years old in 1995 when they visited Nassar. After one of the visits, Donna said, her daughter burst into tears.

“She said, ‘Mom, he put his fingers in me, and they weren’t gloved,’ ” Markham said. Her daughter begged her not to tell anyone, out of fear it would impact her gymnastics career.

“She said that everyone will know, and everyone will judge me, and the judges will know as I compete,” Markham said.

Her daughter soon quit gymnastics, Markham said, and her life spiraled into bouts with drug problems and depression. The image on the projector screen changed to one of Chelsea in her 20s, in a black winter coat, smiling, not long before she committed suicide in 2009, at 23.

“Every day, I miss her,” Markham said. “And it all started with him.”

Decades of abuse

Over the first three days, 68 victims’ statements were heard, describing abuse dating from the early 1990s to 2016. Among the victims were two sisters — one assaulted at 9, the other shortly after she graduated from Michigan State — whose parents sat in the courtroom Tuesday, glowering at Nassar as their younger daughter confronted him, and then returned Wednesday when it was the other daughter’s turn.

Their accounts aligned around common methods first described in a September 2016 story in the Indianapolis Star that resulted in Nassar’s firing from Michigan State, and realizations by dozens of other women that what they had accepted years before as medical treatment was actually sexual assault.

It often happened at Michigan State’s campus clinic, where Nassar’s office was decorated floor-to-ceiling with signed pictures of Olympic stars, acquired from his lengthy career as a volunteer physician for USA Gymnastics. One woman described Nassar’s office as “a shrine of his conquests,” and this week Simone Biles added her name to the list of Olympic gymnasts who accused Nassar of assault, joining Aly Raisman and McKayla Maroney. The photos dazzled the girls, and often impressed the mothers, helping quell doubts about Nassar’s treatment.

Victims described ripple effects of abuse that have played out over years. Many have suffered through depression, post-traumatic stress anxiety disorder and panic attacks. Several have considered suicide. One cut herself, she explained, “because I wanted my outside to look as ugly as I felt inside.”

While many didn’t realize until 2016 they’d been abused, some said they always knew, in anecdotes well-known by other victims, and their lawyers who are pressing cases against Michigan State and USA Gymnastics.

In 1999, Nassar treated former Michigan State softball player Tiffany Thomas Lopez for the first time. She claims she later complained to multiple trainers about how he touched her, but no one contacted authorities.

“Every few years I wondered if there was another Tiffany Thomas,” she said.

In 2004, Brianne Randall, then 17, said she reported Nassar to a local police force whose investigators believed the doctor when he said it was a misunderstanding.

“For 13 years, I wondered if I was the only one,” Randall said.

And in 2014, recent Michigan State graduate Amanda Thomashow filed a complaint against Nassar with the school’s Title IX office and university police. The Title IX investigation cleared Nassar, and the police inquiry languished.

“Michigan State University, the school I loved and trusted, had the audacity to tell me I didn’t understand the difference between sexual assault and a medical procedure,” she said.

Michigan State has insisted it handled the 2014 complaint properly, and — after mediation negotiations involving victims’ lawyers failed to produce a resolution December — is contesting lawsuits filed by more than 130 victims.

Parents’ burden

Among the most anguished testimony this week have been the accounts of parents, many who sat in the room as Nassar abused their children, unaware of what he was doing.

The mother of one 12-year-old victim described feeling uneasy when she noticed Nassar wasn’t wearing gloves.

“I questioned you about that, to which you answered in a way that made me feel stupid for asking,” the mother said. “I told myself, ‘He’s an Olympic doctor, be quiet.’ ”

She then noticed Nassar had her daughter “in some positions that made me uneasy,” she said. Another question prompted another condescending answer from Nassar, who repositioned himself between the mother and her daughter, and continued the treatment.

“The guilt that I feel, and that my husband feels that we could not protect our child is crippling,” the mother said.

As he did through much of the hearings, Nassar looked down at a notepad, his face in a drooping, hangdog expression that left victims wondering if he was feeling genuine remorse, or trying to appear so.

“I think he is remorseful for what is happening to him,” said Stephens, the family friend Nassar abused. “I don’t think he feels any remorse for us.”

On Thursday, Judge Rosemarie Aquilina read aloud portions of a letter Nassar sent her, asserting the lengthy sentencing hearing was a “media circus,” too harsh for him to handle, mentally.

“You may find it harsh that you are here listening, but nothing is as harsh as what your victims endured for thousands of hours at your hands,” the judge told Nassar.

One victim appeared to leave Nassar deeply affected for a few minutes. Jennifer Rood-Bedford was a Michigan State volleyball player from the early 2000s whose testimony produced one of the few moments of levity this week — she said she had made a plan to kick Nassar in the face if he ever tried to touch her improperly again — before she began to cry as she described her assault.

Rood-Bedford told Nassar she forgave him, citing her Christian faith, and her belief in the possibility of redemption.

“Dr. Nassar, I want you to know that I pray for you. . . . Please know my forgiveness towards you is sincere,” Rood-Bedford said. “There is hope that transcends all understanding. . . . You can choose to be a better man, and to be a different person. . . . Seek Him and find that.”

As she spoke, Nassar’s eyes squinted, and his head began to shake, as if sobbing. He removed his glasses, picked up a tissue, and dabbed at his eyes, but the tears never came.