A U.S. military psychiatrist found the man accused of a key role in the USS Cole bombing to be suffering from depression and Post Traumatic Stress Disorder but cogent enough to face trial at Guantanamo Bay.
Abd al-Rahim al-Nashiri was able to keep his focus and for the most part responded appropriately through an Arabic language translator during a nearly five-hour meeting inside his prison building, Army Maj. Anthony Ralston, the doctor, testified Oct. 22 and 23. Ralston evaluated al-Nashiri’s mental competence as part of a Sanity Board ordered by Army Col. Matthew Fitzgerald, the judge overseeing the case.
Al-Nashiri, a Saudi citizen, is accused of conspiring in the suicide bombing of the U.S. Navy warship in Aden Harbor, Yemen on Oct. 12, 2000. Seventeen U.S. sailors were killed in the al-Qaeda attack, and dozens more were wounded. Jury selection is set to start Nov. 2 if Fitzgerald finds him competent for trial.
Ralston offered a starkly different description of al-Nashiri’s cognitive abilities from testimony earlier in the week by a psychiatrist and psychologist, both Pentagon-paid defense experts. They declared him incapable of understanding the court proceedings and assisting his lawyers in his defense, making him incompetent.
Ralston quoted al-Nashiri as telling him several times “I’m not crazy” during his examination. Asked about his mood, the prisoner replied “garbage.” But the doctor said the prisoner’s “outward appearance of emotion, attention was more jovial, more engaging than someone who felt like garbage.”
Prosecutors called no witnesses, leaving it to Allison Miller, al-Nashiri’s lead lawyer, to call Ralston and question him first about his report. He explained that there is a very high standard for finding someone incompetent, and al-Nashiri didn’t qualify. He said he had previously conducted 13 competency exams in his five years as a military psychiatrist and found two prisoners incompetent.
“Just having a diagnosis of PTSD doesn’t make you incompetent,” Ralston said. Someone who is schizophrenic can be competent, he said, but someone who is floridly psychotic is “probably going to be incompetent.”
Al-Nashiri was held by the CIA from 2002 to 2006. At an agency black site in Thailand, two contract psychologists waterboarded him and held him naked in a dark cramped wooden box among other “enhanced interrogation techniques” in an effort to get him to disclose future planned attacks and other al-Qaeda secrets.
Ralston said he had “no doubt” the prisoner had PTSD and depression and also an understandable distrust of his U.S. medical providers at Guantanamo. So, the psychiatrist said, he stopped shaving days before meeting al-Nashiri to conduct the mental assessment and wore a Hawaiian shirt and tan pants to look less like a military physician.
It will now be up to Judge Fitzgerald to rule on his competency after closing arguments Monday.
For the defense, Dr. Terry Kupers, a psychiatrist since 1972, met the prisoner for roughly the same amount of time as Ralston but over three days at the courthouse complex. Al-Nashiri has vomited on himself during the 10- to 15-minute commute from the prison to court, his lawyers say, because he has flashbacks to his time in CIA custody, and so he is medicated with an anti-nausea drug that makes him drowsy on the ride – and then is given a stimulant for ADHD, which make him anxious and sometimes act out.
Ralston, a psychiatrist since 2021, met al-Nashiri just once, for four hours and 44 minutes, no break, at the Camp 5 prison where he could walk from his cell to a conference room, no need for sedatives or stimulants.
Al-Nashiri’s lawyers had asked Ralston to also meet the defendant a separate time at the courthouse complex, to see how his behaviors changed. But the prisoner refused a second meeting.
Kupers said the prisoner’s attention was so scattered at the courthouse during his examinations that the doctor abandoned the idea of conducting a baseline 20-question test that evaluates a defendant’s understanding of the proceedings and roles of different participants in a criminal trial.
Ralston said al-Nashiri had taken a Tylenol and migraine medication during their interview and would digress at times. But Ralston said he was able to get the prisoner back on topic and conduct basic testing, including asking him to memorize five words and interpret proverbs.
Al-Nashiri was able to recall three of the words five minutes later. Through an Arabic translator he interpreted the expression “People in glass houses should not throw stones” to mean “If you are weak then don’t fight with others.”
Allison Miller, the prisoner’s capital defense lawyer, cited the reply as an example of the prisoner getting it wrong. Ralston called his interpretation “abstract but idiosyncratic.”
Over the objections of prosecutor Navy Cmdr. Clayton Trivett, the judge also heard testimony from Dr. Sondra Crosby, a recognized expert on diagnosing and treating torture victims. She has estimated that in her Boston-based practice she has evaluated about 1,000 torture survivors and has been meeting with al-Nashiri at Guantanamo for 13 years.
Crosby is an internist and until recently served as a commander in the Navy Reserve. She was the first doctor to diagnose al-Nashiri with PTSD, a finding that was upheld by a military medical board in 2013. But she is not a mental health practitioner, and so unqualified to offer an opinion on a person’s competence to stand trial.
Instead, Crosby described for the judge a series of episodes of violent and humiliating abuse that al-Nashiri experienced in CIA custody, including some episodes that were described in CIA reports and court testimony that al-Nashiri does not remember.
“He is one of the most damaged people that I have seen,” Crosby said. “He survived a brutal period of torture during 2002 to 2006 that was designed to break him. And it did.”
Crosby said al-Nashiri’s flashbacks and nightmares have been better and worse across the years and that he “cannot regulate himself.” He has angry outbursts over minor things and is known to bang loudly on his cell door over his grievances.
Concentration is also a problem, she said, and he complains of memory loss, although he does not consider himself to be ill.
“Not once in 13 years has he completed a task” assigned by Crosby, such as keeping a sleep journal and, separately, a record of his nightmares. “He’s very apologetic,” she said, but has never done it.
To the suggestion that al-Nashiri was malingering, Crosby replied: “There is no way that someone can malinger for 13 years and be as consistent.”
