David Zalubowski/AP
Police stand outside a King Soopers grocery store in Colorado after shooting on March 22, 2021.
CNN  — 

A retired emergency room physician on Thursday described the “calm expression” on the face of a shooter “hunting” down shoppers at a Boulder, Colorado, grocery store more than three years ago when 10 people were gunned down.

The testimony came after jurors heard a prosecutor describe the final moments of the victims during opening statements in the long-delayed trial of Ahmad Al Aliwi Alissa.

Alissa is facing 10 counts of murder, 38 counts of attempted murder and numerous other charges after a judge ruled last year that he was fit to stand trial in the mass shooting at King Soopers on March 22, 2021. He pleaded not guilty by reason of insanity last November.

Days before the massacre Alissa was able to purchase a Ruger AR-556, which he used in the killings, after passing a background check, according to court records and the owner of a gun shop in Arvada, Colorado.

The mass shooting occurred in a state familiar with such tragedies, including the 1999 Columbine High School massacre in which 12 students and a teacher were killed and the 2012 Aurora movie theater shooting that claimed 12 lives.

One witness, Dr. Alison Sheets, a retired emergency room physician, told jurors Thursday that an afternoon of grocery shopping was interrupted by “loud noises.” She initially crouched behind a cardboard display before sliding sideways into a shelf of potato chips. Her yellow ski jacket blended with the yellow bags of chips, providing her cover, she said. She recalled gunshots and screaming.

At one point, Sheets testified, she could see the shooter walking by the aisle where she was hiding.

“He was hunting … as he walked by,” she said.

She added, “I did see his eyes. He was looking down the aisle… I sort of remember the stare looking down that aisle. It was not something I wanted to lock eyes with. So I turned away pretty quickly.”

She described a “calm expression” on the shooter’s face.

In the next aisle, Sheets testified, she heard a familiar sound from her work in emergency medicine.

“I heard someone die – just a little breath of exhalation of someone collapsing and dying. And I smelled blood after that,” she said, adding that she’s had “the unfortunate experience of seeing and being around multiple people who have passed.”

“I heard no other sounds from that spot for the remainder of the day,” Sheets said calmly.

Several jurors appeared visibly upset; some family members of the victims sniffled in the gallery. The defense did not cross-examine the seven witnesses who testified Thursday.

In its opening statements, the defense said it was “not contesting that the person that killed 10 innocent people and brought fear to so many others and grief and suffering to countless” was the defendant sitting in court.

Public defender Sam Dunn said Alissa has a “severe … treatment-resistant form of schizophrenia” and was “in the throes of a psychotic episode” the day of the shooting. The defendant told a psychologist during an evaluation that he heard “consistent voices … Just the consistent voices.”

On that March afternoon three years ago, prosecutor Michael Dougherty told jurors in his opening statements, the gunman picked “the perfect place for a mass shooting,” a bustling supermarket where people were stocking up for the week, stopping in for coffee, or picking up lunch.

“King Soopers is more than just a supermarket. It’s their place. It’s a community spot,” Dougherty said. “It’s the place they go over and over and over again. And on this day, it’s a place people will go and die.”

As Dougherty addressed the jury, Alissa – in a white button-down shirt with stripes and dark gray slacks and wearing dark-framed glasses – frequently looked around the courtroom and into gallery, mostly at victims’ families. He seemed to pay close attention.

The slaughter commenced at 2:25 p.m., and for 10 victims “their time on earth is about to come to an end,” the prosecutor told the jury.

“Each one of them, each one of the 10, had lives and families and loved ones and careers and dreams. They had gone there thinking about what they were going to make for dinner, who they were going to have dinner with, a loved one they would never see again.”

Dougherty then recalled the horrifying final moments of the 10 people who died that day, starting with Neven Stanisic, 23, who had fixed the espresso machine at the Starbucks and was on the phone with a co-worker in the minutes before he was killed in the parking lot. Kevin Mahoney, 61, described as a “loving husband, father and grandfather” and a Soopers regular, also was gunned down outside the grocery store. The prosecutor said his body was nearly run over by a woman he had just exchanged a smile with when she sped out of the parking lot in fear moments later.

The victims included Teri Leiker, 51, a longtime Sooper employee and fixture in the community who was fatally shot while bagging groceries with a smile on her face, according to Dougherty. And Jody Waters, 65, who lived the final seconds of her life hiding under a checkout counter. The shooter killed the first eight victims in 68 seconds.

At one point, the defendant spared the life of a 90-year-old man who the prosecutor said showed “no fear” or panic as he came face to face with the gunman.

“What does this tell you? This will tell you that the defendant was intentionally targeting people who were in fear and who were running, who he had power over, who he was scaring and who he could chase and kill,” Dougherty said.

He reminded jurors what they will need to decide, noting the shooter hunted down and executed his victims over and over and “finished them off.”

“Was the defendant so diseased or defective in mind that he was incapable of distinguishing right from wrong with respect to the murder of 10 individuals and the attempt to murder 25 more or suffering from a condition of mind caused by mental disease or defect, as the statute reads, that prevented him from forming a culpable mental state?” the prosecutor said.

“And in this case, it’s going to be intent. That’s what this case is going to come down to… The central issue is going to be his claim of not guilty by reason of insanity. Mental illness does not mean someone’s insane. Mental illness does not mean someone is insane when someone kills someone, or two people, or three people, or 10 people.”

In the end, realizing he was surrounded and outgunned, the defendant tried to ambush nearly a dozen officers moving in on him in the rear of the supermarket. He fatally wounded an officer before Alissa himself was wounded in the leg, the prosecutor said.

“At this moment, he’s done his ability to instill fear in others, that’s over. And the killing is over,” Dougherty said.

The defendant hears police announce: “The store is surrounded. Surrender now.”

“When you ask yourself in deliberations, did the defendant know the difference between wrong and right, you’ll ask yourself this question, ‘What did he do when they demanded that he surrender?’” Dougherty said, noting the shooter immediately put down his gun and ammo and removed all his clothes except for his underwear.

“I surrender. I give up,” the prosecutor said witnesses reported hearing the defendant yell.

“That’s how you’re going to answer the question of, ‘Did you know the difference between wrong and right?’ He stripped down to his underwear because he knew that if he presented any armed threat to law enforcement, they would likely shoot him again and kill him. And he wanted to live.”

But Dunn stressed that Alissa is far along the schizophrenic spectrum and being treated with Clozaril, which he called “the anti-psychotic of often last resort.”

Under Colorado law, Dunn told jurors, “You can understand what you’re doing is illegal, and you can be insane.”

For someone like Alissa suffering from delusional, paranoid thinking, the public defender added, “Your reality is not the reality of the world, it’s the reality of the illness in your mind.”

Alissa’s “disorganized thinking led to nonsensical, illogical behaviors,” Dunn told the jury.

The defendant’s family emigrated from Syria when Alissa was very young. His disorder went untreated because in Syrian culture mental illness is sometimes confused with demonic possession, Dunn said. That’s what Alissa’s father thought was ailing his son.

A district court judge in 2021 initially ruled Alissa incompetent to stand trial after he was evaluated by a defense expert, two doctors from a state hospital and a doctor selected by the prosecutors, according to court documents filed by the Boulder County District Attorney’s Office. Doctors determined Alissa’s condition got worse while at the Boulder County Jail. He was later sent to the state hospital for treatment.

Last October, however, the judge found him competent, noting that although Alissa was diagnosed with schizophrenia, evaluations did not show he suffered delusions that would interfere with his ability to stand trial.

Colorado District Court Chief Judge Ingrid Bakke at the time “strongly urged” the Colorado Mental Health Institute in Pueblo to retain him due to the “gravity of this case.” The state hospital granted the request. Alissa had been in the hospital for more than a year before his condition began to improve when he resumed taking his antipsychotic medication, according to Bakke’s order.

On July 30, Bakke granted a defense motion asking that Alissa be returned to the Boulder County jail. His lawyers argued that keeping him in Pueblo would deprive “his ability to understand the nature and object of these proceedings.”

Dean Schiller/ZFG Videography
Ahmad Al Aliwi Alissa is led away in handcuffs from the scene of the shooting in 2021.

Noting Alissa’s right to “consult with counsel” and “meaningfully participate” in his defense, his attorneys wrote: “The magnitude of this case is plain and obvious.”

Families of the victims have grown frustrated with delays in the case, a prosecutor told the court last summer. And more than three years after the bloodshed, a clear motive continues to elude authorities.

The afternoon of the shooting, Boulder police 911 received multiple calls, according to a court affidavit. One caller told dispatchers the shooter shot out the window of a car and chased a man toward the street. Others said the shooter wore “an armored vest.”

Multiple callers said they were hiding in the grocery store. Employees told dispatchers they “observed the suspect shoot an elderly man in the parking lot. The suspect then walked up to the elderly man, stood over him and shot him multiple additional times,” the affidavit said.

Among the people killed was 51-year-old Boulder police Officer Eric Talley, who was one of the first to respond, former Boulder Police Chief Maris Herold said at the time. Witnesses told dispatchers the shooter fired at police, the affidavit said. Officers had exchanged gunfire with Alissa at the store, according to Herold.

The other victims included store manager Rikki Olds, 25; store employee Denny Stong, 20; Tralona “Lonna” Bartkowiak, 49; Suzanne Fountain, 59; and Lynn Murray, 62.

Witnesses described the confusion and fight for survival in the grocery aisles. Some shoppers fled through rear doors to the employee area, where workers helped them navigate the unfamiliar space to safety. Others hid in storerooms. One man waiting for a Covid vaccine grabbed his two young daughters and hid in a coat closet. A pharmacy technician took cover under a desk and called her family to say she loved them.

Alissa, by the time he was arrested less than hour after the first 911 calls, had “removed all his clothing and was dressed only in shorts,” according to the affidavit. He sustained a gunshot wound to his upper right thigh.

Alissa’s family emigrated from Syria, his 34-year-old brother, Ali Aliwi Alissa, told CNN at the time. The brother said Alissa was paranoid and often believed he was being followed. The suspect lived most of his life in the United States.