On 28 January 2013, 75-year-old Stanwood Elkus entered the Orange Coast Urology medical office in Newport Beach, California to attend an appointment he had made under a false name with urologist Dr. Ronald Gilbert. As Dr. Gilbert walked into the examination room to greet his patient, Elkus pulled out a .45-caliber handgun and shot his doctor 10 times, leaving him no chance of survival. After the shooting, Elkus simply stated, “I’m insane, call the police.”

Elkus was found guilty of first degree murder on 21 August this year and found entirely sane by the same jury a week later. He now faces spending the rest of his natural life in prison with no possibility of parole when he is sentenced on 15 September 2017.

79-year-old Stanwood Elkus

75-year-old Stanwood Elkus

One month before Stanwood Elkus was found guilty, another hospital shooting occurred, this time in the Bronx Lebanon Hospital in New York City. On 20 June 2017, 45-year-old Henry Bello entered the hospital armed with an assault rifle. The family doctor and former employee of the hospital wore a white lab coat to hide his weapon while he walked the halls searching for an ex-colleague, reports CBS News. When he couldn’t find his targeted individual he opened fire on medical staff striking seven with a hail of bullets, killing one before turning the gun on himself.

Henry Bello had a disturbing past full of accusations of professional misconduct, sexual harassment and unusual behaviours. He was fired from the hospital just one week before he returned with a firearm looking to exact revenge on the ex-colleague he believed responsible for the loss of his job.

Henry Bello

Henry Bello

Both of these men made the decision to take a firearm into a hospital with the intention of using it to kill a specific individual. An individual they held a personal grudge against which had boiled over to such an extent they had concluded their target had to die at their hands. In their motives for murder they are not alone.

63-year-old Charles Johnston killed two staff members and injured one other after he walked into Doctor’s Hospital in Columbus, Ohio in March 2008 and headed straight for the intensive care ward where his mother had been treated and died in 2004. NBS News reports that after finding the male nurse he felt had not provided his mother with appropriate care and demanding from him, “Do you remember me? Do you remember my mother?” He shot twice, killing him before firing further shots as he left the hospital.

Fourteen years earlier, 20-year-old Dean Mellberg, a former US Airman entered the Air Force Base Hospital at Fairchild in Washington State in June 1994 and opened fire at his former psychiatrist and psychologist before showering anyone he saw with a sea of bullets. Mellberg killed five and injured 22 in a revenge rampage targeted at the two professionals he blamed for the end of his military career.

The underlying motivation in all of these devastating shootings was the personal grievances held by the shooters against medical staff inside the hospital. In research studies specifically examining hospital shooting events there is clear evidence just how common a motive this for these kind of incidents. Research from John Hopkins revealed in 2012 that 27% of the cases they examined that occurred across the US between 2000 and 2011 were carried out by a sole individual holding a personal grudge. Figures supported by more recent research which looked at incidents up to 2015 by researchers at Brown University in Providence who found 33% of cases could be traced back to targeted bitterness held by the shooter.

In the case of Stanwood Elkus, his rage was targeted at a doctor who had recommended him for surgery after he visited him back in 1992. Dr. Ronald Gilbert was a urologist diagnosing Elkus with a narrowing of his urethra causing his symptoms of frequent urination. The operation to fix the problem was carried out by two colleagues of Dr. Gilbert left Elkus with erectile dysfunction resulting in the breakdown of his relationship with is long-term girlfriend. As far as Elkus was concerned this procedure had ‘ruined his life’. He became obsessed with his health issues and focused his obsession and his blame firmly on Dr. Gilbert.

Dr. Ronald Gilbert

Dr. Ronald Gilbert was murdered by Stanwood Elkus in January 2013.

In the opening stages of his murder trial his defense attorney told the court her client suffered from ‘dementia and psychotic depression that was exacerbated by his health issues’. She told how Stanwood Elkus had brain damage which influenced his control over his own impulses and he developed a ‘ritualistic obsession’ with his prostate problems which projected onto Dr. Gilbert. The Orange County prosecutor, focused the jury on Elkus’s obsession over the operation recommended by Dr. Gilbert, “Mr. Elkus began to blame all of his problems on this procedure,” he said. “Whatever went wrong in his life he’d blame on the procedure. He obsessed over this.”

Elkus had clearly planned his actions before he carried out this shooting. He had made an appointment with Dr. Gilbert under a false name the week previously. Before leaving his home on the day of the shooting he left a note and financial documentation for his family members knowing what he was about to do and that he would be arrested immediately afterwards.

Hospital shootings such as the cases of Stanwood Elkus and Henry Bello are events which according to Brown University researchers are increasing, now reaching a frequency of around one incident per month, with an average 16 incidents per year between 2000 and 2015. The availability of firearms and open nature of hospitals provide a potentially deadly combination for a person holding a grudge and wishing to do harm. No one wants to move to a heavy security presence within hospital settings based on the behaviours of a minority but, it is a topic being examined for how to guard against active hospital shooters to protect both medical staff and members of the public.

For now, Stanwood Elkus who chose to sit quietly and wait for police after being satisfied the target of his obsession was dead, is behind bars awaiting his sentencing under the knowledge that he will most likely die in prison. His obsession and his malice now ended, he will spend his final days in a prison cell with only his thoughts for company.