A Dark Night in Aurora

by Dr. William H. Reid

  He kept his cell clean and sometimes stacked papers and books neatly around the base of the cell walls. His possessions, whether by his choice or jail rules, consisted mainly of a couple of books, writing materials, and a hacky sack. His clothing was always the same: standard orange jail issue with white socks and sandal-slippers.

  Holmes sometimes looked through the small observation window in his door; it made his cell seem bigger. He could just see the guard station. The window was often covered from the outside when people were in the common area outside his cell, but when it wasn’t, “lookiloos” would peer in from time to time. He rarely tried to talk to other inmates, though he could often hear them yelling at him or talking about him. They weren’t supposed to talk to him.

  Holmes didn’t have a watch or a calendar. He kept track of time by the consistent routine of jail life. When the custody staff brought fresh clothes, he knew it was Wednesday. Friday was commissary day. They woke him up early for breakfast, and he often went back to sleep until lunch, since he usually stayed awake into the wee hours of the morning. He also kept track of dates with television shows and could vaguely see the angle of daylight coming through the window slit near his ceiling. He rarely got to see the sky, much less the iconic Rockies to the west that are a fixture of Denver-area life.

  When I asked how the isolation affected him, he said, “Doesn’t matter.”

  The blue rectangles on Holmes’s cell walls stayed empty for several weeks, and then he put a couple of family photos over his bunk. By late August, five or six weeks after his arrest, the rectangle with family items was still far from filled, but the other one was full of photos and notes from female fans.

  Fans? People who do sensational things, even heinous sensational things, bring out the trolls. Holmes didn’t have access to the Internet, where most trolling takes place these days. He had to make do with those who sent things by snail mail. Everything was censored by jail clerks, of course. Pornography and other contraband were removed, but even accused mass murderers are entitled to get mail and send it, within reason. He didn’t answer any of his mail.

  Holmes received thousands of letters, notes, and photos from women, many so suggestive that they barely got past the jail censors. Lots of the writers seemed to know what was acceptable and what would be returned for breaking correspondence rules (overly revealing photos, news clippings). As we say out west, this wasn’t their first rodeo.

  Most of the women in the pictures were reasonably attractive—maybe real photos of the writers, maybe not—and their notes, often disjointed but not always unsophisticated, were supportive, offering comfort, seeking conversation, and frequently professing love or puerile lust in bizarrely personal terms based on Internet photos of Holmes, media accounts, or just their imaginations. Many called him “Sweetie,” “Darling,” “Babe,” “Hon.” “Your full, heart-shaped lips are so beautiful,” said one. Another wrote, “You have a pretty girl, me, that really, really likes you.” Still another described her body in as much detail as the censors would allow and wrote within her several-page letter, “I want to be with you so bad I can taste it, sexy man,” closing with a fervent promise of “Love Always.”

  Holmes said he thought the women who sent him letters and pictures liked him. In actuality, the often-lurid-sounding letters seemed to betray a sad emptiness beneath their grotesque passion. They hoped Holmes would fill that space, or maybe they filled it themselves for a little while simply by writing, without any real contact or intimacy. Their writing was a curious caricature of caring, seemingly focused on Holmes but actually self-serving, not the real thing.

  More than a few of the writers enclosed money for his commissary account, as much as $50, usually as money orders. Donations from strangers to Holmes’s jail account would total more than $4,000 over the next three years.

  Other letters weren’t from misguided lonely hearts. Some people wrote two or three times in hopes of getting an answer from an imagined kindred spirit, a fantasied soul mate, or a famous killer. Religion was another common topic, encouraging Holmes to get right with God and accept Jesus in one way or another. Still another group, from inmates of assorted jails and prisons or “fans” of murder, offered commiseration with the writers’ own fights with the law or said they were sure he’d been framed in some broad conspiracy. Then there were the simply crazy ones who ran the gamut from impassioned interpretation of random song lyrics to diagnosing imaginary brain tumors to asking the former budding scientist for help with math homework.

  The first outside mental health professional to interview Holmes after the shootings was an expert retained by the defense, Denver psychiatrist and neurologist Dr. Jonathan Woodcock. Dr. Woodcock was chosen by Holmes’s lawyers less than a day after they were appointed. He was sent to the jail with a defense team investigator, social worker Kevin Bishop, to evaluate Holmes’s psychiatric condition primarily as it might be relevant to defending him against the criminal charges, not to focus on his clinical needs. At the time, Dr. Woodcock’s findings would be available only to the defense.

  Woodcock’s notes and testimony indicate that he met with Holmes for a little less than three hours on July 24, four days after the shootings; jail records say July 22, a discrepancy that was never explained. Dr. Woodcock saw Holmes early in his incarceration only once. That fact would become relevant at the trial. He apparently planned to see Holmes again about a week later, on July 30, but didn’t actually return until almost three years had passed, after jury selection for the trial had begun.

  That first visit was confusing to both Holmes and the jail medical staff. Dr. Woodcock was not James Holmes’s clinical psychiatrist, although he appears to have made certain recommendations about treatment. He was an agent of Holmes’s lawyers, with a forensic (legal) purpose. Although almost all of his assessment focused on Holmes’s psychiatric and medical condition—Woodcock was specifically told, and sometimes guided by social worker/investigator Bishop, not to delve into certain topics related to the wrongfulness of the shootings—he was not Holmes’s doctor. Holmes apparently misunderstood that and, one way or another, was left without psychiatric treatment for almost four months.

  Much of Dr. Woodcock’s purpose in evaluating Holmes at that time was to determine his competency to stand trial, though his defense attorneys considered an insanity defense from the day of Holmes’s arrest. Competency to stand trial is a very different concept from that of an insanity defense.

  Trial competency has to do with a defendant’s current ability to understand and participate in the trial process. Criminal insanity or other psychiatric mitigation of criminal charges is largely predicated on the perpetrator’s mental state, his or her ability to be responsible for otherwise criminal acts, at the time of the alleged crime. That made it important to assess Holmes’s mental condition as soon after the shootings as possible. In that sense, Dr. Woodcock had a better opportunity than any other psychiatrist or psychologist to see Holmes as he actually may have been during the shootings just a few days before. All the other psychiatric and psychological experts came much later to the task of piecing together his mental state as of July 20, 2012.

  Although it was timely, Woodcock’s interview and examination suffered from several problems with regard to its forensic usefulness. First, the defense lawyers restricted what Woodcock could explore with Holmes. That inability to do a complete evaluation would later cast significant doubt on both the validity and the credibility of his opinions. Second, he allowed a defense representative to sit in on his examination and even to participate briefly at times, something usually considered anathema to forensic psychiatry evaluations.

  Third, Dr. Woodcock, a well-trained and respected clinician, lacked subspecialty training in forensic work and had little experience interviewing criminal defendants to assess criminal responsibility. An experienced forensic psychiatrist would have carried out the interview differently and would have rankled at restrictions and interference from the lawyers.


  Finally, there appears to have been some confusion in Dr. Woodcock’s, Holmes’s, and the jail clinicians’ minds about Woodcock’s role vis-à-vis the defendant. He wasn’t there to treat Holmes or be his doctor (which would have further compromised Woodcock’s role as a defense expert), but both the jail’s clinical psychiatrist, Dr. Erwin Mozer,1 and Holmes himself got the opposite impression. That confusion would prove important during the trial, some three years later.

  Dr. Woodcock found Holmes to be tired and a bit angry. In spite of some symptoms of severe mental illness, Holmes sat comfortably during the entire interview. He knew where he was and why he was in jail, the roles of the guards around him, and the general process of going to trial (all topics related to mental competency to stand trial). His “affect” (facial expressions of feelings and emotion) was “blunted,” with little outward appearance of empathy for those hurt or killed in the shootings, something Woodcock labelled “dissociation of affect,” in which a person’s psyche blocks painful emotions from coming to consciousness. Holmes wanted to avoid some topics, such as his family, but otherwise appeared “emotionless.”

  Remember that the defense lawyers told Woodcock not to go into the subject of the shootings themselves, their planning, or anything related to them and kept their investigator in the room to monitor the interview. Dr. Woodcock had no access at the time to the voluminous records that were being collected about every aspect of Holmes’s life. He didn’t—he couldn’t—review the police reports or interrogation interviews. Woodcock was essentially in the dark except for what Holmes said and how he acted during the examination.

  Some people think psychiatrists can read minds, or at least see everything beneath the surface of the people we interview, that we interpret everything we hear and read important meaning into every nuance. That’s not true. Our impressions and opinions and diagnoses are only as good as the information at hand. For Dr. Woodcock, most of the information at hand was Holmes’s own statements, which were few and “blunted,” plus whatever he had heard from the media and defense lawyers at that early date. Holmes’s statements during his relatively short evaluation (at a time when Woodcock thought him to be psychotic), including Holmes’s descriptions of his past activities, behavior, symptoms, and treatment, were incomplete at best, and at worst markedly colored by Holmes’s situation, misunderstandings, and mental illness.

  Holmes told Woodcock that he had been suicidal and that killing people was a way to stop being suicidal. He said that he tried other ways to deal with his problems but had to go to “plan C” and kill people. He talked a lot about impulses to kill and the ways he explored them, but his only references to the actual shootings were framed as “what I did.” Holmes said that once something came into his thoughts, he felt compelled to do it. He had been “catatonic,” he said—suffering from a sort of mentally-caused paralysis—but he also needed to work and study, so he limited the catatonia to his lunch hour (a behavior quite inconsistent with true catatonia).

  He described going on “spending sprees” after starting the antidepressant medication sertraline (Zoloft) that Dr. Fenton had prescribed, which he (Holmes) assumed meant that he had become manic. Never mind that the buying he did was of weapons, ammunition, and other materials that he needed for his assault on the Century 16 victims. That doesn’t suggest mania.

  Holmes apparently didn’t look very anxious or depressed during Woodcock’s assessment. His descriptions were sometimes a little disconnected, but not so disjointed that he could be described as acutely psychotic. Holmes denied that he’d had any hallucinations during the previous several days, though he spoke of earlier seeing vague “shadows” that he couldn’t explain. No “voices” had commanded him to shoot people or to plan the shootings, but he had felt a strong “pressure” to carry out the “mission.” Dr. Woodcock inferred psychosis at the time because of Holmes’s lack of any logical reason for the shootings, what Woodcock believed was delusional reasoning about the value Holmes expected from killing others, and his interpretation of Holmes’s apparent lack of empathy as “psychotically defensive.”

  Defense investigator Bishop interrupted Woodcock’s interview at least twice. The first time, Bishop implied that people in the jail would probably be safe around Holmes if they didn’t do anything to provoke him. In the second instance, Holmes had volunteered a comment about killing people if provoked, and Bishop inserted something like “to defend yourself” into his statement. Both interruptions could be interpreted as downplaying Holmes’s dangerousness in order to help the defense; they decreased the objectivity and credibility of the examination.

  Dr. Woodcock was the first psychiatrist to diagnose a schizophrenia-related disorder in Holmes (although Dr. Fenton had considered one), basing that diagnosis solely on his July 2012 interview. He came to a primary clinical impression of “schizoaffective disorder,” a mental illness that includes significant mood instability, depression, and/or mania in addition to the markedly disordered thinking found in schizophrenia. Woodcock diagnosed antisocial personality disorder as well, and an anxiety disorder.

  Whether or not one or more of those diagnoses was correct, they are to some extent mutually exclusive. That will be addressed in more detail later, along with the differences among the various psychiatric experts’ diagnoses.

  Was Holmes faking when he talked with Dr. Woodcock? Using his intellect to manipulate the examination? No, almost certainly not, but the question of malingering—faking symptoms for personal gain—would be raised many times over the next three years.

  Woodcock did not record or video his interview; he relied on contemporaneous notes that he later described as “spotty.” He didn’t press Holmes for details on very many points. He didn’t gather his findings into a report, nor did the defense lawyers request one, until almost three years later. He sort of disappeared from the case until it finally went to trial.

  Both ACDF clinical psychiatrist Dr. Mozer and correctional psychologist Dr. Elizabeth Sather visited Holmes during his first few days in jail. Holmes politely refused to talk with them, saying mistakenly, “I already have a psychiatrist” (Dr. Woodcock).

  A senior jail administrator initially instructed Dr. Mozer not to examine Holmes, apparently because of directions from the defense attorneys, the sensitivity of the case, a belief that Dr. Woodcock was handling Holmes’s clinical issues, or some combination of those. Dr. Mozer monitored Holmes’s condition by reading jail staff notes and later said that he attempted to contact Dr. Woodcock several times to be sure that Holmes was receiving adequate follow-up. He wasn’t. It appears that Woodcock neither responded to Dr. Mozer (assuming he received the calls) nor returned to follow up with his assessment.

  Holmes was thus not offered, and did not receive, any psychiatric medications for months after his arrest. Dr. Sather and other mental health and medical staff visited regularly to offer counseling and do “welfare checks” and periodic health screenings. Holmes told them each time that he was doing fine; he usually declined further conversation.

  Holmes occasionally wrote things during the several months after his arrest. He described most of his writings as philosophical, sometimes with a science fiction bent. (“I was reading sci-fi at the time.”) He didn’t see himself as a prisoner-author like Galileo or Solzhenitsyn, but he had “important ideas to get down on paper.”

  He wrote a few dozen pages between August and December of 2012, not much for several months of incarceration, sometimes with small drawings, about such topics as “Galactic Colonization,” “The Ultraception,” awareness, and others that could be viewed either philosophically or psychiatrically. He wrote briefly about life and death, infinity and the finite, and about death as a “dreamless sleep.” The pieces are short. Except for inventing a new card game, he never expanded them beyond a few pages. Here are a some examples:

  Galactic Colonization

  1. Locate hospitable planet

  2. Terraform amenable unhospitable planet

  3. Ev
olve human species on earth to niche environment, a replica or unhospitable planet, small scale

  4. Design pseudohuman w/features enabling life on unhospitable planet but still retaining the human spirit or essential essence of being human …

  Devise machine that can create human life when destination reached. Did god do this w/humans as machine to create god? What is destination? What is God?

  Awareness

  The state of awareness changes from wakefulness to sleep, from life to pseudo death. States of awareness are as fundamental as space/time, hot/cold, or solid/liquid.

  And later, probably after he began taking psychiatric medication in November of 2012, a poem,

  Forever more, forever …

  What cruel dyes of fate

  Whom sunken lies in wait

  The past exceeds escape

  To live and love and hate

  With destiny, I cry

  forever more, forever …

  It is easy to interpret some of Holmes’s writing as odd, even as evidence of psychosis, but that would be speculative. Just as Holmes’s preshooting notebook had parts that varied in logic and meaning, none of which could be definitively explained without being in the room with him as he wrote, his jail writings vary as well. Some seem to be practical or philosophical musings, some creative outlets, and some maybe crazy efforts to explain life’s mysteries.

  Having already said that even incoherent writing shouldn’t be interpreted out of context, it is interesting that Holmes’s most normal-appearing jail writing may have been produced after he started taking antipsychotic medication in late November 2012. Contrary to some reports, his own recollections indicate that a poignant six-line poem and very logical directions for a fantasy card game he called “Barons of the Land” were written in December, just after he started taking the antipsychotic medication risperidone.