A doctor-turned-killer was sentenced to death Friday afternoon. 

Anthony Garcia was convicted in 2016 of killing four people connected to Creighton University's School of Medicine. 

Prosecutors say Garcia killed a Creighton professor and his wife, as well as another professor's son and a housekeeper. 

Prosecutors say the killings were motivated by revenge, after the professors fired Garcia from Creighton's pathology program in 2001. 

There was a dramatic pause during the conviction proceedings as one of the judges on the panel said he was experiencing pain and needed a break. 

Judge Gary Randall was reading through the details of the decision about 2:15 p.m. when he told the court he was experiencing pain and could not continue. He was taken from the courthouse in an ambulance.  

Consistent with his behavior throughout the course of his trial, Garcia remained slumped over to one side, appearing to be sleeping or pretending to sleep, as the judge read the details of his sentence.