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In the fall of 2012, Dr. Roger Brumback may have unwittingly sealed his fate.
At that time, Brumback wrote a letter to the Indiana medical licensing board, explaining why former Creighton University pathology resident Dr. Anthony J. Garcia was fired in 2001.
Six months later, Brumback and his wife, Mary, were found dead in their Omaha home.
A similar letter, written in February 2008, to Louisiana medical officials may have sealed the fate of house cleaner Shirlee Sherman and 11-year-old Thomas Hunter, who were killed about a month later.
The boy's father, Dr. William Hunter, worked with Brumback at Creighton University's pathology department and had a hand in Garcia's dismissal.
Garcia was arrested Monday in connection with the four unsolved murders, committed over a span of five years, that sent tremors of fear through Creighton's medical community.
Officials say the former federal prison doctor was motivated by revenge because he believed his dismissal at Creighton had cast a pall over his medical career.
Alison Motta of Aurora, Ill., a lawyer hired by Garcia's family, said Tuesday that the family is “sure this is a mix-up.”
“They fully support him and are certain this is not what it appears,” Motta told The World-Herald.
Garcia, who worked in Chicago, is expected to make his second court appearance at 11:30 a.m. today in Jonesboro, Ill. It is not known whether he will fight extradition to Nebraska. Such fights within the United States are typically futile.
Garcia's former boss in Chicago, Dr. Benjamin Toh, described him Tuesday as a good employee who was well liked by their patients, but who was private and would dodge questions about his personal life.
“Any prying, and you would get an abstract, vague, nondescript answer,” said Toh.
The Indiana medical licensing board on Tuesday released a slew of documents that cast some light on Garcia's residency woes and gave a possible deadly timeline for why he may have returned to Omaha.
Garcia, who once worked as a contracted prison doctor at a federal penitentiary in Terre Haute, Ind., had applied for a medical license in that state in 2008. As a part of that application process, the board sought information from Creighton and other medical facilities where Garcia had worked.
In a 2012 letter to the medical board, Brumback explained that Garcia was fired for “unprofessional behavior toward a fellow resident.” Other documents said Garcia attempted to sabotage a fellow resident by calling the resident's wife while he was taking an exam and demanding that he return to work.
“This (the call) resulted in considerable anxiety and distress for the wife and the resident at a time when the resident was attempting to pass a high-stakes examination which would ultimately determine whether or not he could continue in the residency program,” according to a termination letter sent to Garcia by Creighton.
That letter was signed by Dr. Walter J. O'Donohue Jr., an associate dean at Creighton University. O'Donohue died of a genetic disease in 2002.
The documents also provide another possible motive for the earlier slayings of 11-year-old Thomas Hunter and Shirlee Sherman.
The two were stabbed to death in March 2008, just a month after the Louisiana State Board of Medical Examiners denied Garcia a license based in large part on his termination from Creighton, according to the documents.
Overall, the documents indicate that Garcia's troubles as a resident made it difficult for him to become licensed in other states — except Illinois, which granted Garcia a license in 2003.
Garcia was fired from three residency programs. At the Bassett St. Elizabeth Medical Center residency program in Utica, N.Y., Garcia was fired after he yelled at a radiology technician.
The New York board of medical conduct sent Garcia a letter, saying that his conduct in the residency raised concerns and that if he applied for a license in New York, his application would be “flagged” for additional scrutiny.
“Our reviewer expressed concern regarding your behavior during your entire residency at Bassett and felt that your conduct left serious doubt as to your future ability to successfully practice medicine within acceptable standards,” the New York board wrote in a 2001 letter to Garcia.
Garcia said in a rebuttal letter that he resigned from Bassett after he was suspended.
“On the last month I was there, I was suspended for yelling at a radiology technician. I subsequently resigned my position because I felt I was being treated unfairly,” Garcia wrote in a letter that was a part of his Indiana application.
After New York, Garcia was accepted at Creighton. He lasted only about a year before he was fired.
Garcia also took issue with his firing at Creighton, saying the only thing he did wrong was to call a fellow pathology resident and tell him that his vacation had not been approved.
He then was accepted at the University of Illinois at Chicago family residency program but left after about two years, he said, due to “poor health/migraine headaches.”
His last and final residency program was in psychiatry at Louisiana State University Medical Center in Shreveport. He lasted seven months before he was dismissed.
It is believed Garcia grew up in the wealthy California community of Walnut, east of Los Angeles. He attended undergraduate college at Mt. San Antonio College in Walnut and has used a Walnut home as his mailing address for years, including when he applied for his Indiana medical license.
A man who answered the telephone at the home, valued at more than $650,000, declined to comment Tuesday. “I don't have to talk to you,” he said, before hanging up.
Shortly after he was granted a medical license in Illinois, Garcia appeared to be beset by both medical and financial problems.
In 2004, he apparently returned home to Walnut, where he filed for bankruptcy. A big part of his debt was medical bills. In his bankruptcy documents, Garcia said he was unemployed.
In about 2009, he returned to Chicago with only his black Pontiac convertible stuffed with his belongings. He soon found a job at the clinic Visiting Physicians, which was owned by Toh.
Garcia was hired to go into the homes of elderly patients on Medicare and perform medical services.
When he first got to Chicago, Garcia did not have a place to live or any furniture. Toh rented him a furnished room until he eventually moved into an apartment in the tony Hyde Park area.
Toh recalls that he asked Garcia in the job interview about a fellowship or residency that he had started but not finished at the University of Illinois.
Toh also was curious about how Garcia seemed to be an experienced doctor even though he hadn't practiced in more than five years. He also wondered how he could afford such nice things with no medical salary.
Garcia never really answered those questions, though he did imply that he had some kind of personal crisis or breakdown.
Garcia eventually moved on in less than a year. At one point he had mentioned that he was contracting with another clinic, Toh said.
“Not to make light of the matter,” Toh said of the killings, “but when I heard about it I thought, thank God I didn't fire him.”
Online records linked Garcia with a similar clinic about 20 minutes south of Toh's. But a man who works there said the office is no longer a clinic and doesn't employ doctors. He said he had not heard of Garcia.
World-Herald staff writer Maggie O'Brien contributed to this report.