PRETORIA, South Africa (AP) — Hunched over, vomiting into a bucket by his feet and retching loudly, Oscar Pistorius was vividly reminded at his murder trial Monday of the gruesome injuries he inflicted on his girlfriend when a pathologist described how the Olympian fatally shot her multiple times with bullets designed to cause maximum damage.

The testimony by Prof. Gert Saayman, who performed the autopsy on Reeva Steenkamp’s body, was so graphic that it was not broadcast or reported live on social media by journalists under an order from Judge Thokozile Masipa.

Saayman methodically listed the extent of the three main gunshot wounds Steenkamp suffered on Valentine’s Day last year when she was shot by the double-amputee runner in the right side of the head, the right hip and the right arm through a toilet cubicle door.

The pathologist said Steenkamp, 29, was hit by special Black Talon bullets and that the head shot from Pistorius’ 9 mm pistol was probably almost instantly fatal, causing brain damage and multiple fractures to her skull.

Bent over while sitting on a wooden bench, Pistorius vomited when Saayman reached his right hand up toward the right side of his own head to show the entrance and exit wounds in Steenkamp’s skull.

Masipa briefly halted the testimony to ask chief defense lawyer Barry Roux to attend to his client. The judge later asked whether Pistorius was able to understand the proceedings as he sat with hands clasped over his ears, his body heaving.

“Is your client fine?” the judge asked Roux.

Roux replied: “It’s not going to be fine.”

Roux said Pistorius’ reaction was not going to change. A dark bucket with a handle was placed at his feet.

Pistorius vomited at least two other times and cried. He is charged with premeditated murder for killing Steenkamp and could face up to life in prison if convicted. The prosecution contends the shooting followed a loud argument between the couple. The defense maintains that he shot her by mistake, thinking she was an intruder.

Through the sounds of Pistorius retching in the dock, the pathologist testified that he was able to identify the ammunition from a bullet fragment lodged at the bottom of Steenkamp’s skull. The bullets were designed to expand on impact and cause severe damage.

The hip and arm wounds were also severe, and the right arm was broken, the pathologist said, adding that any of the three gunshot wounds in isolation could have been fatal.

Saayman stood through his testimony to indicate the location of Steenkamp’s bullet wounds by touching his hand to his own head, arm and hip.