43-year-old Derrick Carter of Lansing was clearly agitated and uncooperative during the hearing.
He was supposed to be arraigned via video link, but continuously yelled at the camera.
The judge couldn't understand him or get him to answer his questions, so he paused the arraignment.
Carter's wife, Jessica, was in the courtroom. She was in tears as soon as her husband came up on the screen.
The judge spoke to her after she yelled about Carter's mental health.
She asked me not to show her face, but told me what happened leading up to the incident.
"He was just not himself. He was making statements that did not sound normal to us. He was a strong, spiritual man and he made statements like he wanted to be with God. Mid-Michigan Physicians was not a target. He was in the middle of a mental health crisis. We were trying to get him help, it was just a little bit too late," Jessica Carter explained.
Carter told me she was on her way to St. Lawrence Hospital with her husband to get help Wednesday morning.
But, his mom called asking for her medication and Derrick thought that meant he needed to re-fill his medication, which he does at Mid-Michigan Physicians. And, that's when the crash happened.
Mrs. Carter also told us she sends her thought and prayers to the victims' families.
Both are still in critical condition tonight.