Week 4 of the Pittsburgh Synagogue’s assault trial focused on mental health

Defense experts used words like psychotic, paranoid, illogical and delusional to describe Robert Bowers.

Prosecutors used other words: systematic, calculated, premeditated, deliberate.

Bowers, 50, of Baldwin, was found guilty of killing 11 people as they worshiped at Squirrel Hill Synagogue on Oct. 27, 2018. Let it count for the death penalty.

That was the focus last week as the trial moved into the so-called qualification phase.

To prove Bowers was murdered, the government must first convince the jury that the defendant intended to kill the victims and that at least one of four aggravating circumstances was met.

The victims of the attack were 97-year-old Rose Mallinger, a member of the Tree of Life – or El Simcha, congregation of Dor Hadash and New Light. Bernice Simon, 84, and her husband, Sylvan Simon, 86; brothers David Rosenthal, 54, and Cecil Rosenthal, 59; Dan Stein, 71; Irving Young, 69; Dr. Jerry Rabinowitz, 66; Joyce Feinberg, 75; Melvin Wax, 87; and Richard Gottfried, 65

Below is a summary of the witnesses called last week, their roles in the case, how long they took the stand and the evidence they presented.

Day 14

(On the first day of qualifying phase of the trial)

1. Diane Rosenthal (18 minutes)

Diane Rosenthal, sister of victims Cecile and David Rosenthal, was called to testify in court about her brothers’ mental retardation. She said preschoolers are mentally retarded, can’t read and have trouble tying their shoes. Both men relied on others for help and lived in Achieva’s group home in Squirrel Hill. She said her brothers loved worshiping at the Tree of Life and saw it as a “safe place.”

2. Michelle Weiss (10 minutes)

She told jurors that her parents, Sylvan and Bernice Simon, both suffered from multiple medical conditions before they were killed in the synagogue. Weiss said her mother had both knees and her left hip replaced and used a cane to walk, while her father had macular degeneration, needed hip replacement surgery and had chronic neck and back pain.

3. Howard Fienberg (12 minutes)

He told the jury that his mother, Joyce, spent five years caring for his father, who had cancer, before his death, and cared for her own mother and mother-in-law. Everyone else’s medical needs took priority over hers, he said.

4. Jeffrey Garris (34 minutes)

A Pittsburgh police SWAT officer described Bowers’ assault on law enforcement officers who responded to the synagogue. He told jurors how dark it was in the room where the gunman was hiding, and how Bowers had set up in a corner to dim responding officers.

5. Jody Cartwright. (9 minutes)

She told jurors about her father, Melvin Sum, and how he has hearing loss. He was wearing basic hearing aids, but they weren’t as good as they could have been. Wax is completely deaf in one hearing and 50% hearing loss in the other.

6. Joseph Stein (7 minutes)

His father, Dan Stein, told jurors he used a CPAP machine to combat snoring and lost mobility as he got older. He expects to need hearing aids in the near future.

7. Brian Collins (22 minutes)

Collins, an FBI agent in Pittsburgh and a member of the Evidence Response Team, testified about the multiple ballistic injury sites found in the synagogue where the victims were shot.

8. Stanley Mallinger (9 minutes)

He lived with his mother Rose for at least the last 10 years of her life. She suffered from glaucoma, wore hearing aids and had to use a walker around their home. She could no longer go out on her own and at 97 was the oldest of the victims.

Day 15

9. Dr. Vijayalakashmi RajaseKaran (38 minutes)

A neurologist and epileptologist with UPMC reviewed an ambulatory EEG, which measured electrical activity in the brain over a 48-hour period, on December 14, 2021. She said the results showed a “tendency to have epilepsy.” But he did not have any epilepsy during the test. She also said the test cannot be used to determine whether a patient has had seizures in the past or to predict them in the future.

10. Dr. A.S. Joseph Mettenberg (35 minutes)

A UPMC neuroradiologist testified that he performed the initial MRI evaluation of Bowers’ brain. He says Bowers has widespread “white-matter hyperintensities” that can be caused by many things, including migraines. He called the MRI a “conventional MRI of the brain,” and it’s not diagnostically useful.

11. Dr. James Michael Montez (32 minutes)

A UPMC radiologist testified that he reviewed the PET scan of Bowers’ brain. He said he was asked to look for signs of epilepsy in the scan but found none.

12. Dr. Andrew Newberg (1 hour 56 minutes)

A nuclear medicine physician at Thomas Jefferson University in Philadelphia is an expert in evaluating PET scans, which measure blood flow and glucose processing. He testified that a PET scan of Bowers’ brain showed significant abnormal activity, including an enlarged frontal lobe and abnormalities in the brain. An overactive frontal lobe can lead to a constant state of euphoria, he said. Related problems may include problem-solving, information processing, organizing and planning, and emotional regulation. Newberg also found abnormalities in Bowers’ left medial temporal lobe, which may be associated with memory loss and confusion, and which is controlled by the hypothalamus, the autonomic nervous system.

13. Dr. Murray Solomon (57 minutes)

A California neuroradiologist has been called an expert in MRIs. Solomon testified that Bowers’ scan showed an unusually high number of white-matter lesions indicative of schizophrenia. They can also cause uncontrolled blood pressure, smoking and migraines, he said. Solomon said, in question, that until a few weeks ago he did not know that schizophrenia could cause white-spots. Google said it did and found several articles to prove it.

Day 16

14. Dr. Siddharth Nadkarni (5 hours, 50 minutes)

Nadkarni, who is certified in six specialties, evaluated Bowers for more than four hours in September 2021 and performed a neurological exam on him. He diagnosed Bowers with schizophrenia and epilepsy.

Nadkarni described Bowers as paranoid, “quick to trigger” and unable to assess stimuli and read the world properly. Bowers says he misinterprets information and finds things threatening that aren’t.

“He cannot make decisions using proper judgment based on delusional beliefs,” Nadkarni said.

The doctor recounted the information he found in Bowers’ medical records. In the year In 1985, when Bowers was 13 years old, he was admitted to McKeesport Hospital for “domestic violent behavior” after he threw flammable liquid at his mother and tried to light it on fire and allegedly “threatened to kill himself.” It was the beginning of a nine-month period of inpatient hospitalization for Bowers at three different facilities.

Nadkarni in 2004. Nadkarni told the court he was hospitalized for three days at St. Clair Hospital in Mount Lebanon, worried he might be homeless after putting a loaded gun in his mouth.

He described Bowers as having a flat affect and a slow process. He described problems with the prefrontal cortex, which controls executive functions such as decision-making, planning, judgment, and reasoning. There was damage to the temporal lobe, which controls emotional control, hearing, memory and language processing.

Nadkarni said Bowers was “deeply confused” after he was arrested on charges he believed dye from his Butler County Jail uniform was getting into his body and then out of his ID wristband, leaving him red. Then he poured back into the pen.

Day 17

15. Dr. Richard Rogers (5 hours, 32 minutes)

A forensic psychology expert told jurors the defendant was “absolutely psychotic” when he committed the crime. He spent more than 18 hours evaluating Bowers over four days last fall at the Butler County Jail, where he was incarcerated. He said the results showed Bowers was schizophrenic and delusional at the time of the crime.

Bowers cringed at the thought. “This became his life,” Rogers said. “Thinking, planning, preparation. The action became his life.

Rogers believed that Bowers would be honored for his actions on “Day of Attack,” and deserved a parade or a medal. He said he’s proud of what he did, but disappointed there weren’t more victims.

16. Mike Williams (29 minutes)

Williams, a corrections officer at the Butler County Jail, has been called as a state witness due to a scheduling conflict. He told jurors he had worked at the restrictive housing unit where Bowers had been held since he arrived there 4½ years ago. He described the accused as very orderly and disciplined and said that he understood the instructions and followed the rules. Williams also said Bowers has good hygiene, sleeps regularly and can stay on topic during conversations. The accused watches a lot of news programs on television, does not take any medication and has no mental health tests. Williams also said he never knew Bowers was cheating. As for the prison uniform, they are known to apply the dye to other clothing, walls, and identification bracelets worn by inmates.

Day 18

15. Dr. Richard Rogers (Continued 3 hours 38 minutes from a day earlier)

Testimony continued Thursday, with Rogers telling jurors he didn’t know Bowers was mentally ill and believed the defendant had no understanding of his mindset.