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Respiratory therapist Wayne Albert Bleyle was in New York state on a wintry day when investigators called him about allegations he had molested patients too sick to defend themselves.

When they asked how many children he molested, investigators said, he looked out his window and asked, "How many snowflakes are there out there?"

On Wednesday, Bleyle didn't turn to look as a succession of parents and family members of victims spoke at his sentencing hearing. Some wept; others shook with anger.

As part of a plea deal, Bleyle, 56, was sentenced to 45 years and eight months in prison for molesting five of his young, disabled patients and for taking pornographic photographs of others. Prosecutors said he targeted those who were comatose, brain-damaged or too disabled to talk.

"You have violated the trust of your patients, you have violated the trust of your employer, and you have inflicted indescribable anguish on your victims and their families," Superior Court Judge Kenneth K. So told Bleyle.

Bleyle, who told investigators he molested as many as half the children he treated in his 10 years working in the convalescent ward at Rady Children's Hospital in San Diego, stared straight ahead or cast his eyes down at the table in front of him as victims' relatives spoke.

"I just want you to know it doesn't matter what you say or how many years you spend in jail — it's not going to be enough," Lillian Godfrey, whose daughter is now dead, told Bleyle. "I don't think you have a soul. You're just an empty human shell."

Prosecutors said the extent of Bleyle's molestation will never be known because he targeted patients who were comatose, brain-damaged or too disabled to speak.

He was arrested last year after investigators tracing pornography through the Internet found tens of thousands of pornographic images on his computer, including photographs he took of himself abusing his patients.

He allegedly confessed to investigators in March 2006 when they reached him by phone in New York state, where he was visiting relatives. When he was arrested, he was living in a trailer in a casino parking lot because his wife had kicked him out of the house.

Bleyle worked at the renowned Rady hospital for 25 years, the last 10 at the convalescent home, where the most disabled patients live. The 59-bed convalescent hospital treated 176 patients during Bleyle's 10 years working there.

"He wishes to apologize to all the victims and their families," said his attorney, Casey Donovan, who noted that Bleyle himself had been sexually abused as a boy. "He knows he can never make amends for what he has done."

Investigators identified just four of Bleyle's victims: three girls and a boy who were all younger than 14 when the molestations took place. Two of the children have since died. Investigators were never able to put a name to one of the victims, a 2-year-old girl found in pictures.

Janice Frost, whose 10-year-old daughter died in June 2006, three months after investigators discovered her image on Bleyle's home computer, called it a "parent's worst nightmare."

Frost said her daughter was under Bleyle's care from the time she entered the long-term facility as a 10-day-old newborn suffering a brain condition.

"During her dying moments, I told her I would see this through," Frost said outside the courtroom, as she clutched one of her three older daughters.

Bleyle faced up to 165 years if he had been convicted on all counts in a jury trial. Prosecutors said they made a deal in part because they were anxious to spare one of Bleyle's victims, a teenage girl who claimed Bleyle inappropriately touched her buttocks while she recovered from a stroke, the strain of testifying before a jury.

Bleyle's arrest prompted the hospital to ban cell phones in patient treatment areas, including rooms, and require doors and curtains around patients be left open most of the time, said hospital spokesman Ben Metcalf.

In court, Pandora Johnson said she had asked her son, who cannot speak because of a breathing device in his throat, whether he had been abused.

"He didn't give his usual yes or no sign. He just looked afraid," Johnson said. "And when I said, 'Wayne will never do this to you again,' he gave me a big smile. That smile broke my heart."