After Luigi Mangione made the difficult decision to undergo spinal surgery last year for chronic back pain, he became a proponent of the procedure that changed his life for the better.
He repeatedly posted on Reddit about his recovery and offered words of encouragement for people with similar conditions, telling them to push back against doctors who suggested they had to live with pain.
But notably absent from the posts are explicit concerns about corporate greed in the health insurance industry. Those appear to have surfaced only later: in a handwritten note found after Mangione was detained as a suspect in the killing of UnitedHealthcare CEO Brian Thompson.
That short document references “parasites” in the health care system and laments the power and profits of health insurers, according to law enforcement officials. During his first public words since his arrest in Pennsylvania, Mangione emerged from a patrol car shouting about an “insult to the intelligence of the American people” while sheriff’s deputies pushed him into a courthouse.
There’s no indication Mangione was ever insured by UnitedHealthcare, a senior New York City police official said in an interview Thursday with NBC New York.
The killing has nonetheless prompted widespread speculation about whether he had a bad personal experience with the health care system. But after his 2023 surgery, Mangione’s Reddit posts suggest he was overwhelmingly pleased with the outcome and finally relieved of chronic pain. He encouraged others not to be frightened by horror stories of surgeries gone bad. He also referenced a backpacking trip to Asia earlier this year.
The 26-year-old Ivy League graduate appears to have stopped posting on social media roughly six months ago, around the time he lost touch with loved ones.
Family and friends expressed shock at news of Mangione’s arrest, but little information has emerged about his recent mental and physical health.
Mangione’s Reddit posts reference a spinal condition called spondylolisthesis, which occurs when a fracture causes a vertebra to slip out of alignment. It can result in severe pain if the bone puts pressure on spinal nerves.
The condition, which can originate in childhood or from an injury, started negatively impacting Mangione’s life in recent years, according to his social media posts.
After earning his bachelor’s and master’s degrees from the University of Pennsylvania, he worked at the Santa Monica-based car-buying website TrueCar until 2023 and lived in Hawaii for some time starting in January 2022. During a six-month stay at Surfbreak, a “co-living” space in Honolulu, Mangione’s back pain worsened in part because of a surfing incident.
Josiah Ryan