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What happens when accused killers plead insanity?

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"There was no dispute between father and son. No argument, no grudges," Farry says. "None of that stuff ever existed, so it was an act that was otherwise inexplicable."

Fitzgerald reportedly told detectives that he thought his father was Satan. Family members suspected it was the medication that caused him to kill. Fitzgerald's statements, the family's theories and the paranoid way he acted when Farry first met him prompted the lawyer to hire a psychiatrist. When the psychiatrist concluded that Fitzgerald was insane, Farry wasn't surprised.

The state doctor who evaluated Fitzgerald agreed. But Cecil says prosecutors wanted to make sure. Fitzgerald had been calm after the murder, holding out his wrists for the police to handcuff him before they'd even asked, he says. And at the station, he had invoked his Miranda rights. To check that Fitzgerald wasn't faking his mental illness, the prosecution hired a third expert to review the first two reports. That expert didn't talk to Fitzgerald but concurred after reading the other doctors' conclusions.

"We had three separate professionals telling us that at the time of the offense, he was insane," Cecil says. "We had no evidence to the contrary except that he was calm afterward." Prosecutors could have argued that the mental evaluations were wrong and that Fitzgerald was sane and had killed his father for no reason. But Fitzgerald didn't seem like the type, Cecil says, and so the DA's office agreed to forgo a jury trial and hold a truncated trial before a judge. In September 2009, the judge found that Fitzgerald was not guilty by reason of insanity and sentenced him to the state hospital.

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Holmes pleaded not guilty by reason of insanity on June 4, 2013.

By law, once a defendant pleads insanity, the judge must order him to undergo a mental examination to determine whether he was insane when he committed the crime. In a death-penalty case, the defendant will also be examined to determine if his mental illness is so great that it precludes him from being executed.

If the lawyers or the judge request it, a defendant can also be examined to determine whether he's competent to proceed. Competency is different than sanity. Rather than a measure of what the defendant was thinking at the time of the crime, it's a measure of whether he's now able to understand the charges against him and help his attorneys.

The first mental evaluation of Holmes was completed by early September 2013, three months after his plea. While its results are still secret, Judge Samour has revealed one conclusion: Holmes is competent to stand trial.

A defendant's competency can be restored with drugs and treatment — and it's widely speculated that Holmes is heavily medicated. When he first appeared in court three days after the shooting, he seemed dazed and looked as if he were struggling to stay awake. Experts consulted by every news outlet from CNN to Entertainment Tonight offered the opinion that Holmes was taking serious prescription drugs. He's often seemed unemotive in subsequent hearings, not speaking to his attorneys. Sometimes he clasps his hands in his lap and steeples his fingers.

If Holmes was indeed restored to competency with treatment, it wouldn't be the first time such a thing happened in an insanity case. In fact, it happened in the case of another young man accused of a brutal and seemingly senseless crime.

Joe Valentine Romero was just seventeen when he was arrested in 2003 for the gory stabbing death of George Turner, the 91-year-old former mayor of Walsenburg, a small town in southern Colorado. Investigators determined that in the summer of 2002, someone entered Turner's house as he was taking an afternoon nap, slit his throat and stabbed him more than a dozen times. Turner's body was found in a closet.

At first, the police were stymied. Nothing of value had been taken from Turner's house, there were no signs of forcible entry and there seemed to be no motive for anyone to kill the frail old man. Former prosecutor Cathy Mullens remembers that investigators chased down several leads before a local police detective suggested taking a closer look at Joey Romero. He belonged to a group of teenagers who hung out at a house down the alley from Turner, and the detective knew Romero to be a withdrawn kid who walked around town listening to music on his headphones. His favorite band, Mullens recalls, was the horrorcore hip-hop duo Insane Clown Posse.

"They talk an awful lot about killing people, stabbing people and decapitation," she says. "It's really dark, and it's very loud, and Joey listened to it incessantly."

The detective told Mullens and the other investigators that she'd run into Romero a few days after Turner's murder and that his demeanor had changed; he seemed more confident, and he even waved at her, which he'd never done before. A few days after that, however, Romero suffered a mental-health episode and was briefly hospitalized.

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Melanie Asmar is a staff writer for Westword. She joined the paper in 2009 and has won awards for her stories about education, immigration and epic legal battles. Got a tip? She'd love to hear it.
Contact: Melanie Asmar