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A 45-year-old man killed four people and himself at a medical office in Tulsa, Oklahoma, on Wednesday after complaining repeatedly about back pain following surgery, police said Thursday.

The suspect was identified by police as Michael Louis, whose also went by Michelet Louis, his family told The Daily Beast.

Citing a conversation with police, Louis’ niece said he left a note explaining a motive for the attack, which took place in the Warren Clinic Orthopedic Surgery and Sports Medicine on the second floor of the Natalie Medical Building, near St. Francis Hospital. Officials declined to disclose to her what it said.

“Tulsa Police called me and verified that it’s my uncle,” she texted Thursday morning. “We are so distraught.”

She asked not to be named in the story, citing the “heinous” nature of the crime. “I don’t even want to be associated because I’m so disgusted,” she told The Daily Beast.

Dr. Preston Phillips, an orthopedic surgeon who performed back surgery on Louis last month, was shot and killed in the attack, Tulsa Police Chief Wendell Franklin said at a press conference on Thursday. Louis was released from the hospital on May 24, but continued to complain that he was in pain, according to Franklin.

Louis “called several times over several days complaining of pain and wanted additional treatment,” Franklin said.

“Yesterday, June the 1st, Louis called Dr. Phillips’ office again, complaining of back pain and wanting additional assistance,” Franklin continued, adding that Louis legally purchased a semi-automatic AR-15-style rifle at 2 p.m. that same day from a local gun store.

On May 29, Louis had purchased a .40-caliber Smith & Wesson semi-automatic handgun from an area pawn shop, according to Franklin.

A second orthopedist, Dr. Stephanie Husen, was killed in the shooting, police said. The other two victims were identified by authorities as Amanda Green and William Love.

Phillips, a specialist with several decades of experience, was the section chief of the Warren Clinic. He graduated from Harvard Medical School in 1990 and specialized in spine disorders, joint reconstruction, and surgical procedures.

Patients praised him online as “thorough,” “gracious” and “kind,” and a local charity featured him on their Facebook page for donating several containers of prosthetics for knee replacements in Togo.

https://www.facebook.com/LightInTheWorldDevelopmentFoundation/photos/dr-preston-phillips-an-orthopedic-surgeon-in-tulsa-oklahoma-and-is-affiliated-wi/1564637096997597/

Phillips’ children, and wife, Melody, declined to speak to The Daily Beast when reached by phone on Wednesday evening.

Public records list Louis as a resident of a home in Muskogee that Tulsa police asked local cops to search for a possible bomb on Wednesday night, saying it was related to the hospital incident.

The home was evacuated Wednesday night, according to authorities, and neither Louis nor his wife, Edith Lubin, could be reached by reporters or worried relatives.

“It’s just so shocking. Like, if he had killed himself, okay. But those innocent people, that’s what I’m hurting about,” Louis’ niece told The Daily Beast.

When initially reached by The Daily Beast Wednesday night, Louis’ family expressed disbelief that he may have been involved.

“This is really crazy. Like, this is shocking… No one in our family, like nobody in our family, has this type of behavior. No one,” the niece had said.

Read more at The Daily Beast.

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