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Piecing together factors that may have led to the Fort Hood mass shooting

Army officials shed new light on the suspected gunman believed to have perpetrated the second mass shooting at Fort Hood in five years. Three people were killed and 16 wounded before Ivan Lopez, an Iraq veteran, killed himself. Judy Woodruff talks to Phillip Carter of the Center for a New American Security and retired Brig. Gen. Stephen Xenakis about what’s being learned about Lopez’s mental health.

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    Another shooting rampage on an Army base, and again at Fort Hood in Texas. This time, three people were killed and 16 wounded, before the gunman, an Iraq veteran, committed suicide.

    Police and emergency vehicles raced toward the nation's largest Army base yesterday after the second mass shooting there in five years. First word came in a tweet from Fort Hood officials: "All personnel on post are asked to shelter in place."

    Hours later, when the lockdown ended, the base commander laid out the gunman's moves.

    LT. GEN. MARK MILLEY, Commanding general of Fort Hood: It is believed that he walked into the unit buildings, opened fire, got into vehicle, fired from a vehicle, got out of vehicle, walked into another building, and opened fire again.


    About 20 minutes after the incident began, the gunman shot and killed himself.

    Today, General Mark Milley confirmed his identity as specialist Ivan Lopez of Puerto Rico.

    As for what sparked the shooting:


    We're trying to figure out what the trigger event was. It was mentioned yesterday there may have been a verbal altercation with another soldier or soldiers, and there's a strong possibility that that in fact immediately preceded the shooting. But we do not have that definitively at this point, but we do have strong indications of that.


    More information emerged at a Senate hearing today. The secretary of the Army, John McHugh, said there's no documentation that Lopez suffered traumatic brain injury, or TBI, in Iraq, despite one official's citing reports that Lopez had self-reported this.

    JOHN MCHUGH, Secretary of the Army: He did have two deployments, including one four-month — approximately four-month deployment to Iraq as a truck driver. His records show no wounds, no involvement, direct involvement in combat, as General Milley said, no record of Purple Heart or any injury that might lead us to further investigate a battle-related TBI or such.


    McHugh said there's also no evidence of ties to extremist groups, but Lopez was being evaluated for possible post-traumatic stress disorder.


    He was undergoing a variety of treatment and diagnoses for mental health conditions, ranging from depression to anxiety to some sleep disturbance. He was prescribed a number of drugs to address those, including Ambien.


    General Milley echoed that statement at his briefing today.


    We have very strong evidence that he had a medical history that indicates unstable psychiatric or psychological condition. Going through all the records to ensure that is in fact correct, but we believe that to be a fundamental underlying causal facts.


    As for those wounded yesterday, nine were taken to a hospital in nearby Temple, Texas.

    Trauma doctor Matt Davis updated their condition this morning.

    DR. MATT DAVIS, Chief of Trauma Service, Scott & White Memorial Hospital: Our critical patients have — specifically, they have some injuries to the neck. We have a potential spine injury, and we have an abdominal injury. Those are the three patients that I would still consider in critical condition.


    Fort Hood was also the scene of the worst mass murder at a military installation in U.S. history. In 2009, 13 people died and more than 30 were wounded when Major Nidal Hasan, an Army psychiatrist, opened fire. He was sentenced to death and is now in a federal prison.

    Last night, President Obama said he was heartbroken that it's happened again, and today at the White House, he pledged support for Fort Hood soldiers.


    They have done their duty, and they're an inspiration. They have made us proud. They put on their uniform, and then they take care of us. And we have got to make sure that, when they come home, we take care of them.


    Back at today's Senate hearing, the Army's chief of staff, General Ray Odierno, said there were lessons learned from that 2009 shooting.

    GEN. RAY ODIERNO, Chief of Staff, U.S. Army: The alert procedures that were in place, the response, the training that has gone into the response, forces that responded, I think, contributed this to making this something that could have been much, much worse.


    Base security is increasingly an issue around the country, with an incident just last month at Norfolk's naval station and the mass shooting last fall at the Washington Navy Yard.

    To help us make sense of all of this, we turn to Dr. Stephen Xenakis. He's a retired Army brigadier general who had a 28-year career as an Army psychologist. He's also the chief medical officer at Mindcare Solutions. It's a medical software development company. And Phillip Carter, he's a senior fellow with the Center for a New American Security. He served nine years as an Army military police and civil affairs officer, including one year in Iraq. He also served at Fort Hood.

    And we thank you both for being here.

    Dr. Xenakis, let me start with you.

    We're talking about a 34-year-old soldier who did spend four months in Iraq at the end — after the end of combat operations. He was being treated, we are told, for a variety of mental health and behavioral issues. He was taking some medication. He was being evaluated for PTSD. There may have been an argument. What does all this say to you?

    BRIG. GEN. STEPHEN XENAKIS, MD (RET.), U.S. Army: Well, I mean, it's a tragic event. It's sad for everyone, and really sad to see another one of these incidents happen at Fort Hood.

    It just goes to show that these people who come in and soldiers or veterans need to be really looked at carefully. And I know people are trying and doing their best. But there are a number of factors that affect their mental state, and really can lead to what I think is more important to focus on is the disposition to be dangerous, to harm themselves or others.

    And so there's like a checklist. I know when I see a soldier or a veteran, I have in my head — and I'm a psychiatrist, by the way — as a physician, I have a checklist that I consider and make sure to figure out how much of these — each of these factors has influenced the state of mind, and how much should I be concerned and, in fact, instruct the individual to be concerned about their propensity to commit something that would hurt themselves or others.


    And I'm glad you corrected that. We did mean to say psychiatrist. That was my mistake.

    Phillip Carter to you. When you hear the — you see the profile of this individual, Specialist Lopez, what stands out?

    PHILLIP CARTER, Center for a New American Security: Well, it's like you have got a puzzle with just a few of the pieces right now.

    So, we know that he had a four-month deployment, which puts them at the low range of combat exposure and experience for this cohort. He had a combat record or a military record that was undistinguished. It was average, not a lot of combat decorations, not the sort of thing you would expect to see for someone who had served upwards of 13 years total active and reserve time.

    He had also moved around a lot. He started in the Puerto Rico National Guard. He moved to the active military in about 2008, changed jobs. He had been an infantryman. He had been in the band. He had been a truck driver. And so trying to piece that together is very hard right now. Even the fact that he was prescribed Ambien doesn't necessarily mean that much, given that it is essentially dispensed like candy within today's military.


    That's right. And he was — we are told — we know there may have been other medications as well, but Ambien is one that official said that he was taking.

    Dr. Xenakis, when you look at someone in the military who is being treated for, again, a variety of mental health and behavioral issues — and they mentioned depression and anxiety — one question that comes to mind is, at what point does this disqualify someone from serving in the military?


    Well, the whole — there is a set of guidelines and regulations having to do with who is eligible or should be considered for separation for medical reasons.

    And they have been around for decades. And it really — it boils down to, does their medical illness or injury impair their duty performance? That they can't do their job and or that they are going to put other soldiers in danger and not finish, complete the mission.


    Staying with you, Dr. Xenakis, what does it say to you that he was being evaluated for PTSD, post-traumatic stress disorder, and that there was no — there was no record of a traumatic brain injury?


    That's common.

    And so it really doesn't say a lot to me. And, in fact, when I look at the record, which is important, what I really want to focus on is the patient, because the facts are, when you sit down and people start to disclose their lives and the circumstances, there are innumerable ways that these things kind of come together and bear down and bear stress on them.

    Not much is known about Specialist Lopez. One of the factors that is known that I saw on the news, and haven't confirmed, is that I think his father died in October, his mother died in November. These are very stressful on an individual. I mean, he is set up to have a grief reaction. And you start grieving deeply.

    And then you're having other issues that come along with who knows what the factors are because of that exposure. And combat certainly could be one of them. He could have had a traumatic brain injury. But the cumulative effect will really start to have an individual spiral down, which means that they can be at risk. These are risk factors to be considered of, can they be dangerous? Can they harm themselves or others?


    And we're still trying to piece all the parts of this story together.

    Phillip Carter, I want to ask you about the gun. He had in his possession a concealed weapon, a .45-caliber handgun, which he bought off base. What are the rules? I'm reading reports today that the rules are kind of an honor system at Fort Hood.


    That's right. I mean, most soldiers don't carry weapons around.

    In fact, the only soldiers that would have weapons on them at Fort Hood are the military police. Soldiers lock their weapons up in the armory and use them when they go to fight, because when they are doing their jobs, they don't carry them. That said, the access control points at a massive base like Fort Hood simply wave traffic through if you have got an I.D. card or you have got the base decal.

    There is no TSA-like check that pats you down or checks for weapons. We trust soldiers or contractors or government employees to come on base and follow the rules, which mean no carrying weapons. And, in this case, we had a bad actor who appears to have done that.


    But this is even after what happened in 2009 with Major Hasan?


    It is even after the military's experience there at the Navy Yard and more recently. The military trusts those people who have that access, who have that preexisting connection to the military to come on board and follow the rules.

    And it's hard to imagine practically how would you do this. Fort Hood is a base of 40,000-plus troops, most of which live off-base. There are a number of other employees. I think the line would stretch halfway to Austin, Texas, if they tried to check everyone at the gate.


    But is this something that you think should be rethought, reconsidered in the light of these incidents like these?


    I don't think so.

    I think we trust our soldiers and our other service members to do the right thing in a variety of contexts, whether it's holding weapons at the range or driving vehicles around post. And I think we shouldn't distort the system to reflect the fact that we have a few actors like this. We ought to, instead, do what I think Dr. Xenakis was just saying, is find better ways to find these people and get them the treatment they need.


    All right, well, we are going to leave it there.

    Phillip Carter, we thank you, and Dr. Stephen Xenakis.

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