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Two hours before he embarked on the most violent rampage in history on a United States military base, Major Nidal Malik Hasan heard a knock at his scuffed, second-storey apartment door.

Outside was Patricia Veen, the 47-year-old neighbour he had bestowed with the belongings he no longer needed – four folding chairs, an inflatable bed, some freshly dry-cleaned men's clothing her husband could use and a few packs of unopened frozen vegetables.

She handed him a wrinkly, foil-wrapped mass of fresh-made sweet tamales, a token of thanks for his kindness and a homemade treat to sweeten his impending sendoff to Afghanistan.

If Maj. Hasan had already decided he wasn't going to deploy, he didn't tell Ms. Veen. He politely thanked her and shut his door.

She learned of the horrific alternative he chose later that afternoon, long after the wail of sirens began to course through town and SWAT teams descended on the scrubby apartment building they both called home. At first, though, she thought the police had come because Maj. Hasan was a victim, not the architect of the massacre.

“He was nice. He never had mean looks. He would wear nice clothes,” she remembered, adding: “I can't believe he would do this.”

In the hours since Maj. Hasan strode into the Soldier Readiness Processing site here, armed with two handguns on an apparent kill mission, a paradoxical portrait of the 39-year-old has emerged.

Outwardly, the Army psychiatrist projected an image of dedication and altruism.

He spent the six years prior to arriving at Fort Hood last July training in disaster and preventative psychiatry at Washington's Walter Reed Army Medical Center, working to heal some of this country's most mentally war-wounded; he donated his furniture to Ms. Veen, after discovering she had none and insisted on paying her $60 to clean his apartment when he left – double what she suggested.

Inwardly, though, Maj. Hasan battled turmoil. He stewed over whether to remain in the Army, anti-war sentiments and the difficulty of being a Muslim in post-9/11 America.

But a former classmate said Maj. Hasan “made himself a lightening rod for things” and once gave a presentation in which he argued the war on terror was a war against Islam.

Family members, who said Maj. Hasan's actions were “despicable and deplorable,” thought he felt harassed because of his Muslim faith, but wasn't extremist in his views.

And neighbours who lived alongside Maj. Hasan in the $325-per-month rental units at his building, called Casa del Norte, said he never seemed pushy about his religion. They saw him on occasion in traditional Muslim dress – usually a white flowing robe and hat.

However, his behavioural patterns seemed to alter recently. Jose Padilla, the owner of the apartment complex, said Mr. Hasan gave him notice two weeks ago that he was moving out this week and refused to reclaim his deposit and last month's rent, surrendering $400 that he asked go to someone who needed it.

Earlier this week Maj. Hasan was obviously preparing to vacate his unit – neighbours saw him carting garbage bags to the communal dumpster and some made small-talk with him about an impending deployment to Afghanistan, although it was unclear when, exactly, he was slated to deploy.

He also began offering several neighbours Spanish-language copies of the Koran, including Ms. Veen, who told him she could not read it. On Wednesday, he knocked on her door with an English copy. That night, the apartment property manager, John Thompson, watched Maj. Hasan show up with his first-ever guest, another man in Muslim dress. But the visit seemed uneventful.

“They went up for five minutes and then they left,” he said.

Ms. Veen was the last to see him Thursday morning with her tamale exchange. She confirmed his instructions to clean his apartment on Friday, the day he told her he would deploy.

She knew that plan was off, she said, when the police showed up late Thursday. They confiscated the remaining contents of the apartment, the dumpster and a computer.

Colonel Kimberly Kesling, the medical chief of staff at the Darnall Army Medical Center on base, said that the shootings are “a hard pill for the soldiers here to swallow.

“When you go to theatre, the one thing you count on is that when you come home, you're safe,” she said.

Nothing about Maj. Hasan's behaviour at work recently set off alarm bells with staffers, said Colonel Kimberly Kesling, the medical chief of staff at the Darnall Army Medical Center on base.

“My personal experiences with him were that he was a very quiet, dedicated hard-working provider in my organization. I never would have thought he would have made these choices, she said, adding that she is aware soldiers who treat others with mental health issues do suffer from “burnout” themselves.

“Whether or not that is the case for him, we'll never know probably,” she said.

Nader Hasan, Maj. Hasan's northern Virginia-based cousin, says he has no idea why his cousin, Maj. Nidal Malik Hasan, allegedly committed the attack.

“We are all asking why this happened,” he wrote in an e-mail to The Associated Press. “And the answer is that we simply do not know.”

Many are still wondering whether Maj. Hasan's religious interpretations influenced him.

Soldiers on base reported hearing him shout “Allahu Akbar!” – an Arabic phrase for “God is great!” – before opening fire, according Lieutenant-General Robert Cone, the base commander.

The Muslim community in Killeen moved to distance themselves from Maj. Hasan. Manzoor Farooqi, a local pediatrician and head of the community centre, said Maj. Hasan was not well known among Muslims here, but many recognized his face when they were broadcast after the shootings.

Maj. Hasan began visiting the centre, a red-brick building on the highway outside Killeen, during the recent Ramadan celebration. While he worshipped dutifully, he did not make much of an effort to get to know the 30 or 40 regular members, many of whom are retired or active-duty soldiers.

“We haven't known this individual for long. He was quiet,” said Osman Danquah, the centre's treasurer, who began to sob while discussing the shooting. “It's just such a sad situation. Our hearts and our prayers go out to those who suffered so much.”

Many of the families who are grappling with death or injuries did so out of the public eye Friday. Access to the actual base, which is the largest active duty military training post in the U.S. with 50,000 military personnel and 150,000 family members and civilians, was tightly controlled. Extra guards were posted at entry gates to military housing developments to block media from entering and non-military vehicles were only allowed on the base, which stretches 340 square miles, with an escort.

With a report from The Associated Press