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Navy yard shooter convinced VA doctors he was mentally stable

Washington Navy Yard shooterWASHINGTON (AP) - The gunman who killed 12 people in last year's rampage at Washington's Navy Yard convinced Veterans Affairs doctors before the shootings that he had no mental health issues despite disturbing problems and encounters with police during the same period, according to a review by The Associated Press of his confidential medical files.

Just weeks before the shootings, a doctor searching for the source of the gunman's insomnia noted that the patient worked for the Defense Department but wrote hauntingly "no problem there."

The AP obtained more than 100 pages of treatment and disability claims evaluation records for Aaron Alexis, spanning more than two years. They show Alexis complaining of minor physical ailments, including foot and knee injuries, slight hearing loss and later insomnia, but resolutely denying any mental health issues. He directly denied suffering from stress or depression or having suicidal or homicidal thoughts when the VA's medical team asked him about it just three weeks before the shootings, even though he privately wrote during the same period that he was being afflicted by ultra-low frequency radio waves for months.

The dichotomy between Alexis' apparently even-keeled interactions with his doctors and the torment he was experiencing outside the hospitals is the center of debate about whether the Veterans Affairs Department could have better recognized the need to intervene in his life with mental health care before the shootings.

Congress and the Pentagon are investigating the shootings, including whether faulty security clearance procedures allowed him to get and maintain his job. Some lawmakers have said Alexis fell through the cracks at the VA and should have been treated by mental health professionals, but they have stopped short of specifying what government doctors should have done differently.

In a bizarre incident in Newport, R.I., Alexis told police on Aug. 7 that disembodied voices were harassing him at his hotel using a microwave machine to prevent him from sleeping. After police reported the incident to the Navy, his employer, a defense contracting company, pulled his access to classified material for two days after his mental health problems became evident but restored it quickly and never told Navy officials it had done so.

Just 16 days later, after Alexis told a VA emergency room doctor in Providence that he couldn't sleep, the doctor wrote that his speech and thoughts seemed "clear and focused" and noted that he "denies flashbacks, denies recent stress."

The medical records said Alexis, 34, was found sleeping in the VA waiting room in Providence on Aug. 23 while waiting to see a doctor. During that visit he was prescribed 50 milligrams of trazodone, an antidepressant and anti-anxiety medication that in such low doses can be used to treat insomnia.

"Denies any pain except discomfort rt (right) temple," a nurse wrote the same day. "Pt (patient) taking no medications including any otc (over-the-counter) medications."

An attending doctor provided additional details, saying Alexis suffered from fatigue after sleeping only two or three hours every night over the past three weeks.

"Speech and thoughts clear and focused. Denies flashbacks. Denies recent stress. Denies drugs, cocaine, heroin, caffeine product, depression, anxiety, chest pain, sob (shortness of breath), nightmares. He denies taking nap during the day. Denies SI (suicidal ideation) or HI (homicidal ideation)," the doctor wrote.

"He works in the Defense Department, no problem there," the doctor added.

Sidney Matthew, a lawyer representing the family of one of the shooting victims, told the AP it's possible that Alexis was evasive with his doctors but expressed skepticism that physicians adequately questioned Alexis about why he wasn't sleeping.

"There doesn't appear to be very much curiosity about what the etiology of the insomnia is," said Matthew, who represents the family of Mary Frances DeLorenzo Knight in a federal lawsuit. The lawsuit claims the VA failed to treat Alexis' mental illness.

Matthew noted that Alexis aggressively confronted a family at Norfolk (Va.) International Airport on Aug. 4, just days before his encounter with police on Aug. 7 that was so bizarre that police contacted the Navy about their concerns. Alexis' family also had concerns about his mental health during the period. He said he doesn't believe Alexis could have masked his mental health problems.

If doctors were perplexed about the cause of a patient's problem, there are limits as to how far they can investigate. The executive director of the National Center for Veteran Studies, Dr. Craig Bryan, said conducting an online search of a patient's life history would be time-consuming and unlikely to help. That's particularly the case for a doctor working in an emergency room setting treating a condition as common as insomnia, he said. With few exceptions, it would be illegal to contact others, such as family, friends or an employer to search for clues, Bryan said.

Other experts agreed. "In an emergency setting, a patient with insomnia who does not report stressors or substance use, who denies suicidal or homicidal thoughts and who otherwise does not have urgent psychiatric or medical issues would typically be referred for further, full evaluation of the insomnia in a nonemergency setting," said Dr. William E. Narrow, acting director of quality improvement for the American Psychiatric Association.

The medical records showed that Alexis answered "no" when asked, "Do you have anything that could be considered a weapon?" The VA told the AP that was a standard question it asks veterans whom it treats in a triage setting.

Five days later, on Aug. 28, Alexis visited a VA medical facility in Washington, again complaining of sleeplessness: "Patient presents to ER with c/o (case of) awakening each morning about 4 a.m. like clockwork and he cannot figure out why this is happening."

He answered "no" when asked whether he was having feelings of hopelessness for the present and the future. Another doctor that night described the examination as "unremarkable." The VA gave him 10 more tablets of trazodone and sent him home just before 9 p.m.

Alexis, a defense contractor and former Navy reservist, went on a deadly shooting rampage at the Navy Yard on Sept. 16, spraying bullets in a hallway and firing on workers from a balcony. He died in a gunbattle with police.

He had purchased the shotgun he used from a gun shop in Virginia two days before the shooting. Alexis had been involved in at least two earlier shooting-related incidents, in 2004 when he was arrested in Seattle and charged with malicious mischief for shooting the tires on a construction worker's vehicle and in 2010 when he was arrested in Fort Worth, Texas, for firing a rifle into a neighbor's apartment.

No charges were filed in those two cases, but it was not immediately clear whether Alexis was answering honestly on Aug. 23 when he was asked whether he still had any weapons. The FBI told the AP it found no weapons when it searched the hotel where Alexis had been staying before the Navy Yard shootings.

Before the Navy Yard shootings, Alexis left behind a note that FBI agents recovered saying he had been targeted by ultra-low frequency radio waves for the previous three months - the period that covered his visits to the VA medical facilities when he denied he was experiencing any stress or violent thoughts.

The AP obtained 114 pages of Alexis' medical records under the Freedom of Information Act after requesting them a few weeks after the shootings. It is unusual for the government to disclose anyone's medical files, but the Veterans Affairs Department agreed that the public interest in the mass killing outweighed Alexis' privacy rights in keeping his treatment records secret after his death. In the records the AP obtained, the government withheld the names of all the doctors and others who treated Alexis to protect their privacy.

The medical records also describe Alexis' efforts to qualify for disability payments because of ringing in his ears and orthopedic problems. In February 2011, almost immediately after Alexis received an honorable discharge from the Navy Reserves, he complained about tinnitus, which he said was "annoying and can be distracting." He said it began in 2009 when he was still serving in the Navy. An audiologist in Dallas determined that his hearing in both ears was "within normal limits" and said any hearing loss or tinnitus probably didn't occur when he was serving in the military.

In October 2011, Alexis filed another disability claim for what he said was a broken right foot he suffered when he fell down stairs in 2009, causing him mild to moderate pain daily. The Navy alleged in a nonjudicial punishment in July 2009 that Alexis was drunk when he leaped off stairs and suffered a broken ankle, but Alexis appealed the disciplinary action and it was removed from his record six months later because there was insufficient evidence he had been intoxicated. Alexis also complained to the VA about a spine problem and conditions with his knee and shoulder. An examiner concluded that Alexis had a degenerative disc in his back and less movement than normal in his shoulder and knee.

The government granted him a 20 percent disability rating for orthopedic issues in December 2011. He was awarded an additional 10 percent for tinnitus and received $395 in monthly benefits retroactive to his leaving the Navy.

___

Associated Press writer Eric Tucker contributed to this report.

___

Gunman's medical records: http://www.documentcloud.org/documents/1010448-alexis-medical-records.html

Join the discussion

1000|Char. 1000  Char.
frank1946 February 01 2014 at 12:30 AM

So many Risk Factors present here that the Classification/Measurement/Treatment cannot
possibly be objective or measured.

Every Base Command knows that exceptions will happen.

Premeditated Murder is exteme.

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debnaert February 01 2014 at 9:51 AM

He was paranoid schizophrenic ..... He could NOT help himself. I have a brother with this disease. Unless they are on the CORRECT medication they can and will become violent. Shame on these doctors for not REALIZING or Diagnosing him properly.... it doesn't take a rocket scientist to recognize schizophrenia especially for a DOCTOR!

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2 replies
Wendy debnaert February 01 2014 at 11:38 AM

I have a family memeber with the same. And I have met a couple people who are Schizo-Affective. I wish society would wake up and help these people. I know. I know. "It's not my job" ... Well it will be when they hurt themselves or someone else. People don't get it...psychiatric illnesses are not controlable. And I know of at least one person who in order to leave the hospital told the docs everything they wanted to hear. How sad.

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SeaboardStation debnaert February 01 2014 at 12:15 PM

Its all about volume today. Try getting a doctor to really sit down and talk to you today. They have to deal with volume to pay for their life styles. Not all doctors are like this but most are today. I've changed doctors for this reason and have found the same problem across the board. Isn't it strange that most of these mass murderers had been seen by doctors. Bet they were rushed through for the next patient waiting.

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endmillll February 01 2014 at 10:05 AM

I'm still up in the air on this one,but if this was a government job i feel him and his back ground should have been looked at closer.

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ANICK February 01 2014 at 10:54 AM

This is so crazy and it seems to be increasing. We (non violent commuters) now have at least one thought weekly of what we would do if a SHOOTER appeared. To be prepared we must plan and practice, how we will attempt to escape from the building if a shooter emerges. The very act of giving this scenario consideration can and most likely will lessen the chance of having the most productivity when interacting with people. It lessens our TRUST. It is making us question whether we may have seen a "hothead" who could become a local shooter. Chances of dying today has never been greater. People of the USA need THERAPY. We have been through a LOT. We need to name a DAY..."HEALUSA" which is simply " Heal USA" We can do anything we put our minds to.

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2 replies
G-Money ANICK February 01 2014 at 11:12 AM

Becoming trained with a weapon might give you peace of mind.

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hokanut ANICK February 01 2014 at 11:25 AM

Crime is actually down now compared to decades past. But instant news is up. Our chances of dying today are slim. Have a great day.

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1 reply
tonyjuicey1 hokanut February 01 2014 at 11:59 AM

I see you understand but the stories generate readers and revenue so they sell.

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Kshrrill February 01 2014 at 11:14 AM

I myself was in the Navy. I too have suffered from insomnia. My lasted for over ten years. It is true that you will have times when you do sleep, but not the kind of sleep your body needs. I to was coherent yet I was under a great deal of stress not to mention I pissed of the wrong people. I went to therapy, but that did not work. The only thing that did work was taking psychology courses. I could have easily become a headline, but I was such a thorn in their side they stop bugging me. I kept telling myself that I would not give my haters the satisfaction of becoming a headline.

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1 reply
razpu10 Kshrrill February 01 2014 at 11:48 AM

First of all, thank you for your service. I would think MOST people who have served have insomnia, this could be from the ideas they "train" you for. One is sleep, but don't sleep, anything can happen at ANY given time. I am sure they would wake you from sleep to perform drills, many times. This , to keep you ready for an attack of any kind. Again, I am sure many vets have nightmares, some worse than others, depending on what you may have seen or HAD to do. Not easy to deal with for ANY individual. The military instills an "instinct" to it's personnel, to be ready at all and any time. They need to find a way to undo this "instinct", kind of a debriefing. Then again, there are some who can flip that switch off very easily. Not that it makes one person better than the other. Again, thank you for your service

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topspin360 February 01 2014 at 12:03 PM

A lot of the things he did previous to the shootings screamed that he had mental problems. The microwave beam statements, the incident with the people in Norfolk was enough to fail his background check. He should have been refered to a psychologist before being given a pass and he would have failed.

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Clark Trucking February 01 2014 at 12:06 PM

Those are pretty standard questions you are always asked at the VA before treatment of any kind. I go there quite often for RA and Meniere's, but if you are treated for a heart condition you will get the same questions.

Unfortunately, medical pros, at the VA and elsewhere, depend on people giving them truthful answers to basic quesions about mental health issues, etc. There is just so much they can do.

I have found the doctors and nurses at the VA to be quite concerned and caring about their patients. I don't think they overlooked his mental problems. He had to meet them halfway though.

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1 reply
David S. Clark Trucking February 01 2014 at 12:23 PM

I agree. Mental illness is complex --- people who know nothing abou think anyone who has a mental illness walk around talking to the walls. Far from it; this is a tragic situation that no one could have predicted. I dealt with the VA with my father, and found the nurses and doctors to be excellent.

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bs082156 February 01 2014 at 12:54 PM

Not sleeping;
In the past - we all figure if you get tired enough you will sleep.
That is not good enough.
No sleeping is going to have to be looked as an emergency just like a heart attack

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rox February 01 2014 at 1:01 PM

I believe he should not have slipped through the cracks and that the va and government failed in its responsibility. With all the incidences, filings and medical issues especially with the agreement to leave the navy just screams a serious metal issue. Just because someone answers questions but has gone in to seek help with the issues is more important to the mental illness. The insomnia, visits outlining issues, police reports and logs this is obviously someone with issues that should not have any clearance. I believe the government and va will try to exonerate its responsibility in this as usual. But the facts of the medical and police history cannot be hidden. What ever mental illness he had with that deep and immensity of files would be obvious to any reasonable person let alone a doctor looking at his file. I believe the navy, the government and the va all failed and are all responsible to a substancial degree for the inaction and deaths of the lives taken. I also would like to know how he was able to clearly carry a weapon, purchase or receive a license.

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1 reply
Joebudgie rox February 01 2014 at 7:33 PM

He received treatment for the problems he went to the VA clinic for. When questioned about other issues he lied. The police reports and logs were not known to the doctor treating him for his alleged insomnia. Do you think there is only one doctor at that VA hospital?

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cshae89546 February 01 2014 at 1:30 PM

So, it appears that this guy and everyone he killed were actually victims of the federal government's health care bureaucracy?

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