PHILADELPHIA - Dr. Kermit Gosnell proved a serene but solitary figure in the courtroom during his long murder trial, in contrast to the chaotic life he built as an inner-city doctor, abortion provider and father of six.
Jurors who convicted him this week of killing three babies born alive at his run-down West Philadelphia clinic thought he began his career with good intentions, but then lost his way.
"He started out as a good, practicing doctor. But eventually, it just became a money-generating machine," juror Joseph Carroll said Wednesday, after Gosnell was sentenced to life in prison without parole. "Most of us felt it probably came down to a greed factor."
Gosnell, 72, had been the rare black student from his working-class neighborhood to go to medical school. He became an early proponent of therapeutic abortions in the 1960s and '70s, and returned from a stint in New York City to open up a clinic in the impoverished Mantua neighborhood, near where he had grown up as the only child of a gas station operator and government clerk.
His Women's Medical Center treated the poor, immigrants and teens, offering free basic medical care to elderly people, many of whom were seen in recent years by unlicensed doctor Eileen O'Neill.
But Gosnell made millions performing abortions, charging up to $2,500 or more in cash if women were in their second or third trimester. District Attorney R. Seth Williams said Wednesday that Gosnell put women through labor, then killed their babies, "because it's cheaper to do that."
"We had no evidence that these patients were told that ... after the baby is born, and the baby's alive and squirming and kicking and crying, I'm going to sever its spinal cord."
Former staffers testified that Gosnell once performed mostly first-term procedures, perhaps 20 a night, along with a few later-term procedures. But that ratio reversed itself from 2000 to 2010, as Gosnell increasingly attracted desperate women who were further along.
According to prosecutors, he routinely performed abortions after the 20-week limit in Delaware, where he also worked, and the 24-week limit in Pennsylvania. And he did the late-term surgical procedures in his clinic, while they were more typically done in hospitals.
Gosnell by then was also attracting lawsuits from women who said they were injured during botched abortions at his clinic. One woman said he left fetal remains inside her, another sued over a perforated uterus, and a trial witness said she spent two weeks in a hospital with sepsis after an abortion at age 17 that allegedly took place when she was nearly 30 weeks, or more than seven months, pregnant. Stunned clinic workers took cellphone photos of that baby boy, photos that provided key evidence in the murder charge over "Baby A."
Workers testified that the West Philadelphia clinic deteriorated over the decade they worked there, as Gosnell cut costs by reusing disposable medical equipment that spread venereal disease, and relied on unlicensed doctors and untrained staff to perform skilled medical care. The jury found that contributed to the overdose death of a 41-year-old patient who was sedated repeatedly by medical assistants.
"This is Philadelphia in the year 2013. This isn't some third-world country," Assistant District Attorney Joanne Pescatore said in opening statements in March.
But defense lawyer Jack McMahon countered: "Every time a doctor loses a patient, it isn't murder."
Meanwhile, lines of unsavory patients were lining up to get prescriptions from Gosnell for OxyContin and other frequently abused painkillers. That side of Gosnell's practice led to the 2010 clinic raid, when the FBI stumbled on abortion practices that would come to be termed "a house of horrors" in a 2011 grand jury report.
McMahon blanched at that description, saying prosecutors and the press have "lynched" his client by exaggerating the facts.
"To call him a monster, maybe it's convenient for the press, but that is not accurate," McMahon said Wednesday. "He never intended to kill a live baby."
Gosnell has been married three times, the third time to a cosmetician who grew up in foster care and came to work at the clinic. Pearl Gosnell has pleaded guilty to helping perform third-term abortions but is living at their home near the clinic, with the couple's teenage daughter, Gosnell's youngest child, while awaiting sentencing. Gosnell's adult children include an actor and college professor. No relatives or friends have come to court for him.
"That was intentional," said McMahon, who said Gosnell wanted to spare his children the notoriety of the case. "He talked to them numerous times on the telephone and had their support all the way, but just (not) ... in the courtroom because of the obvious."
The FBI found $250,000 cash stashed in the teenager's bedroom at Gosnell's home, one of several properties he acquired during his 40-year career. He also owned rental properties and a beach house in Brigantine, N.J., the latter of which was sold to pay his legal bills.
"He always led me to believe he was a poor, struggling urban physician and surgeon. I thought he was hurting financially," testified former clinic worker Stephen Massof, an unlicensed doctor who pleaded guilty to two counts of third-degree murder for cutting babies after they were born alive.
With his fate sealed, Gosnell plans to plead guilty to federal drug charges related to his high-volume pain medicine practice, McMahon said. And his client hopes people will someday understand his motives. McMahon has noted that his client didn't pluck women off the street and force them to have abortions.
"He knew that he wanted to air out certain things, and he had a shot at it and he got a good shot at it," McMahon said. "Five of the verdicts were not guilty. That's a victory that is kind of hollow, but nonetheless that's a victory in his mind."