After seven days of courage, emotion and heartbreaking accounts of survivors, former USA Gymnastics doctor Larry Nassar was sentenced to 40-175 years in prison.

The sentence was handed down by Ingham County Circuit Court Judge Rosemarie Aquilina in dramatic, heartfelt and necessarily cruel fashion. Aquilina said it was her “honor and privilege” to sentence Nassar, and told him, “You do not deserve to walk outside of a prison ever again”:

She then read off the sentence, and concluded by telling Nassar, “I just signed your death warrant”:

Aquilina had essentially made it her mission to ensure Nassar, who also worked at Michigan State, heard from so many of his accusers. She was supportive of those accusers throughout the hearing, encouraging them and attempting to give them strength.

“It is so important what you’ve done,” Aquilina told one, 16-year-old Chelsea Zerfas, on Monday. “I am so very proud of you. This doesn’t define you. This strengthens you. Congratulations, ma’am.”

She made sure to let them all know they were being heard. She told them they were strong. She told them they were “amazing.”

And then she told Nassar, right to his face, that she was effectively ending his life.