That Fish was suffering from some religious psychosis was a given as far as Dr. Wertham was concerned. Fish's children had seen him "hitting himself on his nude body with a nail-studded paddle until he was covered with blood. They also saw him stand alone on a hill with his hands raised, shouting: 'I am Christ.'"
Fish told him: "What I did must have been right or an angel would have stopped me, just as an angel stopped Abraham in the Bible [from sacrificing his son]."
Dr. Wertham, the defense alienist, believed that Fish was legally insane: "I characterized his personality as introverted and extremely infantilistic... I outlined his abnormal mental make-up, and his mental disease, which I diagnosed as paranoid psychosis... Because Fish suffered from delusions and particularly was so mixed up about the questions of punishment, sin, atonement, religion, torture, self-punishment, he had a perverted, a distorted — if you want, an insane — knowledge of right and wrong. His test was that if it had been wrong he would have been stopped, as Abraham was stopped, by an angel."
Wertham believed that Fish had actually killed 15 children and mutilated about a 100 others. "That figure was verified many times to me by police officials in later years."
Two other defense alienists testified that Fish was insane. The four alienists who were called by the prosecution testified that Fish was sane. One of those prosecution alienists was the head of the psychiatric hospital where Fish had been detailed for observation a couple of years after the Budd and other murders and where he had been judged "both harmless and sane."