The doctor turned quadruple killer was wheeled into the third-floor courtroom, shoulders hunched, eyes scrunched.

Forced to court by Douglas County sheriff’s deputies, Anthony Garcia rolled into court as if he had rolled out of bed — with his unkempt beard, uncut fingernails and toenails, and the defiance that he has displayed throughout his 5-year court case.

“Wow — he’s a mess,” an attorney said from the back of the courtroom. “Like Howard Hughes (the Texas tycoon and recluse) — without the genius part.”

Garcia’s attorneys spent much of Wednesday — Day One of Garcia’s defense against the death penalty — trying to establish the mitigating factors that they say should spare him capital punishment for the March 2008 murders of 11-year-old Thomas Hunter and 57-year-old Shirlee Sherman and the May 2013 murders of Dr. Roger Brumback and his wife, Mary, both 65. Garcia killed the four, acting on a grudge that had festered after Dr. Brumback and Dr. William Hunter fired him from Creighton University Medical Center in 2001.

Attorney Jeff Pickens of the Nebraska Commission on Public Advocacy essentially offered a 3D defense against the death penalty: that Garcia was too dumb to become a doctor; that he felt the intense drive of his parents to become one despite his mental deficits; and that he became drunk and deranged after realizing that he would never measure up.

In essence, Pickens argues that Garcia became a killer — a sort of Frankenstein creation — because his parents pressed him into a field for which he wasn’t qualified and various medical school administrators passed him along, focused on his ethnicity rather than his ability.

That defense theory is an attempt to establish a mitigating factor recognized under state law: that Garcia “acted under unusual pressures or influences.”

Garcia was severely mentally ill and “burdened by a profound failure,” Pickens said. “All of which caused him to fixate on the two doctors he considered responsible for his failure.”

Douglas County Attorney Don Kleine said prosecutors agree with only one of the defense’s alleged mitigating factors: that Garcia had little criminal record before he killed his victims. Kleine said none of the mitigating factors will overcome the 10 aggravating factors that a jury found could merit the death penalty.

After this week’s hearing, a three-judge panel — Gary Randall and Russell Bowie of Douglas County and Ricky Schreiner of southeast Nebraska — will decide whether Garcia deserves death. An announcement isn’t expected for a month or two.

Garcia’s problems began with his parents’ dream, Pickens argued.

Estella and Frederick Garcia — primarily Fred — pushed Garcia to become a doctor, Pickens said. During Garcia’s childhood, they often would refer to Garcia as their future “brain surgeon.”

Garcia’s grades in high school and college didn’t portend a future in the medical field, Pickens said. He had, at best, a B average.

Despite that, administrators gladly passed Garcia along, Pickens said.

Garcia’s brother, Fernando, told authorities that his brother “did not want to be a doctor.”

In fact, Anthony Garcia, who studied pathology at Creighton, later wrote in a journal: “The primary problem with pathology is that you cannot live or work where you want to. ... People treat you like shit. It’s not what I wanted to be.”

And this: “Math was my favorite subject from first through twelf (sic) grade ... I wanted to be a mathematician. My parents would not let me.”

As those journals were aired in court, Garcia’s parents sat two rows behind their son. Fred Garcia had a long career with the U.S. Postal Service. Estella Garcia worked as a nurse. The couple, from Walnut, California, invested in their son’s education — and were so proud that Fred Garcia once proudly loaded up a van and drove his son cross-country for his first medical gig.

Garcia was admitted to the University of Utah Medical School, even though his test scores and grades were lower than typical applicants.

A current Utah medical school official told defense attorneys that he “had little doubt that (Garcia) was considered because of his ethnicity,” said Shara Aden, a paralegal for the Commission on Public Advocacy.

Nonetheless, Garcia graduated with a medical degree and headed off to his first residency program in upstate New York in the late 1990s.

He was fired from that residency after yelling at a radiology technician who interrupted him as he read flash cards. He then went to Creighton, where he was fired after a series of misdeeds, including leaving an autopsy subject on his face so the body became disfigured, and placing a prank call to another resident taking his medical exams.

Dr. Hunter, who headed the residency program, later told police that Garcia was Creighton’s “worst resident ever.”

After his firing from Creighton, he was accepted into the University of Illinois-Chicago. He took several leaves of absences from that program because of migraines. The director at that program said he accepted Garcia “because he had a quota to fill.”

“The cruelty in all of this,” Pickens said, “is that Dr. Garcia was set up to fail.”

Garcia didn’t prosper in his professional life. After his failings at residency programs in New York, Nebraska and Louisiana, Illinois was the only state to issue a medical license to Garcia.

Even while he was a doctor in Illinois, Pickens said, Garcia’s bosses limited his work with patients. He would do work akin to a physician’s assistant — at times getting decent reviews.

He didn’t last long in any job.

“We are not claiming that Garcia was a good doctor or even a competent doctor,” Pickens said. “There was limited care he was asked to give these patients. He wasn’t asked to do anything heroic.”

As his medical career floundered, Garcia looked to other professions. He once applied to become a police officer in Los Angeles.

He also applied to several law schools — albeit in an unusual way. He simply sent in his medical school applications, subbing the law school’s name for the medical school. The applications still included his reference to various maladies, such as spiked fevers.

That wasn’t the end of his “weird” behavior. One doctor who supervised Garcia noted that he used to eat a head of lettuce as if he were chomping into an apple. He would wash that down by drinking milk out of the jug. It wasn’t the only thing he ingested. He prescribed himself medications, including testosterone, even though tests indicated that he didn’t need it.

One thing that was consistent: Garcia’s affinity for booze and nude bars.

“He was the strip club version of Norm from ‘Cheers,’ ” said psychologist Kirk Newring. “It didn’t seem like he had a high social network.”

Loneliness enveloped him. Neighbors described him doing lawn work in full “Outbreak” hazmat gear. Another set of neighbors told authorities that he once drunkenly reported a theft to them. They told him to go back home, later seeing him standing outside his front door with a coat covering his head.

In 2003 — five years before his first set of murders — he told doctors that he dreamed of killing himself and co-workers. Garcia was hospitalized for 10 days after that vague threat. He later underwent electroshock therapy for depression.

In January 2013, firefighters and rescue squad personnel broke down the front door of his Terre Haute home and found him passed out on the living room floor, surrounded by beer cans and a gun.

Police seized the gun. However, Garcia bought another and used it four months later in the Brumback slayings.

While prosecutors say Garcia clearly acted on his grudge over his firings, Garcia’s attorneys suggested that mental illness fueled the murders.

In 2003, a doctor wrote that Garcia “can’t make the negative thoughts stop.”

“The mental pain is overwhelming,” Garcia told them. “It’s like the thoughts are not my own.”

Outside court, Estella Garcia said she couldn’t believe how her son looked. “Terrible,” she said. “It’s bad.”

And the couple wasn’t buying the idea that Garcia cracked under the weight of their expectations.

“It’s not like we pressured him or anything like that,” Fred Garcia said. “If he had a problem, if he wanted to do something else, fine.

“I can’t understand it. We’ve always supported him.”

Reporter - Courts

Todd Cooper covers courts, lawyers, trials, legal issues, the justice system and government wrongdoing for The World-Herald. Follow him on Twitter @CooperonCourts. Phone: 402-444-1275.

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