Image by Altoona Police Department

Ever since his name was publicized by law enforcement, the internet has furiously been poring over the online presence of 26-year-old Luigi Mangione, the suspected killer of UnitedHealthcare CEO Brian Thompson.

And while it quickly became clear Mangione had it out for the health insurance industry as a whole — from the words "deny," "defend" and "depose" written on shell casings recovered at the crime scene to a handwritten manifesto — we're only beginning to understand his personal motivations for the killing.

Now, as more information comes to light, a depressing profile is emerging: of an individual who felt that the healthcare industry had failed him as he struggled with debilitating back pain.

Whether Mangione was ever denied coverage by UnitedHealthcare in particular, a key aspect in the current conversation surrounding the many glaring shortcomings of the US health insurance industry, remains unclear.

But Mangione was reported missing by his family in November, following surgery on his back a few months prior. According to Reddit posts analyzed by CNN, possibly written by Mangione, he was suffering from spondylolisthesis, which involves a vertebra slipping out of place.

His condition worsened over time, especially following a surfing accident in Hawaii, causing "intermittent numbness" and leaving him "terrified of the implications." Pain left him reportedly bedridden for days.

A former housemate of Mangione named RJ Martin even told the New York Times that "he knew that dating and being physically intimate with his back condition wasn’t possible. I remember him telling me that, and my heart just breaks."

An X-ray of what appears to be his lower black still adorns Mangione's still public X-formerly-Twitter account.

The accident had Mangione "in bed for about a week" with back pain, Martin told CNN. "It was really traumatic and difficult, you know, when you’re in your early twenties and you can’t, you know, do some basic things."

Nonetheless, Martin said that Mangione didn't appear to have it out for the healthcare system, at least at the time.

"It wasn’t like he had an ax to grind or he was even upset or angry about a particular issue," he told CNN.

However, the case that the killing was closely related to Mangione's chronic pain is only growing as more information surfaces. For instance, Mangione had also reviewed several books about coping with chronic back pain on his Goodreads account.

The Reddit account identified by CNN also detailed struggles with "severe brain fog" and Lyme disease.

"It’s absolutely brutal to have such a life-halting issue," the user wrote. "The people around you probably won’t understand your symptoms — they certainly don’t for me."

In a January review of the manifesto written by Unabomber Ted Kaczynski, Mangione also described the domestic terrorist as an "extreme political revolutionary" despite being "rightfully imprisoned" for maiming "innocent people."

"These companies don't care about you, or your kids, or your grandkids," he wrote in the review, referring to the fossil fuel industry. "They have zero qualms about burning down the planet for a buck, so why should we have any qualms about burning them down to survive?"

"Peaceful protest is outright ignored, economic protest isn't possible in the current system, so how long until we recognize that violence against those who lead us to such destruction is justified as self-defense," he wrote.

Something clearly caused Mangione to drop off the internet about six months ago, at least under his real name.

Roughly half a year after posting the review, an X user tweeted at Mangione, saying that "I haven’t heard from you in months."

"You made commitments to me for my wedding, and if you can’t honor them I need to know so I can plan accordingly," the user wrote.

More on Mangione: Suspected Insurance CEO Assassin Manifesto Starts to Trickle Out


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