Russell didn’t see the doctor but still attacked the military clinic, killing five fellow service members with an M-16 rifle he seized from a soldier who was guarding him.

Why did he commit the act of fratricide on May 11, 2009, during his third Iraq deployment?

“I was finished fighting,” he said Monday in court at Joint Base Lewis-McChord. “I didn’t want to live anymore. I wished someone would put a bullet in my head.”

Russell, 48, is nearing the end of the Army’s four-year effort to bring him to trial for the killings. He pleaded guilty Monday to murdering Navy Cmdr. Charles Springle and the Army’s Maj. Matthew Houseal, Sgt. Christian Bueno-Galdos, Spc. Jacob Barton and Pfc. Michael Yates Jr.

His plea deal spares his life. The Army agreed to drop the death penalty charges it filed against him in exchange for his guilty plea.

But the case has one more hurdle before Army judge Col. David Conn can sentence Russell. The soldier refused to plead guilty to murdering the service members “with premeditation,” instead contending he lost control of his emotions while seeking help for distress.

Prosecutors want to convict him of murder with premeditation, increasing the likelihood that Russell would receive his plea agreement’s maximum punishment of a life sentence without the possibility of parole. Attorneys are due back in court May 6 to argue the rest of the case.

In court Monday, Russell spoke in a husky, dispassionate voice when he recollected the killings and described his state of mind.

He read a written a statement, detailing how he moved through the combat stress clinic at Baghdad’s Camp Liberty, slaughtering anyone he came across.

“What I remember most is I just wanted to kill myself,” he said.

Russell’s even tone contrasted with the emotions the families of his victims showed in court. Yates’ mother joined Springle’s wife and son in the courtroom. They held each other tightly as Russell talked about killing their loved ones.

Russell remembered that Yates raised a gun at him after Russell had already killed Houseal and Springle. Yates dropped the weapon and ran away.

Yates ran, “and I ran after him and I shot him,” Russell said.

Yates’ mother, Shawna Van Blargan, cried out when Russell described killing her son. She left the courtroom twice to gather herself.

Russell recalled finding Barton hiding under a table. Russell shot him in the head.

Bueno-Galdos tried to grab Russell’s rifle. Russell shot him in the chest, and then shot him once more while he lay face down on the ground.

Russell had worked mostly by himself at a desk job for the previous 11 months, isolating himself from others who might have noticed his unraveling.

His assignment changed in early May, compelling him to work with more soldiers. He tried to discipline one of them. He said she responded by threatening to file an equal opportunity complaint against him.

The prospect of a complaint made Russell feel other soldiers had created “a conspiracy” to drive him out of the Army. In the following days, he began swearing at officers. He told a chaplain he wanted to kill himself.

Russell recognizes now that he was suffering from severe depression and post-traumatic stress disorder. He has since been diagnosed with both ailments.

He first visited a combat stress clinic at Camp Stryker in Baghdad. A senior officer treated him rudely, ignoring his distress and telling him he had an anger management problem.

“I was so upset after that meeting that I went outside and threw up,” Russell said.

A lower-ranking officer recognized Russell was mistreated and steered him to the clinic at Camp Liberty. He met Springle and had a fairly positive interaction with him.

He returned the next day and had a hostile one with psychiatrist Lt. Col. Michael Jones. Russell left believing Jones wanted Russell to take his own life.

Russell’s military escort drove them for 40 minutes back to their headquarters at Camp Stryker. Russell took the guard’s rifle and forced the escort to give him the keys to the truck.

He testified that he wanted to pull over and kill himself, but he could not find a secluded place to do it. He parked at the Camp Liberty stress clinic. Houseal was his first victim.