Reports now that he was giving away Korans and his furniture the morning before. Giving things away is not uncommon before suicide. Also apparent behavior change in the weeks before, wearing Middle Eastern/Muslim clothing. That he had two handguns and sufficient ammunition to shoot more than 40 people makes this obviously premeditated. He intended to die. Indiciations that he was dissatisfied with U.S. foreign policy, that he did not want to be deployed, that he may have felt persecuted for his religious beliefs. Also that he had been reprimanded for inappropriately sharing his own Muslim beliefs with patients (highly unethical and outside practice norms) and colleagues. Reports that he said "Allah Akubar" as he was shooting. Parents dead, no recent contact with family. Single. Probably never married, no kids. Not clear how connected this man was into the social fabric of society--may have been a loner. Also unknown whether he himself had mental illness--for example depression, delusions, bipolar, mania, drug use.
This may end up being a case of radical Muslim ideology mixing with the disturbed psyche of a troubled loner. In this likely deeply unhappy man--a combustible mix. Note that this is an American-born, American-trained, US citizen.
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