Two doctors were found dead in a medical office in Austin, Texas, late Tuesday after a hostage standoff that lasted more than five hours and ended with what authorities said they were investigating as a murder-suicide.

The Austin Police Department said it appeared that Dr. Bharat Narumanchi, 43, a pediatrician, shot himself after he fatally shot Dr. Katherine Lindley Dodson, 43, whom he had held hostage along with four other people.

It was not immediately clear what led to the shooting, said Lt. Jeff Greenwalt of the Austin Police Department. Greenwalt said Narumanchi had visited the office a week or two earlier to apply for a volunteer position there and was turned down.

“The case as far as who did this is closed,” Greenwalt said at a news conference Wednesday morning. “We really, really want to answer the question of why and provide as many facts and circumstances to the family and friends as we can.”

Police were notified at about 4:30 p.m. local time Tuesday that a man with a gun had entered a pediatric doctor’s office on West 35th Street in central Austin that houses the Childrens Medical Group practice. Five people were inside the office at the time, all of whom were employees, police said. No patients or children were present, they said.

“He displayed a gun and told the hostages to tie themselves up,” Greenwalt said.

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By the time officers arrived, four of the hostages had escaped or had been released, he said. None were injured. Dodson, however, was still inside, Greenwalt said.

The hostages told officers that Narumanchi “was armed with a pistol and what appeared to be a shotgun,” police said in a statement.

SWAT team members were seen and heard on a nearby street negotiating with the gunman Tuesday evening, according to reporters at the scene.

After several unsuccessful attempts to make contact with Narumanchi, police said that officers decided to enter the building. SWAT officers found the doctors dead inside.

Narumanchi had terminal cancer and had just weeks to live, Greenwalt said. “We feel like his terminal cancer probably played a large part in whatever it was that occurred in his life” and what was happening yesterday, he said.

Other than his recent visit to the office, there did not appear to be any relationship or other contact between Narumanchi and Dodson, police said.

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Greenwalt said investigators were asking people who knew Narumanchi to come forward if they had information about why he chose to target the practice.

Dodson had been a partner there since 2017, according to her LinkedIn profile. People who knew her were leaving flowers outside the practice Wednesday, the Austin American-Statesman reported.

Police said that the Travis County Medical Examiner would conduct autopsies.

The homicide was Austin’s fourth of the year, Greenwalt said. “Austin is a pretty safe place,” he said, describing the shooting as “a pretty unusual thing” for the Texas capital.