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Dr. Lynne Fenton took the witness stand today, visibly shaking as she recounted her seven psychiatric appointments with defendant James Holmes. On multiple occasions he told Fenton that he had thoughts of killing people.

Fenton’s final report noted, “he may be shifting insidiously into a frank psychotic disorder such as schizophrenia, although he does not have the more rapid dysfunctioning typical of most psychotic breaks.”

The defendant was in the typical age group for a first psychotic break, and Fenton was worried enough to alert the campus police department.

Fenton’s last meeting with Holmes was about a month and a half before he walked into Aurora’s Century 16 movie theater and opened fire, killing 12 and injuring 70 more.

Fenton’s testimony is crucial because she was the last psychiatrist to treat him before the July 20, 2012 rampage. The defendant has pled not guilty by reason of insanity. If convicted, he may face the death penalty.

“I don’t have relationships with people, people have relationships with me,” the defendant told Fenton during their first meeting. Statements like this had Fenton keeping watch for potential psychotic-level thinking. After this appointment she prescribed him Sertraline for long-term social anxiety and Klonopin for panic attacks, but chose not to prescribe an antipsychotic.

“An inconvenience, Fenton,” the defendant said on April 22, 2012, in a chilling email to the psychiatrist when she mistakenly put the wrong last name on his prescription. The email was signed “Holmes.” this was the only time he referred to himself in this way. The subject line was “<(o.X)>Q(o.O)Q,” which the defendant later explained as him punching Fenton in the eye.

Fenton was so concerned about Holmes, she called in a colleague with experience in violence and suicide risk assessment. Because some of Fenton’s questions weren’t well received, she also thought he might be more open to talking to a male psychiatrist.

“He had an air of relief about him when talking about exiting the program,” Fenton told the court. She further described the defendant as “inappropriately nonchalant” in their last meeting, when explaining that he failed his exams and planned to drop out of the neuroscience program instead of retaking them.

By June 11, the date of the last appointment, the defendant had already purchased, among other things, tear gas canisters, a gas mask, guns, road stars and two pairs of handcuffs with which he planned to lock the theater doors. He never revealed to her his plans to kill people, nor did he tell her about a specific target.

Fenton told the court he always arrived on time, dressed appropriately, and acted appropriately.

“He never met the criteria for me to hospitalize him,” Fenton said. In order to qualify for a mental health hold, there needs to be evidence that dangerous thoughts are not just a plan but are moving toward action, and that there is a specific target.

After the shooter walked out of Fenton’s office for the last time, she continued to have concerns about his homicidal thoughts. That same day, she checked with the Behavioral and Environmental Threat Assessment team about his background, talked to the head of the neuroscience program, and even called his mother.

Fenton was looking for signs that his behavior had changed recently, which would be consistent with a psychotic break. His mother told Fenton that he had been like this since he was 10 years old.

Defense Attorney Tamara Brady cross-examined Fenton for the majority of the afternoon, picking through her report and highlighting specific pieces for the jury. She also had Fenton chronicle her appointments with the shooter on a calendar.

“He told you he thinks about homicide three to four times a day, and attempts to distract himself from these thoughts by watching television,” Brady clarified with Fenton. Correct. Brady also brought attention to the defendant’s lack of eye contact, his eyes sometimes very wide open.

District Attorney George Brauchler’s first redirect question suggested that had she attempted to contact the shooter after he quit treatment, she would have been breaking HIPAA rules. Fenton, sounding relieved, ascertained that the defendant did not meet the criteria for hospitalization at the time. She is subject to be called to the stand again by the court.

In other testimony, the boyfriend of Ashley Moser, who’s daughter Veronica was the only child killed in the attack, took the stand. Jamison Toews started crying recounting checking the pulse of Ashley and Veronica. “Ashley had a pulse but Veronica didn’t.

Moser-Sullivan was the youngest victim of the shooting, and Moser was three months pregnant at the time. She lost the child and was left paralyzed after the attack.

The judge gave jurors 20 minutes this afternoon to review the defendant’s financial records from Point Loma Credit Union. Deborah Foley, the Point Loma custodian of records, returned to the stand during the final 15 minutes of today’s proceedings. Financial records are another piece of evidence that the prosecution is using to show that he was sane enough to do normal things, such as pay his bills.

Court will resume Wednesday at 8:40 a.m.

Editor’s note: CU News Corps will honor the victims of this tragedy with every post via this graphic.