Luigi Mangione was living an ideal life until a spinal condition requiring surgery brought him significant hardship, potentially fostering resentment toward the healthcare and insurance industries.

Luigi Mangione, 26, was arrested on December 9 in Altoona, Pennsylvania, five days after fatally shooting Brian Thompson, the CEO of UnitedHealthcare, one of America’s leading health insurance companies.

The incident has shocked the public, but the true motive behind Mangione's actions remains a major question. At the crime scene, police found three bullet casings inscribed with the words "deny," "defend," and "depose"—phrases associated with the insurance industry. Investigators suspect Mangione may have held personal grudges against Thompson or the U.S. health insurance system. A deeper look into Mangione’s medical history suggests a life-altering event two years ago may have completely transformed him, potentially fueling his anger toward the American healthcare and insurance system.

A Privileged Background

Mangione was born into a prominent Baltimore family and lived a life of privilege. His grandfather, Nick Mangione, who passed away in 2008, was a successful real estate developer. The family purchased the Hayfields Country Club in Baltimore in 1986 and has a history of charitable giving.

One of Mangione’s relatives is a Maryland state legislator. He attended elite schools and delivered the valedictory address at his graduation from Gilman School, a prestigious private high school.

Mangione graduated with honors in computer science from the University of Pennsylvania, an Ivy League school, in 2020. He was physically fit, pursued programming in college, and dreamed of becoming a video game developer.

The Turning Point

Mangione’s promising future took a turn when he moved to Surfbreak, a co-living community in Honolulu, Hawaii, in early 2022. Co-living offers private bedrooms in shared homes with communal spaces, catering to young professionals and remote workers.

R.J. Martin, founder of Surfbreak, vetted Mangione’s background before admitting him and found no red flags. "Luigi was seen as a great guy with no complaints against him," said Josiah Ryan, Surfbreak’s spokesperson. "There was nothing to suggest he would become a killer."

However, Martin later learned Mangione suffered from chronic back pain stemming from spondylolisthesis, a condition where spinal vertebrae slip out of place. This condition worsened after Mangione attempted surfing, leaving him bedridden for a week.

Mangione’s Reddit posts described his back pain and the emotional toll it took, including feelings of "fear and despair" after the incident. Martin recalled Mangione expressing frustration over his spinal condition, which had progressed to the point where even basic activities were challenging.

"He couldn’t even engage in intimate relationships because of the pain," Martin said. "I remember him telling me that, and it broke my heart."

After six months at Surfbreak, Mangione left Hawaii but eventually returned before relocating to the mainland U.S. in the summer of 2023 for spinal surgery. In July, a Reddit user matching Mangione’s profile shared that surgery had alleviated some symptoms. He sent Martin an X-ray of his spine, which showed metal implants. When Martin asked about his condition, Mangione replied, "It’s a long story. I’ll explain in person when I return to Hawaii."

A Growing Resentment Toward the System

On Reddit, Mangione expressed frustration with the American healthcare system, advising patients to use specific language to secure surgery approval. He suggested claiming they were unable to work, as this seemed to prompt quicker responses than merely describing pain.

Friends say the spinal surgery was a catalyst for a significant change in Mangione’s demeanor. According to a source who knew his high school peers, the operation "changed everything" for Mangione and left him "completely unhinged."

The Crime

Mangione’s resentment reportedly escalated to hatred toward the healthcare and insurance industries. When arrested, he carried forged identification, a gun with a silencer, and a handwritten three-page letter explaining his motives. In the letter, he accused insurance companies of exploiting Americans for profit, labeling employees like Thompson as "parasites." He criticized the U.S. healthcare system as the most expensive in the world while failing to improve life expectancy.

Mangione seemingly viewed the murder of Thompson as a symbolic act against "corruption and power games" in the healthcare sector, portraying himself as the first to confront these injustices "brutally and directly."

Psychological Insights

Experts emphasize that chronic pain and dissatisfaction with the healthcare system cannot justify violence. Dr. Afton Hassett of the University of Michigan notes that frustration with treatment options can be overwhelming for patients but stresses that this does not excuse violent actions.

Robert Kerns, a senior scientist at Yale School of Medicine, adds that individuals with chronic pain often experience higher rates of mental health issues, such as depression and anxiety, which may exacerbate feelings of isolation and anger.

Unanswered Questions

It remains unclear what transpired with Mangione after his surgery, including any disputes over medical bills or insurance claims. However, those who knew him agree that this was the turning point that derailed the life of a promising young man, ultimately leading to tragedy.

(Sources: Telegraph, Daily Beast, AFP, Reuters)

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