Warning: This article contains references to suicide, sexual assault and other details that readers may find disturbing.

Joel Le Scouarnec is not the name on everyone's lips in the western French seaside town of Vannes, where this week the former surgeon was sentenced to 20 years in prison for raping and sexually abusing nearly 300 of his patients — most of them children — over more than three decades.

His face was not on the front page of the local newspaper the morning after his conviction, and, as the weather oscillated between gray rainy skies and bright May sunshine, people mulling around the boat festival at Vannes harbor — a 10-minute walk from the courtroom — preferred not to talk about one of France's most prolific abusers.

"It's the shame of the Brittany region," said 83-year-old pensioner Joelle Leboru. "He started everything here."

"How could he get away with it for so long?"

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That's the question that's been keeping people in Vannes up at night. Under the authorities' noses, dressed in a white medical coat of respectability and in the heart of middle-class society, Le Scouarnec sexually abused hundreds of children. The crimes in the latest case against him spanned from 1989 to 2014 and were committed in a dozen hospitals in western France.

Le Scouarnec often violated victims while they were under anesthesia or waking up from surgery. He wrote graphic descriptions of hundreds of these instances of rape or sexual assault against children — and animals — in his journals, which police discovered when they raided his apartment in 2017 after he was accused of sexual abuse against a child who lived next door.

"I'm a major pervert. I'm at once an exhibitionist, voyeur, sadist, masochist. I'm scatological, a fetishist, a pedophile. And I'm very happy about it," he wrote in one 2004 entry quoted in Le Monde. Police also found a collection of dolls, some the size of a baby, some the size of toddlers, around the apartment — according to the French newspaper.

The 2017 knock on Le Scouarnec's door came over a decade after his first brush with the law. The surgeon........

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