Mental stress is emerging as a prime factor in the horrific shootings at Fort Hood Thursday, when 13 soldiers were killed and 31 wounded before the suspect, an Army psychiatrist who had counseled soldiers suffering from combat stress, was himself wounded and taken into custody.
Two additional soldiers were initially detained but later released. The FBI was called in to help investigate, but officials stressed that they have not yet determined a motive for what appears to be the worst soldier-on-soldier violence in American history.
The shootings at the sprawling Texas post broke out about 1:30 p.m. Central Standard Time at the Soldier Readiness Center, the central processing station for tens of thousands of soldiers deploying to Iraq and Afghanistan or returning from year-long combat tours.
U.S. officials identified the gunman as Army Maj. Malik Nadal Hasan, who had been promoted to major in May. Sen. Kay Bailey Hutchison (R-Texas) said military officials told her that the gunman, 39, was about to be deployed to Iraq and was "upset about it." Hasan, an American citizen of Jordanian descent, also had complained of harassment within the Army because of his Arab background, officials said.
The gunman reportedly used two handguns, one of them a semi-automatic. Weapons are not normally carried by soldiers at Fort Hood.
Lt. Gen. Robert Cone, commander of Fort Hood and III Corps, said Hasan wounded a female officer before she returned fire and wounded him. She was taken into surgery and is in stable condition, he said.
Immediately after the shootings, Cone said, soldiers began treating the wounded, ripping off their shirts to make improvised tourniquets and pressure bandages. Most soldiers are trained as combat first aid experts.
"As horrible as this was, it could have been a lot worse,'' Cone said Thursday night. He said both the quick arrival of civilian and military police, and the first aid provided by fellow soldiers, helped save lives.
Hasan had been a psychiatrist at Walter Reed Army Medical Center in Washington, D.C., for six years before being assigned to Fort Hood, military officials told the Associated Press. The officials said he had a poor performance report while at Walter Reed.
Being sent into a war zone was Hasan's "worst nightmare," a family member told Fox News, because Hasan had engaged in counseling sessions with so many soldiers who spoke of the terrible stress of combat.
Single with no children, Hasan is a graduate of Virginia Tech University, where he was a member of the ROTC and earned a bachelor's degree in biochemistry in 1997, the AP reported. He received his medical degree from the military's Uniformed Services University of the Health Sciences in Bethesda, Md., in 2001.He did his internship, residency and a fellowship at Walter Reed.
Fort Hood is home to the tank-heavy 1st Cavalry Division. Three of its four brigade combat teams, with more than 10,000 soldiers, are currently deployed in Iraq. The base also has housing for tens of thousands of families, as well as schools, shopping centers, day care facilities and a military hospital.
At the Soldier Readiness Center, outbound soldiers receive thorough physical and mental health examinations. Those results are used as a baseline to assess the impact of the deployment, determined at the Center in a second set of exhaustive tests after they return.
The Army established these procedures several years ago after mental health teams found that at least one in five soldiers suffer from acute stress. The Army and the other military services have mounted unprecedented efforts to identify and treat mental health problems.
But Defense Department mental health officials acknowledge they do not fully understand the mechanisms of stress injuries. And the overwhelming ethos of the military services is to absorb the stress.
"Stoicism is necessary for their survival,'' said Dr. William Nash, who directed the Marine Corps' combat stress program until last year. But coping with stress by ignoring it or "toughing it out'' only lasts so long.
"Everybody,'' Nash told me, "has a breaking point.''
President Obama, speaking late Thursday afternoon, cautioned that the cause of the incident may not be known for a while.
"My immediate thoughts and prayers are with the wounded and with the families of the fallen, and with those who live and serve at Fort Hood,'' he said. "These are men and women who have made the selfless and courageous decision to risk and at times give their lives to protect the rest of us on a daily basis. It's difficult enough when we lose these brave Americans in battles overseas. It is horrifying that they should come under fire at an Army base on American soil.
"I would ask all Americans to keep the men and women of Fort Hood in your thoughts and prayers,'' the president said.
Defense Secretary Robert Gates said in a statement Thursday night that he was "deeply saddened by the tragic events today at Fort Hood. My thoughts and prayers are with the families of the fallen, the wounded, and all those touched by this incident. There is little we can say at this point to alleviate the pain or answer the many questions this event raises, but I can pledge that the Department of Defense will do everything in its power to help the Fort Hood community get through these difficult times."