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Confused, frustrated and angry about life's pain and injustice, Richard Worthington often lies awake at night, moving a foot back and forth in nervous angst.

Now he'll be doing it on a prison bunk bed, probably for the rest of his life.A 3rd District judge Thursday evening ordered the 40-year-old Worthington to begin serving a minimum of 35 years in Utah State Prison for his "reign of terror" at Alta View Hospital this past fall.

Though much less than the 130 years requested by prosecutors Greg Skordas and Kent Morgan, the sentence was only five years more than what defense attorneys asked for.

Following sentencing, Worthington family members had little comment. Asked how the family was reacting, Karen Worthington, who divorced Richard Worthington shortly after he was charged, pointed at her younger children and said, "Just look at their faces. They're just heartbroken."

David Roth, husband of slain nurse Karla Roth, appeared ambivalent about the sentencing, saying he was just glad it's over so he and his family can get on with their lives. But he said he thought his wife, who always complained that the criminal justice system was too soft, probably would have thought the sentence was too light.

Calling it a case that has "weighed more heavily on my mind than any other I've ever had," Judge Timothy Hanson said he was torn between the magnitude of the crimes and the type of person who committed them.

"But for this reign of terror, Mr. Worthington . . . was the type of person you might live next door to."

The judge minced no words, however, in letting Worthington know that what he did was inexcusable and will have long-term effects on the victims and their families.

Shortly before midnight on Sept. 20, Worthington, armed with guns and a bomb, went to the hospital in a search for Dr. Glade Curtis, who, over his objections, had performed a tubal ligation on his wife. Though he didn't find Curtis, he took Roth hostage, shot her and then held eight other hostages at gunpoint for 18 hours.

"The events of that evening intruded in a place we members of society would like to believe is a sanctuary, where people go for help, for healing, for comfort," the judge said. "Mr. Worthington, you invaded that sanctuary and made it a place of terror and death."

Before handing down the sentence, Hanson said, "I've considered the overall impact of your actions . . . For all intents and purposes, you've ruined your own life in this senseless, uncalled-for tragedy . . . This didn't have to happen."

Using a variety of options that could have put Worthington away for 130 years, the judge ordered Worthington to serve a minimum of 35 years in prison and pay restitution amounting to more than $882,000.

Prior to sentencing, witnesses for the prosecution and defense spent about three hours arguing for justice and mercy.

In poignant testimony for the prosecution, nurse Susan Woolley recounted how she witnessed the killing of Roth, 37, whom Worthington shot in the hospital's parking lot as she tried to disarm him.

"I believe it was absolutely a deliberate act," Woolley said. "I saw the bullet hit her back . . . That vision haunts me, seeing her fall, hearing the wind knocked out of her and knowing there was nothing I could do to help her."

Woolley, a 30-year veteran, has not been back to work at Alta View and said she probably never will because of the trauma she suffered.

Also testifying for the state was Christan Downey, who during the siege gave birth to a girl on the third floor of the Alta View Women's Center.

"It was supposed to be the happiest day of our life," she said. "It ended up being the most horrible thing we could ever experience."

Downey's boyfriend, Adam Cisneros, whom Worthington forced to carry the bomb into the hospital, called Worthington a number of vulgar names, over the judge's objections.

Katherine Egan, Worthington's neighbor, was in the hospital on Sept. 20, and it was through her hospital room window that Worthington broke into the building. Although she admired Worthington for his service to community and family, she said, "It would be a very difficult, with the anger he showed that night, to ever see him a free man again."

Dr. E. Keith Hansen, who shares office space with Curtis, condemned Worthington's "monstrous outrage, not just because of what he'd done, but where he chose to do it. He chose a sanctuary, a place where life is supposed to begin . . . not end."

Hansen said some children of hospital employees still urge their parents not to go to work, fearing "the `robber' might come back." Patients, he said, still ask whether it's safe to come there to have their babies.

Defense attorneys Andrew Valdez and Candice Johnson called six witnesses, including two of Worthington's brothers, two of his sons and two of his friends. Recounting how much they loved and admired Worthington, all of them asked the victims for forgiveness and asked the judge for mercy so Worthington and his family could have hope that one day he will be free to do good again.

Worthington then took the stand and, amid frequent sobs and rambling, told the court that he is sorry but doesn't know what he can do to take away the hurt he has caused. He also indicated he doesn't completely understand why he snapped into an uncontrolled rage last Sept. 20.

Addressing the victim's husband, David Roth, Worthington said, "I wish I could trade my life for hers . . . I am sorry."

Worthington also told of his painful childhood and the shooting death of his father, whose accused killer was acquitted by a jury in 1984. He said he has often lain awake at night, tapping his foot back and forth nervously over what he perceived was an injustice.

After reciting by memory a poem called "The Touch of the Master's Hand," he asked his many victims for forgiveness and referred to his nervous foot habit.

"The miracle of forgiveness doesn't have to be stemmed on whether I serve 15 or 30 years or the rest of my life . . . only if you are able to forgive in your heart and stop tapping your feet at night."

- Deseret News staff writer Brian T. West contributed to this report.