(AP Photo/California Department of Motor Vehicles)
Could he have been the same person, neighbors wondered, who showed up 20 miles away at Long Beach Memorial Medical Center on Thursday, shot his two bosses to death and then, scorning the terrified pleas of co-workers, put his gun to his head and killed himself?
There were conflicting reports about whether the 50-year-old pharmacy technician was worried about losing his job, but no one at the sprawling medical campus or in Ramirez's tidy neighborhood just east of Los Angeles seemed to see the deadly outburst coming.
"The main unanswered question that everybody wants to know is what is the motive," Long Beach police spokeswoman Nancy Pratt said. "To be quite honest, we're not sure if we will ever determine a motive in this case."
Police were interviewing scores of witnesses to the shooting, and Pratt said she wasn't sure how long it would take to complete the investigation.
(AP Photo/Damian Dovarganes)
The hospital laid off some workers last month, but spokeswoman Stacie Crompton-Hime said no further layoffs were planned. Still, hospital employees say there had been rumors of more layoffs, and it wasn't clear if Ramirez knew his job was secure.
Bustamante, who ran the pharmacy department, had been depressed himself in recent weeks at the prospect of having to let some of his employees go. But he brightened two weeks ago when he found a way to save their jobs, said Della Smith, a friend who works as a nurse at another hospital.
"He was so excited because he had figured out a way to cut costs by changing the scheduling," Smith told the Long Beach Press-Telegram. "He told me he wasn't going to have to lay off anyone after all.
"That's the thing that really hurts," she said.
Ramirez's co-workers and neighbors recalled him as a friendly, happy-go-lucky family man. Co-worker Melo Dotski said his good humor reminded her so much of comedian George Lopez that she nicknamed him George, something he seemed to enjoy.
Ramirez's home in Alhambra is one of three small, flat-roofed bungalows strung along a driveway intersecting a street that during the day is filled with children playing and riding bikes. Someone placed candles by the front steps Friday.
Ramirez's 14-year-old son, Aaron, poked his head out of the door briefly to say softly that the family did not want to speak to a reporter. The boy had spent part of the night before outside on the step, crying and asking what happened to his father.