AL BIRAH, WEST BANK — When Rafik Ismail Hamad last traveled from the West Bank to visit relatives in the United States, he was struck by the pressures one of his nephews was facing.
The younger man, a U.S.-born Muslim of Palestinian descent, spoke to his uncle of ethnic taunts by Army colleagues. A sensitive man, he was haunted by the wartime disabilities of soldiers he treated as an Army psychiatrist, Hamad recalled, and was overwhelmed by a growing caseload he felt unable to manage.
Late Thursday, Hamad was home in the West Bank town of Al Birah when he heard the news on television: A gunman in Ft. Hood, Texas, had killed at least a dozen people, and his nephew, Maj. Nidal Malik Hasan, 39, was being accused of the horrific attack.
"The whole family is in a state of denial," Hamad said Saturday. "We don't believe he is capable of doing something like that. I was amazed and shocked, because it's not him. He's very quiet, gentle.
"Maybe it built up together -- the harassment, too many patients, the workload, the tragedies his patients brought to him," said the 65-year-old retired real estate broker. "Whatever it was, it must have been big pressure, something terrible he couldn't handle."
Hamad and another West Bank relative, Mohammed Munif Hasan, said they learned recently that Maj. Hasan had consulted a lawyer about securing a discharge from the Army.
Hamad said he had not seen or spoken to his nephew since that visit in the early part of last year, when Maj. Hasan was stationed in Washington. But the West Bank branch of the family had kept up with him through relatives in the United States.
The major's octogenarian maternal grandparents, Salha and Ismail Hamad, live in Al Birah with Rafik Hamad, their son. In an interview outside the family's three-story apartment building, he declined to make his parents available to reporters.
Rafik Hamad, a heavyset man with a trim white beard, described his nephew as a gentle soul who once, as a young adult, mourned for three months after rolling over during a nap and crushing his pet parakeet. During medical school, his uncle said, Hasan switched his major to psychiatry after fainting at the sight of blood while delivering a baby.
The young man became more religious after the death of his parents, who were Muslims but not observant, Hamad said. He noticed the change during the visit last year, when his nephew urged him to accompany him to pray at a mosque.
His turn to religion had nothing to do with political identity, Hamad and other West Bank relatives said. He never traveled outside the United States except for two brief visits to the West Bank, the last more than a decade ago, they said.
"He never knew anything about politics," Hamad said. "He didn't know who is the president or the king of any Arab country. He's American. . . . He once told me, 'The chances I have in the United States I couldn't have in any other country in the world, so I appreciate what this country has done for me.' "
Hamad said that although his nephew complained last year about ethnic slurs, he appeared to be handling them well.
Fellow soldiers once handed him a diaper and told him to wear it around his head, the uncle said; another time they sketched a camel on a piece of paper and left it on his car with a note that said, "Here's your ride."
"He told me: 'They're ignorant. I'm more American than they are. I help my country more than they do. And I don't care what they say.' He felt sorry for them. He didn't feel grudges; he felt sympathy."
Hamad said that during their time together last year, the major seemed more afflicted by his caseload of physically disabled and traumatized war veterans.
"He didn't have time even to breathe," Hamad said. "Too much pressure, too many patients, not enough staff. He would say, 'I don't know how to treat them or what to tell them,' because he didn't have enough time. They just kept coming one after the other.
"Sometimes he cried because of what happened to them. How young they are, what's going to happen to the rest of their lives. They're going to be handicapped; they're going to be crazy. He was very, very sensitive."
Mohammed Munif Hasan, 24, a cousin of the major, said he heard the same story from relatives in the U.S.
Maj. Hasan brought his caseload home, he said, seeing patients at his house when the clinic wasn't open.
"He was a good doctor, and he liked working with soldiers and helping them," Mohammed Hasan said as he absorbed the news of the shooting. "We're the first to wonder how he could have done something like this. It's baffling."
The uncle said: "I think he snapped. Something big happened and he snapped."
Hasan is in a coma after being shot during the attack, and his West Bank relatives said they were uncertain whether they would travel to Texas.
"I'd like to go visit the families [of the shooting victims] and apologize to them and give them my sympathies," Hamad said.
"But for him, I don't know what I can do. If he wakes up, I want to ask him, 'Did you do it, and why?' I want to know. Otherwise, I have nothing to say to him."