Former USA Gymnastics team doctor Larry Nassar was sentenced to up to 175 years in prison Jan. 24 for sexually abusing more than 150 girls and women. (Reuters)

After seven days of listening to more than 160 girls, women and parents describe the impact of his sexual abuse, disgraced gymnastics physician Larry Nassar turned to the courtroom Wednesday and quietly attempted an apology, saying, “There are no words that can describe the depth and breadth for how sorry I am for what has occurred.”

Then Judge Rosemarie Aquilina read from a letter Nassar wrote last week in which he expressed very different sentiments. In the letter, Nassar complained about the length of his sentencing hearing, maintained that his touching of patients was legitimate medical therapy and termed some of the alleged victims’ accounts “fabricated.” As Aquilina read excerpts, some in the courtroom gasped.

“My treatments worked, and those patients that are now speaking out were the same ones that praised me,” Aquilina said as she read Nassar’s words. “. . . The media convinced them that everything I did was wrong and bad. . . . Hell hath no fury like a woman scorned.”

The judge then addressed Nassar directly.

“It was not treatment what you did; it was not medical,” Aquilina replied. “I wouldn’t send my dogs to you, sir.”

Several victims began testified during the sentencing hearings of Michigan sports doctor Larry Nassar. He has been accused of sexually abusing more than 140 women. (Amber Ferguson,Monica Akhtar/The Washington Post)

Finally, Aquilina delivered her sentence — a minimum of 40 years, a maximum of 175 years in Michigan state prison — effectively guaranteeing a life sentence for the 54-year-old former Michigan State University and USA Gymnastics team physician, who also faces a 60-year sentence for federal child pornography crimes.

“I’ve just signed your death warrant,” she said.

And with that, the judge brought an end to an extraordinary sentencing hearing that introduced fresh national attention and outrage to a case whose core facts have been well established for nearly a year.

Originally expected to take four days and feature 88 statements, the hearing ultimately spanned seven days and including testimony from 156 accusers, as dozens more women — many emboldened by the sight of the cathartic impact the statements appeared to have on others — came forward wishing to confront Nassar. They told of the shattered psyches, the suicide attempts and the torturous guilt that resulted from Nassar’s abuse, which typically involved him, under the guise of pain therapy, slipping his hand under their clothes and penetrating, probing and fondling them.

Wednesday’s sentencing featured the first extended commentary from the prosecutor on the case, Angela Povilaitis, who, before Aquilina issued her decision, read a statement summarizing how Nassar escaped prosecution for so long, foreshadowing potential fallout still to come for the organizations through which he accessed his victims.

Judge Rosemarie Aquilina did not hold back Jan. 24 while sentencing former Team USA doctor Larry Nassar to prison for up to 175 years in prison for sexually abusing more than 150 girls and women. (Monica Akhtar/The Washington Post)

“What does it say about our society when victims do come forward and they are automatically met with skepticism and doubt, treated as liars until proven true?” asked Povilaitis, who then turned to the dozens of Nassar accusers behind her in the courtroom and, her voice breaking with emotion, thanked them for coming forward.

“We have seen the worst of humanity and the best in the last couple of days . . . how one voice can start a movement, how a reckoning can deliver justice,” she said.

Before this month, the Nassar case — which first burst into public view with a September 2016 story in the Indianapolis Star featuring one woman publicly accusing Nassar of assault, which soon resulted in dozens more victims coming forward — had appeared to have largely reached a resolution. Nassar had pleaded guilty and faced lengthy prison terms; USA Gymnastics’ chief executive had resigned over his handling of the case; and Michigan State had made $10 million available to reimburse victims for therapy while asserting the university had not mishandled previous complaints.

But the seven days of wrenching victim impact statements in a Lansing, Mich., courtroom — following the MeToo movement that has swept through the media and entertainment industries — appeared to galvanize national outrage to an extent that hadn’t previously existed regarding the case over the past year.

Last week, Michigan State acquiesced to requests from victims and their attorneys for an independent review of the university’s culpability for Nassar’s crimes. The state attorney general’s office agreed to conduct the inquiry. On Tuesday, the NCAA sent Michigan State a letter, expressing its interest in opening an investigation into how athletics officials responded to concerns about Nassar. On Wednesday night, the school’s president, Lou Anna Simon, submitted a letter of resignation.

Victims have said they complained about Nassar’s conduct to Michigan State athletics officials as far back as 1997, and in 2014, an investigation by the school’s Title IX office cleared Nassar after a woman alleged he assaulted her. The school’s attorneys have insisted Michigan State officials did not mishandle previous complaints and asserted that Nassar’s methods of abuse were particularly insidious and difficult to detect.

On Monday, three top USA Gymnastics board members resigned, and then Tuesday, AT&T became the latest sponsor to drop USA Gymnastics.

On Wednesday, moments after the sentence was announced, the chief executive of the U.S. Olympic Committee announced his organization would launch an independent investigation of what officials in the Olympic community knew about Nassar. Among Nassar’s accusers are Olympians Simone Biles, McKayla Maroney, Gabby Douglas, Aly Raisman, Jordyn Wieber and Jamie Dantzscher, and they have claimed Nassar abused them at the Karolyi Ranch outside Houston and at international competitions around the globes, including the Olympics.

The independent inquiry will “examine how an abuse of this proportion could have gone undetected for so long. We need to know when complaints were brought forward and to who,” including officials at USA Gymnastics officials and those at the USOC, and Blackmun said the organizations will make the results public.

Blackmun wrote he anticipated USA Gymnastics would cooperate with the inquiry, but when contacted Wednesday afternoon, USA Gymnastics spokeswoman Leslie King said this was the first she was hearing of the USOC letter, which also called for the resignations of the rest of USA Gymnastics’ board of directors. Hours later, USA Gymnastics released a statement supporting the USOC’s proposals.

Later on Wednesday, Sen. Jeanne Shaheen (D-N.H.) tweeted that she was “drafting a letter to Senate leadership calling for an immediate investigation into how these horrific abuses were allowed to happen.” Hours later, both senators from Michigan — Debbie Stabenow (D) and Gary Peters (D) — called for the resignation of Simon.

Wednesday’s hearing began with three final victim’s statements, the last coming from Rachael Denhollander, the Louisville woman whose decision in 2016 to file a police report and contact the Indianapolis Star ultimately brought about Nassar’s prosecution.

“He did this with my own mother in the room, carefully and perfectly obstructing her view so she would not know what he was doing . . . It was clear to me this was something Larry did regularly,” said Denhollander, who, as a 15-year-old club gymnast from nearby Kalamazoo, visited Nassar for treatment. “. . . As Larry was abusing me each time, I thought it was fine because I thought I could trust the adults around me.”

Denhollander spent much of her statement addressing officials at Michigan State, detailing allegations made by other women of complaints made about Nassar that went ignored: a 1997 complaint to a Michigan State gymnastics coach, a 2000 complaint to trainers for the softball team, another early 2000s complaint from a volleyball player who said her teammates referred to Nassar as “the crotch doc,” and the 2014 Title IX investigation that concluded the woman didn’t understand the difference between legitimate medical treatment and sexual assault.

In response to these accusations, Michigan State’s attorneys, in statements, have said no one at the university knew Nassar was sexually assaulting his patients until Denhollander came forward in 2016. Denhollander is among more than 140 girls and women suing the school, as well as USA Gymnastics, over Nassar’s abuse.

“The reason that everyone who heard about Larry’s abuse didn’t believe it is because they did not listen,” Denhollander said. “No one knew, according to your definition of ‘know,’ because no one handled the reports of abuse properly.”

After she finished speaking, the judge commended Denhollander as “the bravest person I have ever had in my courtroom.”

After Denhollander spoke, she embraced several fellow Nassar victims in the courtroom, including Kyle Stephens, the first one who spoke, on Jan. 16. Stephens, 26, is the former family friend Nassar abused in his boiler room starting when she was 6, whose parents didn’t believe her when she came forward when she was 12 and who uttered words in her statement to Nassar last week that the prosecutor noted appeared last weekend on posters at Women’s Marches across the country: “Little girls don’t stay little forever. They turn into strong women, who have come back to destroy your world.”

As the women hugged, a line of other Nassar victims formed, waiting to embrace them both and celebrate a moment many of them doubted would happen. Tears started to well in Stephens’s eyes as they separated, and she turned to Denhollander and mouthed two words: “Thank you.”