Dr. Joël Le Scouarnec was a veteran surgeon when the police burst into his home in 2017 searching for evidence after a girl who lived next door accused him of exposing himself to her.
What they discovered in his home, in a small town in western France, went well beyond anything to do with the girl’s case. Rooms were cluttered with boxes packed with sex toys and more than 20 dolls. One doll, the height of a 3-foot-3 child, was dressed in a white nightgown and laid out on a couch.
They also found computers and more than two dozen hard drives — some stuffed under his mattress — filled with child sexual abuse imagery.
Dr. Le Scouarnec, now 74, was eventually convicted of raping the child for penetrating her body with his finger, which reflects the definition of rape in France, and for raping and sexually assaulting three other women when they were girls, including two of his nieces. He was sentenced to 15 years in prison.
But that was only the beginning of the story. Months into the investigation, a police officer methodically going through the hard drives discovered hundreds of pages of the doctor’s personal diaries as well as two spreadsheets. His diaries elaborately detailed the sexual abuse of individual children and the spreadsheets listed many of their names, ages, addresses and synopses of the abuse they suffered, according to the investigative judge’s summary of the case.
Starting on Monday, based on that discovery, Dr. Le Scouarnec will be tried on charges of raping and sexually assaulting 299 people over 25 years — almost all his patients, almost all children at the time of the suspected abuse. The rape charges are mostly related to penetration with fingers. He has denied some charges of rape, but admitted to touching some patients’ genitals during medical examinations, while some were under anesthesia, according to an overview of the case by the investigating judge.
The trial, which will take place in the coastal town of Vannes, in Brittany, is considered the biggest pedophilia case in French history.
To make space for all the people listed as victims and their families, 65 lawyers, more than 460 accredited journalists and the public, the courthouse has requisitioned two rooms in a nearby law school building, along with a 450-seat lecture hall. A psychologist and five support dogs will be on hand.
Opening just two months after the verdicts in the widely publicized case of Gisèle Pelicot — in which dozens of men, including her husband, were convicted of raping her — this trial is expected to provoke more soul-searching about the extent of sex crimes in France.
And although the country’s medical system is not officially on trial, the perceived failures of health authorities in this case is sure to be a secondary theme. Dr. Le Scouarnec had been convicted of possession of child sexual abuse imagery in 2005 — years before the raid at his home. Yet he was allowed to continue to treat children unsupervised until his arrest in 2017.
In the end, he was stopped only because his neighbors reported their daughter’s accusations and then the single police officer searched back through the more than 300,000 files found on his electronics and discovered the voluminous diaries and the spreadsheets.
The French journalist Hugo Lemonier called that sleuthing a “miracle.”
“If the case had been handled with the same laxity as many other pedo-criminal cases in France, we would never have discovered anything,” said Mr. Lemonier, who investigated the case for three years and recently published a book about it called “Trapped.”
The prosecutor in the case, Stéphane Kellenberger, said that Dr. Le Scouarnec faced a maximum of 20 years in prison if convicted. (There are no consecutive sentences in France.) It is unclear if he would serve that on top of the 15 years he is currently serving.
The children listed as victims in the case were spread around the west of France, following Dr. Le Scouarnec’s career as he moved from central Indre-et-Loire to Brittany and finally south to Charente-Maritime, working in nine private clinics and public hospitals, according to the investigating judge’s overview. The average age of the patients he is accused of assaulting was 11. Most were experiencing appendicitis.
As most of those patients were drowsy, having come out of surgery or treatment, or simply exhausted and in pain, few had any memory of the abuse, Mr. Kellenberger has said. They found out only decades later of the suspected abuse, when contacted by the police after the discovery of their names on the doctor’s spreadsheets or diaries.
A number attempted suicide after learning of the suspected abuse, according to lawyers in the case. Others have since gone through divorces, and faced emotional and mental breakdowns.
Francesca Satta, a lawyer for 10 of the patients, said that two of them had killed themselves after hearing from the police. But she said she believed that for most of her clients, learning about the allegations and being recognized as victims would help them heal.
“I am one of those lawyers who believes that people should speak out in order to free themselves from the grip of their tormentor,” she said.
Many of the doctor’s former patients said the revelations from the police explained years of sexual dysfunction, depression and anorexia. Some who remembered feeling violated said that they felt confused and incapable of raising concerns because Dr. Le Scouarnec was a doctor conducting medical procedures, according to the investigating judge’s summary.
Céline Mahuteau was 7 when she was rushed to the Loches hospital with acute appendicitis. She has just snippets of memory from that time, but she said that she changed soon after, cutting her hair short and swapping her dresses for pants, which she now believes was because she was abused.
As an adult, she had been unable to be physically intimate with her husband for many years.
“Now I have a reason for these problems,” Ms. Mahuteau, a security guard for the French marines who agreed to be identified, said in an interview. “I am a victim in this story,” she said. “I am not ashamed.”
Now 41, she said she had not read the passages Dr. Le Scouarnec wrote about her, fearing they would prove too damaging.
The hundreds of pages of Dr. Le Scouarnec’s intimate writings, often drafted as disturbing love letters mixing fantasy and abuse, offer evidence, rare in cases of child abuse. But they also trap victims in Dr. Le Scouarnec’s web, said Marie Grimaud, a lawyer representing 20 former patients and 17 of their parents.
“It’s like putting someone unprepared into the worst horror movie you could possibly make and the main actor in that film is them,” said Ms. Grimaud, adding that many of her clients felt unsupported by the judicial system to deal with the ensuing trauma. She worked with psychologists and psychiatrists to help her clients deal with the trauma, she said.
Many of the doctor’s former patients and children’s rights lawyers are critical of the way the medical and justice systems dealt with the case.
Frédéric Benoist, a lawyer at Voice of the Child, a nonprofit association advocating for children’s rights, is one.
When the police were alerted by the F.B.I. in 2004 that Dr. Le Scouarnec was among thousands of people found to be gaining access to websites where child sexual abuse imagery was featured, they asked him to come to the station instead of showing up to his house for a surprise search. That gave him precious time to hide evidence, Mr. Benoist said.
“If they had arrived at 6 a.m., they would have found everything. We wouldn’t be talking today. It all would have been stopped then in 2004, and there would be no more victims,” he said. More than 50 of the 299 patients were abused in the ensuing years, according to the judge’s summary.
Then, after his 2005 conviction in connection with the websites — for which he received a suspended sentence — the court failed to notify Dr. Le Scouarnec’s medical clinic, despite a law requiring it to do so.
Once the medical system was finally alerted a year later, after the intervention of a whistle-blower, the regional oversight body of doctors voted overwhelmingly that Dr. Le Scouarnec’s actions did not violate the medical code of ethics.
“Not only did they not sanction him, they did nothing,” Mr. Benoist said. “There were no preventive measures.”
The national oversight body of doctors said in a recent statement that it had “undertaken a number of reforms to reinforce vigilance and coordination with the judicial authorities.”
“Such acts should never have happened, must never happen again,” it added.
When Dr. Le Scouarnec was hired for his final posting at a hospital in the town of Jonzac in 2008, the hospital director knew of his conviction but decided no precautions were necessary since “there had been no physical aggression,” she told the police, according to the investigative judge’s overview.
Mr. Lemonier, the journalist whose book closely examines the case, said that he hoped the trial would force French society to address its “collective blindness” to the all-powerful position of respect it offers doctors.
“We can’t imagine a predator could hide beneath a white coat,” he said. He added that if the trial was treated simply as an extraordinary case of suspected mass pedophilia and not a reflection of more systemic failures, “then we will miss the point.”