Yoselyn Ortega, the 51-year-old nanny accused of the most horrific crime in New York memory, sat impassive at the defendant’s table in a pale yellow shirt on Monday morning.

Forensic psychiatrist Karen Rosenbaum was reading aloud from transcripts of two exams she had conducted in March at the behest of the defense to determine Ortega’s competence to stand trial. The defense was challenging a government-ordered evaluation that had found her fit.

Q: What is your case?

A: That I killed two people.

Q: Who are the people?

A: Two children.

Q: What are their names?

A: Leo and Lucia.

Two-year-old Leo Krim and his 6-year-old sister Lucia were discovered slashed to death in the bathroom when their mother returned home from taking her third child to swim class. Ortega lay nearby, a wound to her throat, apparently self-inflicted with the bloody kitchen knife on the floor beside her.

Q: Do you think the charges are serious?

A: I don’t know.

Q: Do you think the charge of killing children is serious?

A: Yes. Serious.

Q: Do you think you killed the children?

A: No.

The transcript noted that Ortega had begun to cry.

Q: Why are they accusing you?

A: I don’t understand the question.

Rosenbaum asked Ortega about the possible verdicts. Ortega said that guilty meant she had killed the children, not guilty that she had not.

Q: What do you think would happen to somebody guilty of murder?

A: They go to jail.

Q: What do you think would happen to you if you were found guilty of murder?

A: I don’t know.

Q: Do you know what life in prison means?

A: Jail until I die.

Q: Do you think that can happen to you?

A: I don’t know. Do you?

Rosenbaum had asked about the plea that Ortega is most likely to enter if she is declared competent and the trial goes ahead.

Q: If I say not guilty by reason of insanity what does that mean?

A: I didn’t know what I was doing … Because I’m sick in my mind.

Q: Do you hear voices?

A: Yes.

Q: When did you last hear voices?

A: Last night.

Q: What did they say?

A: Ugly things. To hurt people.

Ortega had apparently spoken to another doctor about seeing a devil with a monster face. She also had suggested the devil may have been involved when she was forced to vacate an apartment in the Bronx and move in with her sister.

Q: Why didn’t you tell me the devil had a monster face?

A: You didn’t ask me.

Q: Did the devil make you leave the Bronx?

A: I’m not sure.

The questions returned to the case itself.

Q: If the judge says you killed the children, what will happen to you?

A: I don’t know.

Q : Which is worse, separated from family or being dead?

A: I’m not sure.

Q: Why are you crying?

A: I feel bad.

Q: Why do you feel bad?

A: The situation I’m in … I asked why I was handcuffed.

Q: What did they say?

A: Because I’m in jail.

Q: Why are you in jail?

A: Because of what happened.

Now in the courtroom, Ortega sat as blank and still and if she were waiting for a bus, save for a moment when she raised a hand to smooth her shirt. The transcripts show that she remembers the children’s names and clearly understood they had been killed, but she had not expressed a word of grief, ascribing her tears only to her own predicament.

“She took care of them for three years,” Rosenbaum insisted at one point in her testimony on Monday. “She loved them.”

If Ortega really did love them, then perhaps she blocks out the killing because she cannot face up to the crime she is accused of committing. But if she is blocking it out, it would necessarily seem to mean that some part of her knows what she may have done and how monstrous an act it was. Maybe she did not do what she is accused of doing because she is crazy. Maybe she is crazy because she is unable to accept what she may have done.

Rosenbaum said that in addition to examining Ortega on numerous occasions, she had studied 8,000 pages documenting the defendant's medical and psychiatric state. Rosenbaum noted that in the weeks immediately after the killing, Ortega imagined that it was still the year 2000 and was unable to count backward from 20 and “could not spell the word ‘world’ in Spanish.”

Rosenbaum said Ortega had since improved somewhat but presently still suffers from psychosis compounded by depression as well as brain damage caused by her apparently self-inflicted wounds. Ortega had managed to cut her dura, allowing potentially destructive air into the normally sealed brain cavity, while a nick to the interior side of the carotid artery had reduced the flow of oxygenated blood.

As a result, Rosenbaum said, while Ortega may be able to recite what she had been told about the workings of the criminal-justice system, she is unable to integrate it into an understanding of her situation. The psychiatrist might have been more convincing had she herself demonstrated a clearer grasp of the criminal-justice system in New York state.

As prosecutor Stuart Silberg pointed out during the cross-examination, Rosenbaum had spoken to Ortega at one point about a no-contest plea, when no such plea exists in criminal cases in New York. Silberg got Rosenbaum to acknowledge that this was the first New York criminal proceeding where she had testified as a forensic psychiatrist.

“I am just starting out in my career,” Rosenbaum said.

Rosenbaum seemed a little taken aback at Silberg’s aggressiveness. She should consider that he has been required to view the crime-scene photos and to speak to the slain children’s parents. He is not likely to welcome such nuances as Ortega correctly defining guilty as a legal concept but not understanding it as it applies to her.

At one point in the transcripts, Ortega says the prosecutors are in court to “defend the family,” meaning the family of the victims. She was not completely wrong and was never more right than in this case.

At the day’s end, Ortega seemed not at all puzzled when a court officer handcuffed her and led her off to the cells. She is scheduled to be back on Tuesday morning as the hearing continues.