RALEIGH, N.C. — Defense lawyers for the Raleigh teen who killed five people in a mass shooting began presenting their evidence in his sentencing hearing Tuesday, depicting a seemingly normal child subjected to a sudden mental episode brought on by his acne medication.

Austin Thompson, 18, was 15 years old when he killed his older brother and four others and seriously injured two people in the October 2022 shooting in Raleigh’s Hedingham neighborhood. He pleaded guilty to all charges against him last month, The News & Observer previously reported.

Thompson’s sentencing hearing began last Tuesday as part of a requirement under state law for defendants found guilty of crimes committed when they were under 18. Superior Court Judge Paul Ridgeway will weigh evidence to decide if he will have a chance at parole after 25 years. The hearing is expected to last through Friday.

The prosecution finished presenting its evidence Friday.

Public defender Deonte’ Thomas gave a brief opening statement Tuesday, arguing that Thompson “lived a normal, ordinary life” until the day of the shooting.

“His brother was his best friend,” Thomas said. “He could not tell you why his brother was his first victim.”

“He cannot tell you why he wrote that note the way that he did,” Thomas continued. “And he cannot tell you why he ran down the streets of Hedingham terrorizing people that day. But leading up to that, there were no red flags.”

Rather than a premeditated attack, the then-15-year-old went on his rampage during a dissociative episode caused by minocycline, an antibiotic he was taking for acne, Thomas claimed.

“Austin did not know what he was putting in his body,” he said. “We know that it’s a rare side effect, but like I said, it is documented and noticed, and they make people aware that this is something that could happen.”

Thompson accepted what he did and tried to spare his victims’ families from further pain by accepting a plea deal, Thomas said. But, he argued, his client deserved a chance to return to society someday. — and, therefore, a chance at parole.

A normal childhood

The defense recalled Elise Thompson, Austin’s mother, as its first witness.

As defense attorney Kellie Mannette questioned Elise Thompson, she took the court through a series of family photos, beginning with Austin’s first days of life at UNC Rex hospital up to his last first day of school with his brother, James.

Clutching a tissue in one hand, Thompson described the seemingly picturesque childhood she and her husband, Alan, gave their two boys, Austin and James. Her family of four had lived in the same home Austin’s entire life, she said, and they attended church every Sunday. Austin and James saw both sides of their family regularly, with her parents flying down once a year and the Thompson family regularly traveling to Whiteville to see Alan Thompson’s relatives.

The brothers were always close, Elise Thompson testified, recalling how older brother James stuck a pacifier in baby Austin’s mouth when he heard him cry for the first time.

“He always watched out for him, too, when they were little especially,” she said.

The boys enjoyed traditions like baking cookies on Christmas Eve and donning Halloween costumes she made every year for her favorite holiday. As they grew older, Austin and James developed their own interests and personalities, with James becoming the extrovert to Austin’s more introspective personality, Elise Thompson testified.

In school, both children excelled, and the Thompsons never had to nag their sons to complete homework or get up on time, she said. Austin didn’t have any notable medical issues besides a one-off incident as a toddler, when laughing gas for a cavity treatment caused him to become angry, Thompson testified.

“The dentist said that was a pretty normal or pretty common reaction for children that don’t do well with laughing gas,” she said. “We had to go to a specialty pediatric dentist that actually put him under completely to have his two cavities filled on his bottom tooth.”

Family meeting on gun safety

A January 2017 photo of the boys and their father documented Austin’s love of hunting. He would regularly go with Alan on weekend trips to hunt squirrels, turkeys and doves, Elise Thompson said.

“As they got older, it was mostly Alan and Austin, and then James and I would be home for the weekend,” she testified.

That hunting interest included a family meeting on gun safety, she said.

“We all sat down, I remember, on a living-room couch one afternoon, and Alan (was) going through how to always keep the safety on and that we never keep the ammunition in the gun,” she recalled.

Neither boy saw their friends much outside of school, Thompson testified, and they handled the isolation of the COVID-19 pandemic well.

“It was an even keel the whole year-and-a-half or so that it lasted,” she said.

In a September 2021 school project for a Spanish class played for the court, Austin Thompson could be heard describing himself in Spanish as calm, creative and independent — an assessment his mother testified she agreed with.

In the last picture she would ever have of both brothers alive, Thompson described an Aug. 8, 2022, photo of the siblings as a typical first day of school portrait. Both boys appeared serious because they’d grown tired of the annual tradition for her scrapbook, she said.

After walking through Austin’s childhood, Mannette turned to his minocycline prescription, displaying photos Elise Thompson regularly took of Austin’s prescription bottle to remind her to call his medication order in — including photos from the day of the shooting. Both boys took minocycline, she testified.

“I remember that he took it on time once a day,” she said. “The medication ... did clear up their skin, and I didn’t notice any changes in (Austin’s) mood from taking the medication.”

Since the killings, the Thompsons have maintained their relationship with their surviving son, visiting Austin as much as his detention center has allowed and sending him weekly gifts, like books and jokes. Elise Thompson didn’t hesitate when Mannette asked her if she still loved her son.

“Yes, dearly,” she said. “Still hurts terribly, but yes. Love him dearly.”

Hospital visit after the shooting

Thompson testified she saw Austin for the first time after the shooting at the hospital, about 10 a.m. the day after the incident. WakeMed staff had met with Thompson and her husband to explain the gravity of his brain injuries, which he sustained when he shot himself in the forehead with a shotgun during a standoff with police. The 15-year-old was covered in tubes and medical equipment when his parents came to see him.

“We were told we could just see him for like 15 minutes or something and that there would always be a police officer there because of, unfortunately, the situation,” Thompson testified. “What I remember happening is I went, ‘Oh, my baby,’ and I tried to cover my mouth, because I started to scream, and I remember that (the nurses) caught me because my knees just buckled.”

Several observers in the courtroom gasped when Mannette displayed a photo of Austin Thompson in his hospital bed, two days after the shooting. The teen’s eyes were shut and his head was covered in tape and swollen, with blood pooling on his pillow in the photo.

“When the bullet went in his forehead, it went out the upper left side of his skull,” Elise Thompson said. “He did not have a skull for, I want to say until the following March, maybe less. They had to stitch up the entire side of his head.”

Nearly four years later, though Austin has made a significant recovery, the dreams she had for her son are gone, she testified.

“I know he did this horrible crime and that he has to pay for this crime,” Thompson said. “I just hope that ... hopefully he can be reevaluated and have a mental analysis with another neurologist and whatever else needs to be done to see if he can go back into society, if he’s capable of doing that.”

In the meantime, she said, Austin has mentioned hoping to work as a dental hygienist wherever he is incarcerated.

No history of mental health issues

Dr. George Corvin, a Raleigh-based psychiatrist, took the stand next to speak to Austin Thompson’s mental state before and after the shooting.

The 18-year-old is “a different human being” now because his frontal lobes were destroyed when he shot himself, Corvin testified.

“This has been one of the more unusual forensic evaluations I’ve ever completed,” Corvin said, noting that he was “shocked” Thompson survived his injuries and somewhat recovered.

In meeting with Austin, he found the teen to be “cooperative, genial [and] childlike” with a “very restricted range of emotional expression,” save for a sense of humor, Corvin said. He struggles with finding words and memory issues, especially around the time of the shooting.

Thompson’s IQ has improved about 20 points since his first post-injury tests, Corvin noted. But for a long time, his cognitive functioning was so impaired, his medical team didn’t feel he’d be competent to stand trial.

“He could not communicate effectively,” Corvin said. “He really was not viewed as understanding his situation, both in terms of what had happened and as a criminal defendant, initially.”

Nothing stood out in Thompson’s personal or medical history that could have triggered his massacre — except for the acne medication, according to Corvin. And no one in his life had raised concerns prior to the shooting.

“Rare things happen rarely, but they happen,” Corvin testified. “And there became more information to rule out the typical stuff that you see in mass homicides.”

Descriptions from eyewitnesses portraying Thompson as zombielike and eerily unaffected during the killings caught Corvin’s attention, he said.

“That’s the sort of thing you hear from people who see people in a paradissociative state, not in a typically motivated mass homicide, not somebody who is mad at the world, seeking revenge,” Corvin said.

Dissociation is a known, uncommon side effect of minocycline, which Thompson had been taking for around a year, according to Corvin, who testified he wouldn’t recommend taking such an antibiotic for years.

“In these medications, you can be on the medication for an extended period of time and then have it happen ,” Corvin said. “It can happen suddenly and acutely.”

The court broke for lunch just before 1 p.m. and was scheduled to resume Corvin’s testimony at 2:30 p.m.

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