CHARLESTON, W.Va. -- Dr. Bruce Foster believed death was an end to physical suffering and specialized in helping his terminally ill patients overcome their fear of it. He lightly referred to death as "graduating."

Detectives continue to investigate what led Foster, 63, to apparently shoot his wife, Marlise, 64, and then himself Monday at their home along Flairwood Drive in Cross Lanes.

Cpl. Brian Humphreys, of the Kanawha County Sheriff's Department, said Tuesday detectives are tracing who owns the revolver used in the apparent murder-suicide.

The couple each were killed by one gunshot to the head. Detectives found the revolver in Foster's hand. There wasn't a suicide note or anything like it found, Humphreys said.

"Investigators are not releasing the possible motives at this time as the investigation is ongoing," Humphreys said.

Neighbors said the couple, although private, appeared to be very much in love and never showed signs of fighting or violence. A neighbor and co-workers found Foster's arm draped over his wife's body after not hearing from him since Saturday.

Bruce Foster was chairman of ethics at Thomas Memorial Hospital. Marlise Foster managed his office.

Ernest Trent, a former patient and friend, said Bruce always talked fondly of Marlise, but never discussed her ongoing health problems. Neighbors said she suffered from kidney trouble, had only one kidney for most of her life, and had been ill for the past couple of months.

Trent, 61, of St. Albans, believes Foster wanted to help his ill wife "graduate" from her pain and suffering.

Trent met Foster about four years ago because his father, Raymond Trent, was also his patient. He remembered him as a jolly doctor who was always laughing and decorating his South Charleston office with cartoons and humorous quotes.

Foster helped Ernest Trent with his ongoing diabetes complications and later when the elder Trent's health worsened.

"He was real good to my dad. He would say, 'Ray, when it's time to graduate you let me know,'" Trent said. "Dad kind of looked at him, and [Foster] said, 'You know what I'm talking about, don't you, Ray? I don't want you to suffer.'"

Later, Foster asked Ernest Trent to appear in his DVD "Facing Your Future," a tool to help grieving families and those making end-of-life decisions.

Trent said he talked about his elderly father and his stepson, who died in 2000 after being stuck by a vehicle. He urged families to be realistic when it comes to end-of-life decisions and to not dwell on grief.

"When you feel you've done all you can do, it's time to let go," he said.

Raymond Trent died in 2011.

"By me sharing my experience with the doctor and my personal relationship with him, when Daddy did pass, it was easier on me," Ernest Trent said. "I had already relinquished the pain in myself and began healing before he passed away."

Trent said he was shocked by the Fosters' deaths and never would have suspected that Bruce Foster would commit suicide.

"You never got that indication whatsoever ... that he could do something like [it]," Trent said.

Officials at Thomas Memorial Hospital released a statement Tuesday about the Fosters' deaths.

"Dr. Foster volunteered at Thomas as the chair of the Ethics Committee for 19 years. During that time, he helped patients, families and health-care providers resolve medical decision conflicts with a balance of compassion and candor," said spokeswoman Paige Johnson. "Our thoughts and prayers are with their families and friends, his patients and his office staff during this most difficult time."

Foster's office was in South Charleston, near the hospital.

Reach Travis Crum at travis.c...@wvgazette.com or 304-348-5163.