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 on Aug. 23. "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.
The medical records showed that Alexis answered "no" when asked, "Do you have anything that could be considered a weapon?" The VA told the AP that was a standard question it asks veterans whom it treats in a triage setting.
Five days later, on Aug. 28, Alexis visited a VA medical facility in Washington, again complaining of sleeplessness: "Patient presents to ER with c/o (case of) awakening each morning about 4 a.m. like clockwork and he cannot figure out why this is happening."
He answered "no" when asked whether he was having feelings of hopelessness for the present and the future. Another doctor that night described the examination as "unremarkable." The VA gave him 10 more tablets of trazodone and sent him home just before 9 p.m.
Alexis, a defense contractor and former Navy reservist, went on a deadly shooting rampage at the Navy Yard on Sept. 16, spraying bullets in a hallway and firing on workers from a balcony. He died in a gunbattle with police.
He had purchased the shotgun he used two days before the shooting from a gun shop in Virginia. Alexis had been involved in at least two earlier shooting-related incidents, in 2004 when he was arrested in Seattle and charged with malicious mischief for shooting the tires on a construction worker's vehicle and in 2010 when he was arrested in Fort Worth, Texas, for firing a rifle into a neighbor's apartment.
No charges were filed in those two cases, but it was not immediately clear whether Alexis was answering honestly on Aug. 23 when he was asked whether he still had any weapons. The FBI told the AP it found no weapons when it searched the hotel where Alexis had been staying after the shootings.
Before the Navy Yard shootings, Alexis left behind a note that FBI agents recovered saying he had been targeted by ultra-low frequency radio waves for the previous three months — the period that covered his visits to the VA medical facilities when he denied he was experiencing any stress or violent thoughts.
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.