"An american giallo" is the best possible description, and I was extremely pleased with this one.

Atmospheric and violent, this film traces the exploits of a med student who witnesses his sister's death
(as a child) at the start of the film.

This is apparently all he needed to go on a murderous rampage, but there's style to spare in this senseless
horror film filmed largely in my state (Texas).

Side Note: The ending is quite masterful, as subtle as it happens to be. 7/10 from me.