On television and in true crime magazines, Dr. Joël Le Scouarnec liked to follow stories of men who resembled him: pedophiles. He saw himself in them, proud to be different. With one exception – he would never get caught. That only happened to others; he felt untouchable. Over the course of his career, no medical staff had ever caught him in the act, no complaint had ever been filed by a young patient or their parents. With chilling efficiency, the surgeon had devised the perfect sex crime.

Ultimately arrested in 2017, just a few months before retirement, Le Scouarnec, now 74, is set to stand trial for the rape or aggravated sexual assault of 299 alleged victims, most of whom he has admitted to abusing. The average age of his victims at the time of their abuse was 11 years old. Yet while the doctor will stand alone in the dock, the failures of French institutions in protecting children are expected to take center stage in the proceedings.

The town of Vannes, Brittany, where his trial started Monday, February 24, is where the vast majority of the crimes are believed to have occurred. Now defunct, the Sacré-Cœur clinic was a small, private facility run by nuns when Le Scouarnec was hired there in 1994. At the time, the healthcare sector was already sinking into crisis, marked by ruthless restructuring and chronic staff shortages. The arrival of a 44-year-old digestive surgeon – formerly an intern at the Nantes hospitals, married with three children – seemed like a blessing.

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