The hearing follows a Los Angeles Times investigation that detailed Puliafito's double life of using drugs and partying with young criminals, including a 21-year-old prostitute that overdosed while she was shacked up the 67-year-old ophthalmologist.
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Puliafito blamed his bad behavior on bipolar disease, testifying that he was suffering from a mental illness that took hold of him in 2015.
"I was sick," Puliafito said in his testimony. "I've come to learn how sick I was. And part of my illness was to deny what was going on and even to deny the diagnosis."
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Puliafito claimed he first met the prostitute in early 2015 through an escort website that he had utilized in at least five previous instances.
The Harvard-trained eye surgeon said that he lavished money upon the young woman, putting her up in hotels and apartments as well as taking her on trips to Las Vegas, Miami, Boston and even Switzerland.
Puliafito spent at least $100,000 dollars on clothing alone for the woman, according to his testimony.
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"I didn't spend $100,000 on clothes to have sex with her," he testified. "I did that because I was madly in love with her and lacked judgment about how much money I was spending."
Puliafito claimed that she drugged him in Las Vegas, putting Xanax in his drink. There were also "threesomes," sexual encounters that would at times include illicit drugs.
Through it all, Puliafito viewed himself as a "rescuer," someone who was saving the young woman from a life of prostitution and drugs.
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Puliafito said that he has been to rehab and has not used any illicit drugs since June of last year.
Thursday's testimony also revealed that USC had entered into a settlement with the young woman's family.