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Ethics and Morality

Mass Shooters and the Myth That Evil Is Obvious

A forensic psychiatrist reveals lessons for us all in her proximity to a killer.

Key points

  • Psychiatrist Lynne Fenton treated mass shooter James Holmes before he killed multiple people in a movie theater.
  • The press and public scapegoated Fenton, erroneously believing she’d seen the signs and done nothing.
  • Fenton’s harrowing experience shows the need for public education on mass-murder psychology.
Drawing by K. Ramsland
Drawing by K. Ramsland

Those who treat people with serious mental illness know they risk treating someone who might become violent—maybe extremely violent. Author Kerrie Droban, a former defense attorney, interviewed Lynne Fenton to bring us Aurora: The Psychiatrist who Treated the Movie Theater Killer Tells Her Story. The subject is James Holmes, from his arrival as a grad student at the University of Colorado’s Anschutz Medical Campus to his arrest, trial, and sentencing for mass murder.

Droban explores Fenton’s experience of her notorious patient. Ordered to remain silent for three years, Fenton is the “only psychiatrist in the history of the United States to have been publicly outed, vilified by the press and media, her life threatened, and subjected to an internal investigation by her own university.” Now the records are unsealed and we can learn from her ordeal. No one is untouched by such a destructive act of violence. Uninformed allegations only worsen the collective trauma.

The Incident

At a midnight showing at Aurora’s Century 16 movie theater in 2012, Holmes threw gas and smoke canisters into the crowd and started shooting. He killed 12 and wounded 70. Only months earlier, he’d been a promising grad student in an elite neuroscience program. But he was troubled. He’d been uncommunicative in his limited therapy sessions with Fenton and he’d finally dropped out of school. No longer in therapy, he prepared a notebook with his vile musings and mailed it to Fenton a few hours before he entered the theater. She didn't receive it. She had no idea he even had a gun permit, let alone the multiple bombs and weapons he’d recently amassed. Although Holmes had revealed to her a desire to kill people, it had seemed more a life philosophy than a plan of action: he’d offered no hints about who, where, when, or how.

Fenton had tried to help him. She’d enlisted others. Even after Holmes lost access to her services, she offered to see him, anyway. He declined. She had no connection at all to the shootings. Still, post-massacre, she was on the receiving end of death threats and accusations, as if she were to blame for letting a monster rip through the community. People called Fenton a murderer.

Risk Assessment

Aurora tackles the notion that mental health experts possess a unique ability to foresee when an individual will behave violently. But it’s complicated. Threat assessment involves making educated predictions from a variety of factors from multiple domains, such as past history, present support systems, medical history, substance abuse, and the presence of certain types of personality disorders. They need accurate data and a lot of it, but Holmes yielded very little.

In addition, there are different levels of risk. In general, when threats are vague, implausible, inconsistent, or indirect, with no specific targets, this is considered low risk. They might just be venting. The risk level rises with specific targets and dates, evidence of planning, and an ability to carry it out. Then, the psychiatrist’s duty to warn or protect kicks in.

Fenton thought Holmes could be dangerous. He made her skin crawl. But she couldn’t identify a target or his timing or method. She asked a colleague to participate in the sessions. He also noted nothing that would warrant controlled psychiatric supervision. The law prohibits committing potentially violent people if there’s no clearly imminent threat.

That July, Holmes struck.

Fenton's Story

When news of the attack reached Fenton, “a darkness crept across the floor, a rushing heaviness that felt like a punch to the gut.” Horrified, she gathered with colleagues to follow the reports. She went through everything in her records to see if she’d missed something. Soon, she wondered if her university considered her a liability now, a mark against them that had to be removed. She wanted to set the record straight but she was court-ordered to remain silent. Due to threats, she wore a bulletproof vest. The press named her as Holmes’ psychiatrist, with the implication that he’d told her his plan. Even when her role was sorted out, people couldn’t release the blame. Many believed that her training should have made her able to spot the signs of impending violence.

Fenton opened her records to show she couldn’t have seen anything in her former recalcitrant patient. She had no idea why he’d sent her his notebook. “It was a sobering fact,” she told Droban, “but Holmes’ evil wasn’t obvious; it defied explanation. He fit none of the over four hundred categories of mental health disorders listed in the DSM. He was unique….He was that rare malignancy, that silent killer no one could have predicted.”

Afterward, Fenton gave up her home and her practice, and retreated to a private place: “There was a part of me that had irrevocably changed.”

The gut-punch of this book is the shooting itself and its immediate aftermath. It’s raw and disturbing but also full of heart. First responders held airways open or intestines in place as they slipped in puddles of blood trying to save whomever they could. “There was so much blood,” one said, “I could hear it sloshing in the back of my car.”

Author Kerrie Droban was affected. “It was easily one of the most difficult books I've ever written,” she said, “not only for the subject matter but also for the lingering trauma. I knew this world so well, having been a capital defense attorney and representing clients like Holmes, the ‘worst of the worst.’ My job, for many years, was literally saving killers. I would argue before the Supreme Court justices the reasons why people like Holmes ‘deserved’ a second chance. I knew what it was like to be reviled by jurors and the public as Holmes' lawyers were and what it was like to straddle that fence of representation and revulsion. Lynne's story was the lens I used to write about the ripple effects of trauma, how no one really survives these kinds of tragedies; we just fashion a new ‘normal.’ During the writing of this book, I resigned from capital litigation.”

No one who knew Holmes came forward to say they’d seen it coming. He’d kept his secrets. Even psychiatric training and experience will fall short when patients remain guarded and duplicitous.


Fenton, L. & Droban, K. (2022). Aurora: The Psychiatrist who Treated the Movie Theater Killer Tells Her Story. Berkley.

Monahan, J., & Skeem, J. L. (2014). The evolution of violence risk assessment. CNS spectrums, 19(5), 419–424.

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