Dr. Rachel Davis takes the stand Monday at the Aurora theater shooting trial in Centennial, Colo.
CENTENNIAL, Colo. — On his charts, they called him Brady Arkansas.
When he was admitted for psychiatric care in November 2012, Aurora theater shooter James Holmes was so well-known that doctors treated him using a pseudonym.
The defense called three of those doctors, Dr. Rachel Davis, Dr. Philippe Weintraub and Dr. John Holland, to the stand Monday to testify about the defendant’s unsettling jail behavior four months after his July 10, 2012 attack on the Aurora Century 16 movie theater. The defendant is now on trial for killing 12 people and injuring 70. If convicted, he could face the death penalty.
Because Holmes has pled not guilty by reason of insanity, his defense team’s strategy centers around his struggles with mental illness. Expert witnesses testified Monday that, at least in mid-November 2012, the defendant was suffering from delirium and psychosis.
It was a juror who asked the question most bluntly: What is the difference between delirium and psychosis?
According to Davis, delirium is a medical condition caused by factors like sodium deficiency or dehydration. Psychosis is more likely caused by mental illness, and can last much longer. Because it is not caused by a metabolic defect or other physical problem, it can be much harder to treat.
Four months after being admitted to the Arapahoe County Jail, the defendant began exhibiting strange behaviors. After much contemplation, he fell backwards off his bed into the fetal position. He rammed his head against the wall and smeared feces around his cell. He seemed disoriented, lethargic and confused.
Davis, who saw Holmes at 11:15 p.m. on November 11, 2012, the night his strange episode began, called psychosis “the predominating presentation” when she saw him. The defendant had been given an anti-psychotic medication 30 minutes before.
The medicine worked quickly: When Weintraub saw him several days he said Holmes had improved significantly. According to Weintraub, his delirium had been resolved. All that remained was his psychosis.
During Monday’s testimony, all three psychiatrists were questioned about the presentation of delirium versus psychosis. The difference is relevant because Holmes had refused food and water prior to his apparent breakdown. Dehydration, fever and sodium or potassium deficiencies can all induce delirium.
Notably, Holland said that it was psychosis that caused the defendant’s refusal to eat or drink.
This chicken-and-egg question remains central to the case of the People of the State of Colorado against James Eagen Holmes. Prosecutors have argued for months that the defense’s main argument — that Holmes was psychotic in prison — is irrelevant because it occurred so long after his crime. But if, as defense witnesses argue, Holmes was psychotic even before his November breakdown, it could sway jurors’ opinions.
Two of the defendant’s coworkers from the pill-coating factory where he worked before attending graduate school also testified Monday. Both described the defendant as quiet and shy. They described his behavior as odd and childlike and mentioned “episodes” during which he would be silent and non-responsive.
Monday marked the beginning of the trial’s 10th week. Court will resume Tuesday at 8:40 a.m. Defense attorneys are expected to show more footage from the defendant’s time in jail sometime this week.
Editor’s note: CU News Corps will honor the victims of this tragedy with every post via this graphic.
