Whenever Heidi Lynch thinks about priests molesting children, her stomach churns, her head spins and her questions multiply.

“Are they really taking care of the children?” asked Lynch, a 60-year-old San Carlos resident, who between the ages of 8 and 11 was repeatedly raped by a priest. “Are they really taking care of the abusers? Are they still hiding this?”

Ten years ago this week, the Roman Catholic Diocese of San Diego agreed to pay $198.1 million to settle the lawsuits filed by Lynch and 143 other adults. As children, each had been sexually assaulted by a priest or, in one case, a layman supervising altar boys.

This was a landmark moment in one the largest scandals in the church's 2,000-year-old history. From Dublin to Manila, Boston to Portland, Ore., Catholic officials were hauled into court and forced to account for shielding predatory clerics, often for decades.

The San Diego settlement was the nation’s second largest, trailing only the Los Angeles diocese’s $660 million. By at least one measurement, though, San Diego’s settlement was more significant. After legal fees, the 508 victims in L.A. averaged a payout of $780,000. In San Diego, the average was $825,000.

Absorbing these damages led the San Diego diocese to file for Chapter 11 bankruptcy. In the end, insurance paid $76 million and the Diocese of San Bernardino, which had part of this diocese, contributed almost $15 million.

Selling properties and tapping its bank accounts, San Diego paid the remaining $107 million. Seven months after going to bankruptcy court, the diocese’s case was dismissed.

The financial hit had been huge, but nothing compared to the blow to the church’s moral credibility.

The scandal, Bishop Robert McElroy said, “was a grave wrong and sin on the part of the church.”

Since assuming leadership of the San Diego diocese in 2015, McElroy has enacted reforms to reduce the chances of clergy preying on children. Every employee, from vicars to janitors to visiting clerics, undergo background checks. Catholic school pupils and their parents are taught to recognize inappropriate behavior and warning signs of predators.

Still, the bishop warns the problem hasn’t vanished.

“It will never go away, it is part of human nature — sadly,” he said. “Here’s the twin problems we face: we are not in the moment of crisis, but we can’t let the lessons we learned during the time of crisis diminish.

"We have to maintain vigilance. I use the word vigilance advisedly. That’s an active stance and we can't become complacent.”

If the diocese is determined to remember, some victims struggle to forget.

Asked how her life has changed in the last decade, Lynch opens a shoebox she keeps on the kitchen table in her ranch-style San Carlos house. The box is packed with prescription drugs to treat ulcers, colitis, anxiety, insomnia, depression.

“When this happens to you as a child,” she said, "you think you must be the most horrible person in the world.”

Open wounds

Like many Catholic children enrolled in public school, Heidi Lynch attended weekly catechism classes at her local parish, St. Rita’s. While learning church teachings and preparing to receive the sacraments, Heidi descended into a nightmare.

At the age of 8, Heidi and her classmates first received the sacrament of reconciliation. Also known as confession, this became a regular part of the children’s routine. As students queued outside the confessional, Heidi was directed to the end of the line.

"I was always the last,” Lynch said. “Once, we had a new nun and she started wondering why I was always the last one. She asked questions -- and then she disappeared.”

Heidi was always last because the priest would usher her into his part of the confessional booth, close the door and sexually assault her.

The girl felt ashamed, unclean, confused. Who could she turn to? She had no allies at home: her parents were alcoholics and her father was also abusing her.

And if a priest was forcing himself on her, how could this be wrong?

Adults who sexually abuse children come from a wide range of professions, often holding positions of authority — teachers, Scout masters, spiritual leaders from virtually every denomination.

“It's not just priests,” said Msgr. Dennis Mikulanis, San Diego’s vicar for ecumenical and inter-religious affairs.

But within Catholic congregations men of the cloth often are regarded as living saints, beyond normal human failings. “Priests are looked up to with more respect and are expected to have more of a moral commitment,” Mikulanis said. "It’s the Bing Crosby/Pat O’Brien model.”

Enshrined in movies like “Going My Way,” that model has been honored in real life by many priests. Yet others were poorly prepared for this calling's demands. “Who wants to work in a parish seven days a week, make no money and even if you have strong faith, have no partner and be lonely the rest of your life?” asked John Manly, one of the lawyers who sued the diocese.

Moreover, church officials failed to weed out problem candidates for ministry. This failure was compounded at least through the 1970s, McElroy said, when bishops routinely shipped offenders to church-run centers for months of psychiatric evaluations and counseling.

"And in those years," McElroy said, “many institutions would say that this person was — I've seen the letters — cured.”

They were not. Yet these priests often resumed pastoral duties, often sent to a new parish for a new start. Instead, many resumed their old criminal behavior.

In the 1950s, the Rev. Franz Robier had already undergone at least one round of treatment when he was assigned to Holy Spirit parish in San Diego’s Oak Park. There, he often attended the girls choir’s practices. After ordering other adults out of the church, he would fondle some children and rape others.

“He’d have me sit on his lap. The other girls, he took places,” said one former choir member, who sued the diocese as “Jane Doe Number 5.”

Doe was 9 when these assaults took place. “I felt it was wrong, but I didn't get it. I didn't understand it.”

She was especially baffled by the behavior of the choir leader, a nun. Whenever Robier appeared in the choir loft, the sister would leave the premises.

“That nun knew about it,” Doe said, “and she did nothing.”

While this had happened decades ago, McElroy heard this story and similar tales from parishioners while visiting the diocese’s 99 parishes in 2015.

“Most of them have moved beyond that, but they haven’t forgotten it,” McElroy said. “It’s still an open wound in many ways. It’s just hard. It becomes part of the life of the parish.”

Someone who hasn’t moved beyond: Jane Doe, who left the church to become a Mormon.

“There's a special place in hell for him,” she said of Robier, who died in 1994. “He sure screwed up a lot of lives.”

All she wanted

After the scandal erupted, the diocese made some personnel changes. The victims assistance coordinator, Msgr. Steve Callahan, was replaced by a lay person, Lisa Petronis, a licensed clinical psychologist.

And the Diocesan Review Board — a panel that reviews allegations of child sexual abuse by church employees — received a new member: an adult survivor of this crime.

“We thought that was an important perspective to have,” McElroy said.

Today, McElroy said, every allegation of sexual abuse of a minor is referred to either the police or child protective services. “It depends on whether the minor is still at risk,” he said.

At the same time, allegations are forwarded to a private investigator who has a contract with the diocese. This investigator’s report goes to the authorities and the aforementioned Diocesan Review Board.

“We act as the finder of fact for the diocese,” said Chris Hulburt, a career defense lawyer who chairs the board.

Meeting quarterly, the board includes a prosecutor of sex crimes; a retired judge; a marriage and family therapist; a school nurse; a pastor; and the sexual abuse survivor. McElroy is present when the board hears evidence, including the investigator’s report. Then he leaves the chamber so the board can discuss whether an instance of abuse occurred and, if so, what should be done.

The latter is a recommendation. It’s McElroy's decision whether to take any action.

“We are an advisory group,” Hulburt said.

In Hulburt’s five years on the board, he’s heard five allegations of new cases and five of cases that allegedly occurred decades ago. None of the former led to the removal of a San Diego priest. One allegation was retracted. Another involved a priest from the Los Angeles diocese. A third stemmed from a priest’s questionable communications, but no physical contact, with a minor.

“It did not rise to the level of a violation,” Hulburt said, but the board expressed its concern to the bishop. “That did raise red flags and we felt it was the sort of thing that should not happen again.”

The five older allegations, all leveled against priests who are now dead, were judged more serious. In several cases, the board recommended the diocese pay for the victim’s counseling. At least once, the board recommended -- and the bishop approved — payment to a victim.

While board members include several legal professionals, this is not a legal proceeding. In fact, the board may deliberate while the legal system — including the church’s lawyers — come to grips with civil or criminal cases prompted by the allegation.

“We're not involved in the church’s legal strategy at all," Hulburt said. “We are concerned about people — concerned about the people that may have been harmed and the people that are being accused. We are concerned about family members and concerned about the people in the community.”

Ideally, Hulburt said, these private hearings can heal wounds. That’s not what happened during the negotiations that led to the massive 2007 settlement. Victims and family members are bruised from the adversarial experience, saying the diocese stonewalled, destroyed documents, hid assets and acted in bad faith.

The settlement, large as it was, did nothing to heal this rift.

“All she wanted was for him to say he was sorry, ‘Sorry, I did something wrong,’” said Gordon Rister, the widow of Nicki Rister, who was 17 when she was seduced by the Rev. Patrick O’Keeffe.

“But that never happened."

A lonely teen, Rister was flattered when the handsome priest took an interest in her. Over several months, O’Keeffe introduced her to oral sex, then intercourse, all while professing his love and promising to leave the clergy and marry her.

Then he dumped her, leaving the girl confused, angry, alienated from her faith and family. When she worked up the courage to tell loved ones, her father sided with the priest, refusing to believe his daughter.

O’Keeffe retired in 1994. Five years ago, a fatal heart attack dropped Nicki Rister in the garden of her Kremmling, Colo., home.

Those final years after the settlement “gave her some relief, you’d say,” Gordon Rister noted. “It wasn't so much peace, I can’t say that for her. It was a matter for her — it was something she really felt strongly about for a long, long time.”

Root of the problem?

Historians note that accusations of child abuse have been leveled at priests and monks since at least the Middle Ages, modern awareness of this scandal grew after the Boston Globe published a 2002 series about that archdiocese failed to shield parishioners from dozens of predatory priests.

Months later, the U.S. Conference of Catholic Bishops’ “Charter for the Protection of Children and Young People” ordered “zero tolerance” for these crimes.

At the same time, church figures debated a pivotal question: why was this happening?

Two studies from New York’s John Jay College of Criminal Justice advanced some answers. Commissioned by the American bishops and conducted by criminologists and other academics, the papers — issued in 2004 and updated in 2011 — argued that most offenders attended seminaries in the 1940s and ’50s. They had been taught to handle their normal sexual desires by repressing them.

Celibacy, the studies concluded, was not the root cause. Nor did the scandal erupt because of a sudden influx of seminarians who were gay — a popular theory among some conservative critics — or especially attracted to children.

“Priest-abusers were not ‘pedophile priests,’” the 2011 report concluded. “The majority of priests who abused were not driven by particular pathologies, and most did not “specialize” in abuse of particular types of victims.”

Instead, they were sex offenders similar to those found among the laity, the report continued.

“They had some motivation to commit the abuse (for example, emotional congruence to adolescents), exhibited techniques of neutralization to excuse and justify their behavior, took advantage of opportunities to abuse (for example, through socialization with the family), and used grooming techniques to gain compliance from potential victims.”

The John Jay studies recommended five steps to decrease the incidence of child sexual abuse, many of which have been adopted by the San Diego diocese:

• Educate children, parents and priests about how to maintain safe environments and proper boundaries.
• Take a clear, tough “zero tolerance” line with abusers.
• To help reduce priests’ stress and reduce isolation, encourage clergy to form “social friendships and suitable bonds with age-appropriate persons.”
• Offer priests stress-reduction seminars and support groups.
• Educate priests on appropriate behavior with minors, and about the harm done to victims of abuse.