Watch the Moment Judge Tells Larry Nassar 'I Just Signed Your Death Warrant'

A Michigan courtroom erupted into applause as Larry Nassar, former USA Gymnastics and Michigan State University doctor, walked out the door after being sentenced to 175 years in prison by Judge Rosemarie Aquilina on Wednesday afternoon.

Judge Aquilina sentenced Nassar to between 40 to 175 years in prison for counts related to sexual abuse of women and young girls, in addition to the 60 years he is already charged with serving on child pornography charges.

In her statements before sentencing, Aquilina did not hold back her contempt or disgust for Nassar, who she says "doesn't get" the severity of his actions that he pleaded guilty to.

"I just signed your death warrant," Aquilina said.

The Michigan judge read aloud from a letter Nassar had written her last week before his publishing, in which she says it's obvious Nassar was only serving himself.

"'What I did in the state cases was medical, not sexual, but because of the [federal porn conviction] I lost all credibility,'" read Aquilina from the letter.

"So I'm trying to avoid a trial to save the stress to my community, my family. But look what's happening. It's wrong,' " she continued.

Nassar then wrote about his victims in words that were a far cry from a statement he had made moments earlier in court.

"I was a good doctor, because my treatments worked and those patients that are now speaking out were the same ones that praised and came back over and over," Nassar wrote. "The media convinced them that it was wrong and bad."

The crowd gasped as Aquilina then read from the letter: "Hell hath no fury like a woman scorned."

"I was so manipulated by the Attorney General and now Aquilina, and all I wanted was to minimize stress to everyone," Nassar wrote.

After reading the excerpt from the letter, Aquilina told Nassar that his letter proved to her how little guilt he felt for his years of abuse — and that he still saw himself as a legitimate doctor.

"I wouldn't send my dogs to you, sir," she told him.

She asked him why he didn't seek help for his lifelong perversion.

"Sir, you knew you had a problem. That's clear to me. You knew you had a problem from a very young age. You could have taken yourself away from temptation and you did not. Worse yet, there isn't a survivor that didn't come in and say how world-renowned you were," she said.

"You can't give them back their innocence, their youth," said Acquilina of the victims, all of whom she had allowed to receive restitution. "You can't give a father back his life."

Judge Aquilina then took the letter and tossed it towards the defendant, washing her hands of it for good.

"As much as it was my honor and privilege to hear the sister survivors, it is my honor and privilege to sentence you," Aquilina said before issuing her sentencing of 40 to 175 years. "Because, sir, you do not deserve to walk outside of a prison ever again."

She then noted: "If you are ever out, which is doubtful, you'll be required to register as a sex offender."

She also told Nassar that he is required to pay each victim restitution.

"You will pay restitution based on whatever amounts are submitted," Aquilina told Nassar, later adding that his attorneys could ask for a hearing.

Nassar has pleaded guilty to seven counts of criminal sexual conduct in Ingham County, Michigan, and has admitted to sexually assaulting and abusing young girls under the guise of providing medical treatment. He also has pleaded guilty to three charges of criminal sexual conduct in Eaton County, Michigan, and already has been sentenced to 60 years in prison for federal child pornography charges.

On Wednesday, Judge Aquilina heard from a few more victims and then sent Nassar to prison on the seventh day of a remarkable hearing that has given the girls, young women and their parents a chance to confront Nassar in court.

As part of his plea deal, all of the victims who reported assaults to Michigan State Police were allowed to give victim impact statements at the sentencing. Prosecutors said Wednesday that a total of 156 victim impact statements were read or delivered in court.

As victim after victim shared horrific tales of assault and abuse, Aquilina has acted as both judge and therapist, offering empathy, comfort and advice to each individual.

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"I wish my robe came with a magic wand so I can wave it over you and heal you," she said to one victim. "But that's fairy tales."

Aquilina said Nassar will "be in darkness the rest of his life." He faced a minimum prison term of 25 to 40 years on the molestation charges.