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By Katherine Fung
Senior Writer
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With a suspect in custody, online observers of the investigation into the shooting of UnitedHealthcare CEO Brian Thompson are turning to find a motive behind the killing and whether Luigi Mangione was driven by debilitating back pain that friends say he underwent surgery for recently.
On Monday, authorities identified Mangione as the suspect in last Wednesday's fatal shooting in New York City. The 26-year-old computer science graduate of the University of Pennsylvania was arrested at a McDonald's in Altoona, Pennsylvania, after an employee at the fast-food restaurant recognized him.
The developments come five days after Thompson was shot in front of a Hilton hotel in midtown Manhattan at around 6:45 a.m. Mangione was charged with forgery and gun charges during a court appearance in Pennsylvania late Monday. Online court records show that he's also been charged with murder in Manhattan.
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Moments after Mangione's identity was revealed by law enforcement, observers flooded his social media accounts to learn more about the suspect and potential reasons for the killing. Before Mangione was named, many had viewed the shooting as an expression of anger at America's health care system and insurance companies. Posts on his social media and new information from Mangione's friends seem to bolster those suspicions.
A Goodreads account belonging to Mangione showed that the suspect had at least six books related to chronic back pain on his bookshelf, including Back Mechanic, a popular book that has been widely praised for helping those suffering from back problems. The banner on Mangione's X (formerly Twitter) profile includes the image of an X-ray of a spine with hardware in it, likely from some sort of fusion. It is not clear if the image is of Mangione's spine.
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R.J. Martin, a friend of Mangione's, told The New York Times on Monday that when the two moved into a co-living community in Honolulu in 2022, Mangione had mentioned his back problems. He said he was hoping to get as healthy as possible before a major back operation that was scheduled.
"His spine was kind of misaligned," Martin said. "He said his lower vertebrae were almost, like, a half-inch off, and I think it pinched a nerve. Sometimes he'd be doing well and other times not."
During his time in Honolulu, Mangione's back pain was so debilitating that he could not surf and had to switch out his mattress, Martin said.
His friend also said that Mangione confided he wasn't in a relationship because "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," Martin said.
Martin confirmed that Mangione underwent spinal surgery in 2023 and that when he asked him how it went, his friend simply replied "long story" without elaborating. They had texted in April and discussed catching up on the phone but did not. Martin said he hadn't heard from Mangione since then.
About 21 percent of American adults, or 51.6 million people, live with chronic pain, according to a study released by the National Institutes of Health (NIH) last year. Chronic pain is also often referred to as a "silent killer" because of how disabling it can be for the many people who suffer from it and the link between chronic pain and the opioid epidemic.
"Chronic pain is pain that is experienced on most days or every day in the past three months; and [high-impact chronic pain] is pain that limits life or work activities on most days or every day during the past three months," the NIH said in a May 2023 release.
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