WASHINGTON (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.