The “shocking and abhorrent” accounts of 21 women sexually assaulted by once-popular anesthesiologist Dr. George Doodnaught while semi-conscious on the operating room table each have the “ring of truth,” a judge ruled Tuesday.

Together they are more than enough to find him guilty beyond a reasonable doubt on 21 counts of sexual assault on 21 women aged 25 to 75, Ontario Superior Court Justice David McCombs ruled. McCombs had asked the packed courtroom to refrain from emotional displays when the verdict was read, but as he declared Doodnaught guilty, one man whispered “yes.”

Several women broke into tears.

“I am elated. I finally believe in the justice system,” said the woman whose complaint that Doodnaught fondled her breasts and forced her to perform oral sex while undergoing a hysterectomy in February 2010 sparked the investigation.

“I’m so proud of (the other victims who came forward),” said the woman, whose name is protected under a publication ban. “I am so happy that we got the job done,” she said, following an emotional meeting with the other victims and the Crown attorneys. “We got him.”

She added, however, “it’s not over until he’s taken away in handcuffs.”

All but one of the assaults took place at North York General Hospital, where Doodnaught worked for 26 years.

While Doodnaught has his medical licence under heavy restrictions, he has not practised medicine since being charged and will not practise for the foreseeable future, said Doodnaught’s lawyer, Brian Greenspan.

Greenspan said his client was disappointed by the verdict, adding the decision will be carefully reviewed.

“The evidence supporting guilt is overwhelming,” McCombs wrote in his 85-page judgment, which reviewed evidence from 98 witnesses over the 76 days of what he called a “long, hard, emotional” trial.

Between 2006 and 2010, McCombs found, Doodnaught took advantage of his position in the operating room, concealed behind a sterile screen that separates patients’ upper and lower bodies.

Hidden from the doctors and nurses, Doodnaught fondled the breasts of sedated female patients, kissed their mouths and forced them to perform oral sex and masturbation, McCombs found.

Much of the case hinged on whether the women’s accounts of sexual assault were hallucinations caused by the cocktail of anesthetics administered by Doodnaught to achieve “conscious sedation,” described as a twilight state hovering between consciousness and unconsciousness.

McCombs found that despite their “conscious sedation” the women were “conscious and aware during significant parts of their surgeries and were able to recall these shocking and abhorrent events.”

He gave “considerable weight” to evidence from a Crown expert who testified that sexual hallucinations in patients is virtually unheard of.

McCombs also found that the amnesiac effect of the drugs is reduced when “shocking and intrusive” events happen.

“The accused was one of roughly 25 anesthetists working at NYGH dealing with patients under conscious sedation using similar drugs in similar doses. Yet all of the complaints of sexual assault are directed at him,” McCombs wrote, noting that such a coincidence is nigh impossible.

He also rejected the defence suggestion that it was physically impossible for Doodnaught to position himself to assault the women without detection.

Doodnaught was familiar with surgical routines and had the opportunity to sexually assault the women in his care, McCombs found.

Patients had made three formal sexual assault complaints to North York General Hospital about Doodnaught before the 2010 complaint that sparked the criminal investigation, wrote McCombs.

The hospital’s chief of anesthesiology was aware of the complaints but the senior hospital administration only learned of them after the 2010 complaint was made.

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On Tuesday, Tim Rutledge, president and CEO of North York General Hospital, offered an apology to the patients assaulted and their families.

“We have repeatedly asked ourselves how this could have happened . . . That he did this in the operating room, a place of ultimate trust . . . is frankly shocking,” he said.

Serious complaints against hospital staff, such as sexual assault, are now being directly reported to him.

He says the hospital has also introduced software to document patient feedback, and connect similar incidents.

The hospital settled lawsuits with 26 women alleging sexual assault by Doodnaught in early 2011.

Doodnaught will no longer work at the hospital and, following his sentencing, faces a disciplinary hearing with the Ontario College of Physicians and Surgeons.

The hearing may rely on findings made during the criminal proceeding, said Kathryn Clarke, spokeswoman for the College.

It could result in the loss of his licence.

“I would certainly hope that’s the case,” said Crown Attorney David Wright.

This case is unprecedented in Canada and possibly North America and Europe, said Wright.

He is not aware of another case where anesthetic drug-induced sexual dreams have been used as a defence, he said.

The maximum sentence for one count of sexual assault is 10 years, but Wright could not say whether sentences on multiple counts could be served concurrently or consecutively.

What he could say was this: “Justice has been served. Twenty-one times.”