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FAX NO. 817 782 4294

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MEMO ENDORSED
NAME: Siddiq~,Aaha REGNO. 90279-054 DATE: Novcmbar 6,2008

IDENTIFICATION AND REASON FOR RRF&RRAL:

Ms. A d a Siddiqui is 36-yeawld fanale of Middle Enrtem docent &om Knrochi, Watm She
won 06nt to thc P d d W e a l Catm P C ) , CarmmU, by the Uuited S b t a District Court,
SouthernDistrict of New Yarlr,pmuslrt to Title 18,U.S.C. # 4241(b)with queetbm rcguding
her competence tb stand trial. Ms. Siddiqui io baing chargad with Attempted Murder of Oficcrs
and Employass of tho United States, Attempted Murder ofUnited Statee Nationals, Anaed
Assault of United Statse Ofliccm and Emplayaas, P i m e of a Fircam During a Ciime of a
Violence, and t b c oortlltr of Asuult of United Statem Ofttcas rmd Bmploycea.
Prior to the initial intenhaw, the nature end purpoas of thb Corat-ombd ovalualion woo
expiabed to Mu.Siddiqui. She wan infinmad that during the oourse of tbia avllnasion, tht wual
conditions ofc o n f i d s a which
~ apply to a doctor-patlent rclatiouship would not exist. She
was infPrmed any i n f m m obtaid dwhg the o o w of intervimr, M u g , and obcorvation
would be subject to hc1udoa in a mport which wouM be 8nbmittod to the md both
attonuays. Ma.SWqui indicated 00 of thb wamhg asrd a p o d to proccad with
the svahratim,

EVfiUATION PROCEDURES:
During the courso of this evrrluation, Ms.Siddiqui war intarviewed by LaUc Powem, Ph.D.,
Fornusic Psycbolo@t. O t k memkm of the f d team,as well as ~ o n rmdl medical
stnEf, had the opportunity to observe hsr behavior d u a g tbe mum of thie evaluation. Their
mmenta and observations were d Mprior to tho p r e p d o n o f thie mpoxt. la addition,
many of her talophoue cdlr b her m a ,Mu- Siddiqul, wore monitared.

Sarah Kunak, Defanne Attamcy, October 3 aad 30,2008

Christopher LaVlgac, Amismt U M Seates Attomy, October 3 and 8.2008
Muhammad Siddiqui, brother of tbe MWlmt, Odoba 9 and 17,2008
Motrtab Syad, Feden1 Buroau ofSnvashigWon November 6,2608
Jodi Almodova~,F o d d Bureau ofinvsaigaoion &ow, November 6,2008

Ordm for Psychiatric Bxamirurtion, dated October 1.2008 (2 pagar)

Memo writton by Dr. ZPhair Qweshi, datbd October 3,2008 (1 page)
Criminal Indictment, detd Saptember 8,2008 (8 pages)
Letter writtau by Christaphar Lavignt to Tha HoaDnble Richard -1, dated
September 5,2008 (1 page)
.la#er written by Cameron Lindsay to The Honorable Richard Barman, dated
September 10,2008 (2 papa)
WM
E*h; h;+
11/14/08 F R I 18:Ol ITXlR.1 KO 88911
MlRENSIC EVALUATION
SIDDIQUI, MFSA
REG NO.90279454
PAGE 2
Letter written by Elizabeth M.Fink to The Hmombb Rlohatd B4sman, dated
September 3,2008 (6 page61
Medical toconfr ftom Tbe Medical Collegs of Gaotgk dated Au* 4, U)08 (1 0 p a w )
Medical mwrds B.om B q p m Airfield, A f m b m , dated July 18 - August 3,2008
(apptoximatety 120 pagcu)
Federal Burwu of Inveoti@on report, dated July 21,2008 (2pages)
Fedora1 Bunau of Inmatigation report, dntd A m 7,2008 (2
Federal Buroau of I n v d g d o n report, bted A u m 8,2008 (2 pages)
Bureau of Primns Hdh S d # r PaydWrio notarr, dated August 23,2008 - September 10,
200B (36pages)
-
Bureau of Primom Poychology Data Sy8Ssm not* dattd August 23 Septembsr 15,2008
(40 PWa
United Statm Depmbnbnt ofJuetico Telaphcme Call Lmguagc Tmnscripts f k a oall made
by MB.Siddiqui to hcr brather, Mubonrmd Siddiqui, dated October 23,2008 (12 pages)
United States Department of Juotica Telephone Call LsngualEa T h m d p t a fb a call made
by Mr.Siddiqui to Syad Husrain, r mprcaontptive frorrn the Palcirtaa Bmbaesy. dated
O c t o k 23,2008 (18 pegas)
The mcdW mca& -g during tho cotme of W. Siddiqui's cvaluatim at
FMC cmrweu
BACKGROUND INFORMATION:
The information corrtaird in thin section t a com&te of that obtrincdthough ditect inmews
with Ma.Siddiqui d 6om the cdlatsd muma lhdabove, 3hc wan viewed as a poor
hirtorian; t h d r e , information tbnt w u to t
bquestiom llaked of the Court worc
verified with 001htmlmuw6.

Ms. Siddiqui was born on h

& 2,1972, in Kuclehi, Plrklstan. She haa one sister, F &
Siddiqui, and one brother, Muhwuaad Siddiqui. Me.Siddiqui rqmtad living in Zambia, AtXca
until primary scbaol. When rhe was 17 ysus old,she m o d to ]Hourton, Texas, to live with her
brother Muhammad, and than moved to Baston, Maawhwetts, to rttand graduate shaol. While
in graduate school, sbe met und married Mohammed Kbm, aa ancsthcstolologistof Pakistani
dcoent, and tbis union pduood three children: Maryam (age 12), Ahmed (age lo), and Sulbmm
(age 5). MB.SWqui and Mr.Khan rsportdy d i v d In 2002. hlthou,eh it baa bean widely
rcporcod through d o u s MWSmurceo thai Ms.Siddw'rr oldeat child, Mayam, ie currently In the
custody of her parents in Pakistan, tho loation o f har two younjjest children arc believed to be
unknown.
FORENSIC EVALUATlON
SIPDIQUI, AAFU
REG NO. 90279954

PAGE 3

Regarding ha education,Ma.Siddiqui attmdsd the univanity of ~oustoubu a p p t b x ~ 1 oy m

and tben t r a z l l f H to the M ~ u s e t t Institute
a of Techno-, where she d v e d a
Bachelors&D o p e in Biology in 1995, In 2001, Ms.Siddiqul received a Docforate Dtgrse in
Neuroscience hnnb n d e i s Univdty.

MEDICAL/PSYCHIATRIHISTORY:
Several attempts were made by a psychiatrist or pqwbologist to conduct a thorough psychological
exam at the Mctmpolitgl Detention Cartar 0in h o k l y n , Now Y m but Ma.Siddiqui
oansistcntly refbed to uuww mything mom than W c quadon8 re@ing her mental health
fmotioning. When she was intcndcwed at FMC Carswsll, ohe displayed dmilm -6;
however, she wm able to deny any hia4ty of mental health prablssnr. When Muhrmmad
Siddiqui was intmiewcd, he rapartad bis sirta3.had new raught tmatmmt ftom a mental htalth
profeesional aad the Gmily hod not prcviourly now Ma.SWqui to have my -tal Mth
pmblerna. He admitcod, howavor, that he has hed fmu contsrcta with hio wsbr in the laut thrw to
four yeere. Ho did report that his visits to FMC Carswell, the coatart of hie untarsa
converaationa were codbaing md diiecult to Ibllow.

R q d i n @ rha msdioal birtory, no i n t 4 o u was fbund to indicate Ma. S W q d had any

sijplficmt msdiad problem the rummar of 2008, whea she mffcred gunshot worn& to her
abdomaa. She hrs beca reluctant to allow medical &to tm t ha;however,htx ltut medical
cxaminatioa indicatad her at-1 wounds no lmgm q d d medical dressing and w m beliaved
to be healing woll. She waa alm fbuud to be h m excessive rntmtnd bl#dtne whcn
she amived at FMC Carswall but wae placed mmedication to mgulote her mcnarual cycle.
COURSE OF EVALUATION:

When Ms.Suddiqui arrived at FMC Cmwell, she t c M to submit to the vioual seamh p a s ,
which involves disrobing, as quired by Bureau of Riamaspolicy. A Use of Fome t m was
gathered and a vidm camera was brouht in for docummtath. When Ms. Suddiqui sow the
video cemcm, she began to cry and scream loudly, that the cuncra had Jiaady killed her
once. Bvcnturlly, rhe agreed to participate in tbe search voluatvily as bng as it was done by a
famde ofAcur and no video carnsrrur wsrs used. Nbr ecnnplethg the admimion process, she was
plaosd on the McdicaUSuqiooi Unit fw fhthcr evaluation due to her mwnt gun* w&.
After ttnw dam, ah0 waa moved to tha Mental H d t h Japdent ( M I ) Unit, am L rtaPdard practice
fbr dofendents undergoing C o u ~ 9 F d cvduaticm.
d Thm war some macan about her eating
llabits whan she amved became B ~ had O mibaed several meals at MDC Brooklyn and had an
extremely thin a p p e a m w . When asked abut Imr eating, she stated ahe was not reftrsing to eat
but rather, she simply had no appcdtc. She continued to express her Lack of appotitc during her
FORENSIC EVALUATION
SIDDIQUI, M A
REG NO.902791054

PAGE 4
stay at FMC Carswell. Ma.Siddiqui remrincd on Unit M 1 throu#hout the evalmtian, and b a ~
bean routinely observed and monitored by modtad, psychiatric. ard psycbolopical stafj. She has
rpcnt moat of het time iu h a mom d isolated ~~ the mt of the p&onQ. Although she
asked fbr a copy of the Kom, h e mted rbc waa unabla to road it vsry well. Duo to her religious
dliliation, she requested 8 cornmon fia% tray, which b pmpmd ~llowingthe dietmy
rcquhmnents of the Mualim religion. The firrt dmc she was sewed this my, nhe mpartad har food
had a "bitter tasta" and roposrtbd cxparimaing uavaw abdornM pain immediately afteroating om
or two biter. Tho next day, she axpraswd the belief that ba fi;ood was b d q poiranod and
requested to mceive the same tray am the other patients, stating, "Ifthe m y hm pork on it. I will
move it out of the way and ask my Qod fbr foq$vdllcm but I don't wrnt to oat poisoned fd."
She IdQatpmasd to a 8taiTmsmber thal &a Wt mme ofthe NUging M w o m trying to kill her
by poirotring hen W,and mentioned It least four nunsr by name. She also &amd thia belief
with her bmthmend a r s p m v e itamhe PakieUd Consulate d m telephone
mvdom.

She aleo deadbod e x p i w i n g auditory hall- during her evaluation period. She told
s w d serffmsmbm that s b o h a d r a n h e r b a b y d o ~ ~~~
andraquostedskberrbletogoto
sas him. Days lotar, shb nportbdher baby had waked into her mom to see her th4 nlght befom. ,

When demibin~thir incidant, rhc b s p to cry md stated, "'He was so thin and I don't think they
~ ~ when Mtctd about who warn caing far ha child, but contiuuod
arc W n g him." She w a ur\eloar
to report that her child viritd ha b h a call on numamu8 occprlom. Sbc also rsportcdthis belief'.
to othm patients on ha unit ,mt wall rn her brother md 8 rqmmtatiyt fiom dro PIWiltmt
Conarlata. This is conristent with ha behavior whbn shs wru king housed at MDC Bmoklyn,
where she also tcrportad recine her c M d m d exproad b u g b Qut the comctioaol and
clinical staff wsrs trying to ham k Sim# ha d v d at PMC Cmwoll, ehc bw mfhsed to
conrickr any puychotmpic modiootiaa and hae bson bxmhtont in agreeing to puticipata in
routine medical o m .

MENTAL STATUS:
Me.Siddiqui L a 36-year-o1d, Pakimani f h d e ofpetite build who appetrs her chronobgical age.
Her hygieac and pomfny throughout tha evaluation poriod wore adequate. She conriotsatly
maintained poar eye contact. She was mluotrnt to pmieipte in clinical interviawanand ox-
proeecutory belie& about the purpose of tho evaluation. Mom npecifidy, she rafusad to talk rn
pryahalogy staff when rha fint Mivcd, stating thlt the Court w ~ t hm
d to be killed and the
prychologim worked far tha Court. Whon har brother Muhammad wrs enliaod to explain thn
purpow of the waluation to bar, she bsgm to be slightly mole forthcoming during clinical
intmiowr. She continued to display difeculty in being dmkd to her sumdinge, chpite
numerous attempts to explain the lacation and pupoae of h a waluadon. When ahe would offcr
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FORENSIC EVALUATION
SIDDIQul. AAFIA
REG NO.m79-054
PAGE 3
aocounts of her erpssisnoa d h g tbo llus & month, she would often 09dWthe details and
locatiom where theso ~~~(pdoncee occurrud. Ha dtsntioa and Coacontrationwcrs poor d, by
her own admission, she got8 confLeed sarrily wban tryin& to procc~sinfomation. Sho npoxtrd, '2
get confirad and I thfnlr I oonfirsc other people when I sm talking My b r o t b even soid I
canfurai him when hc a m a to visit." Ha rpaochwar quiet, with appropriate mte and tom,but
the content of her a p c h wre o h prooccupied with tboughtr that focursd on har cumntly being
doad. For instance, whm aekod a q d o n , u b would oitm w n d , "It docs nat matter, I em
d d myway." Much of tbe con- of im c o n v d - were tangential d difticult to follow.
She was alao very difllcdt to rcdbct. She rsparted dmui halluchtionn of her o h i l b . She
displayad soma range of motion. but h a a f f b twr;s m t l y dapresd during clinical
intanris~saadsbewaclo~obatrvdbyothers~manberstobaoryingiahuroom. Her
psychornotor activity waa chawtdzed by n o d movements and aotivity laval, but has
mportcd that aha is unable to rsld or write since she a n i d at FMC Camwell bsuu# sbe is dead.
She rsportcd having diflhlty eloepiu pd c o m p of~a pool appetite. She d d o d cumnt
suicidal or homicidal ideation.

CAISEDISCUSSION:

The detail8 of hda Siddiqui's lifo Bmm early 2003 untilthe aummer of 2008 remain unclear. It has
been rsported by hor a t t o w that a# war tcrlran into cunody by fbmign Military Intolligencs
olongwithhertbtabchildrcs I t h a r ~ ~ r a p o s t a d t h a ! w b c a e h e w a s h c l d ~ s h o w a s
treat& PI a political prisones and war torturd, aermally abused, md beat01 routinsty. Whm
arked about thie period, W. Siddiqui'r repoft mema b comborate m m of thie inPomatioa,
although her account ir tangential and Ptoquantlyadwined with other ovum that haw o a x m d
during bot li6, Altbwgb lpecifio datrilr of thir expdemo xumain unclear, it can be masonably
assumed that if one did endure thi~bnrmu, it would h v o a significant negative impact on the
individual's mcntal haaltb and their ability to capa with ndure p@mlogical dirtrwr. Given this,
the di.gnosie of Pout Traumrtic Stmas DiKwdcs should be comrid4lutd aa more idimnrtion
becomes available and,if mbrtentirtad, should be ytstdod m a primary fma of clinical
attention.

In addition, being hold in captivity d krrtursd doq with one's childrm would likely meat8 a
ekewed view of the world that includes mbatantial elemonta of oxtnmt E m and learned
helplessnose. Her current pmmtaticm cartrinly coJltdne thaoe elamma. Her psychotic
experiences b e centered on v i d hallucinat&~ of hca chikhtn, whom she rcportnare thin and
hove bbt been aduptsly f a . Ha MU^ hPr included trying to save some of h a own
bod fbr hat childron who as hungry. Her thoughtm have iaoludcd the belief that 0th- are
~ i s o n h her
g food and ttying to hm ha, If Ma.Siddiqui and her childran wer* held captive apd
tovtued, ttrm unusual cxpuiencos. thonghS%and bsh.vha are likely rooted in zctual tmamatic
CVClntB.
FORENSIC EVALUATION
SIDDIQUI, AAElA
REG NO,9027-

PAGE 6
Ma.Siddiqui meeta the diagnostic miteria for Mqjar D s p d v o Dimrdor, Severe witb Mood
Congruent Psychotic Festurea. She baa beon obscmod to display doprdve symptoms, and has
reported thoughts of hopeleunsss and deotb. She rbows no btta in participating in activities
on the unit, and 6.cqwmtly complains of au inability to think or concentrate. She alm reports a
deaase in appetite md deep. Hor hallucinations m h t e witb her daCn#uive thcmm of
worcying about her ohi- and being harmed by a h .
M@.Siddiqui coaaistcartly to pazticipata in any fbnnal teating for this evaluation; homer,
she did v r t rrom mu;rsunl ideas about har Court mse &at are worth noting. Sha stated the
Court had already wntcncd h a to death and killed her ao mhc docrr not believe she will be going
back to Court for an additiorut hearingr. She aleo rtporttd "Idon't understlod this country. 1
cannot undcrshuuj why they would sentence the victim of a cake to death. I was the victim
here and they killed me," The "death**she @peakso f involvedBrrreau of Prisons officersat
MDC Brooklyn who utilized tbe Federal Bumnu of khom'Urn of Fane policy in &to
conduct a medical avalrraion of-. Sibdiqui. Tbin policy dictama that a video oamcra must be
used durjng tbh procais. Ma Siddiqui ha6 ~~ in m t detail many tima d u d q hex
evaluation that the officus wem "dark ar@s" vrlho crmb in and 'IciUsd her with tbe carncra."
She bolicvse that these "aagala" w m acting on thu cammrndr of the Court aa a acntencc far her
alleged Ctiminrl condwt. With -6 ~~
to her ability to mamiat her attorney, ahe to receive
legal mail from the attomaye wotkiug on her cros nnd axpromod ha wish that her attorney not be
allowed to vieit her in prim11Her muon& &though difljcult to follow, sppeared to be baaed an
hcrbcliefthatthcarto~hawbosoaninatnunenti n t h o s ~ s C o u r t ~ t h a t b s d a l r e a d y
killed k.
Brwd on her sducatianrl backmuod, she potentially posre~sfithe aptitude to undmtand the
basic tenanta of the Caurt prowar. Howevor, rt thk the, rbe is unable to proccts iafbm&on.in
a rations1 manner due to psychosis. FurthersMa.Siddiqui believe8 har anotlseyr arc worleing
against her. An a result, in my opinion, ahc is unable to owjlt k attorneys in her dofcnse.

DUGNOSJS AM) PROGNOSIS:

Axis I: 296.24 Mnjor Deprdw Disatder, Sevssc With Mood Congruent Psychotic Fcatwcs

309.81 Poottrwmatic Strms D i d a I Rule Out

Axis II: D w a i sD a f d
A x i s U: Gun Shot Wowds in Abdomea
Axie N : Palding Criminal TGal

Axis V: Cumnt Global Asresrment Functioning = 35

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NOV-14-2008 FRI.-. 04:02 PH FHC CfiRSUELL-PSYCOL&y
---.--- -- M NO, 817 782 4284

~oRJlk3IcEVALUATION
SIDDIQUI, AAFIA
REG NO. 90279454

PAGE 7
Ma.Sidbiqui'r proponis in gwrded. She baa connistently rafhcd to amida taking medication to
addrew her mant.1 hcalth tiyqbmology. She has displays a dguificant di6tru8t of her atbmeys,
medical parsonal, Court officials, and p~ycho1ogicalcmmiw. This dintruat v e n t a her from
getting tho propar madical a t t d o n far hot wounds, f b m meaiving appmpristc intervantion to mat
her psychological distress, md fbm e y wr%pging with Court l~xuotma1involved in her criminal
cma. In addition. ahc crmently lack8 the motivation to improve her fbctioning, m she adamantly
holds tho belief that h e ir dead and will be triad in W ' r Court ao it dosr not matter what hagpsns
tohsrh.

REC0MMEM)ATIONS FOR TRE COURT:

While there is a probability that psyhtmgic modioation would address the dspmsrion sad psychotic
symptoms that affect h a comptmcyDMs.Siddiqd h~ 8tuadfWly mfwcd to wnsida this option.
Howaver, as sho d c a not cwrently mpmmt a danger to h l f m othm and does not require
mtdjcaijen to anrura her &&4y or tha &y of othcm in thh tndltutional uctting we cannot fbmibly
medicate her on that ? d r . The prhnuy pwpo# of madioatmg Me. Siddiqui would be to mitore ber
to competence to stand trial, Hsr~oo,thc Cowt muat cbtedne w M m r h c d medication io
appropriate in thin cmc bued an tha hur criteria arficulatodby tho S u p m e Court in tbe &ll w.
Unftsd Slatas dccidnn. Tho FMC Canswell Forensic Tmatmont Team can advise the Cowt ou t h e
of thew cribaria.
Firat, in our opinion, psylehotropic medi&m is a medically yrpraprists tmtnmat tlrr
Ms. Siddiqui's dopmssive symptomaIogy, Sacond, it b our opinion that motticadon can be
prcecribad which will be ~ubrtMtL1lyudikoly to h v o ridbeffbctswhich uadsnnine the trirrl's
frrinrcu. Third,it Q our opinion tbat no It#-intnuivc lltemativum cxiet whiob will efktively traat
Ms. Siddiquinssymptom. The f e &&a, whether f h d mediation is neccsaary to
rignificantly finthsr inrpart.at govunmentd trial-nalrtcd intoresb, is salcly a legal quostion not
properly addmeed in e psychologicJ repait.

In summary, in my pmhional opinion, MS.Siddiqui ir bmpctsat to procaed at this timo as a

result of her memtal~~~~. We am unoblo to proceed4 t h treatment aa a mutt of MB. Siddiqui's
d b a l of mcdicrtion, aDd it is newsmy \llLd45 Sell w. UlJIbd Shrtu fir ua to receive a Court Orddt
to h i b l y medicate her. Without thin medoation, MI.Siddiqui will likely tsnoinincompetent to
plocaad ibr ths fiiuaeeable firm. At tha Court's m q e t , our chiefpeychiarrirt, Judith Chnry,
D.O.,could provide tha Court with a propod p h for Me.Siddiqui's plyoNatric trsadmasrt based
on the thmc criteria oatlined above. Ms.Siddiqm'e craraat mental condition b such that trarrepodng
her f a a court appmrauct is not recosnmsndd FMC Camwell has thc capability for video
confmncing, and this can be m ~ a ifdthe court wirhcs.
I I.

_ _NOV-_. 14-2008
' '" __ FR I 04 :. 02 PH FHC CARSWELL-PSYCOLOGY
_-. -. ..- FfiX NO. 817 782 4294

FORENSIC EVALUATION
SIDDIQUI, AAFlA
REG NO. 90279-054

PAGE 8

OPINION O N COMPETENCY:

L my professional opinion. Ms.Siddiqui i6 not ouao~tlycompetent to pmcood aa a result of her

mental dioonu. which rend- ha unable to undartand the nature md consequences of the
proccadingr against heir or to assist properly in her dcfdnsc.

Submitted by: Reviewed by:

Forensic Psychologist Chief Peycholo@st

Wkt s n d 8k on cwun)
a- +k&&ts*

sooRD~.',"4 ?&~fl,
-3
Richard M. Berman, U.S.D.J.
I

11/14/08 FRI 18:Ol ITX/RX NO 88RII