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On December 5, 2024, a leading publication ran the front-page story “Insurance CEO Shot Dead In Manhattan”. The article then noted that Brian Thompson was “shot in the back in Midtown Manhattan by a killer who then calmly departed the scene”. The daytime killing was truly chilling and disturbing. But many Americans had a different response: for those who faced insurance rejections or faced exorbitant healthcare costs, the news felt cathartic. Online platforms erupted. One comment stated: “All jokes aside … no one here is the judge of who deserves to live or die. That’s the job of the AI algorithm the insurance company created to maximize profits on your health.”

Less than a week after, Luigi Mangione, a good-looking, twenty-six-year-old University of Pennsylvania alumnus with a graduate degree in computing, was arrested at a fast-food restaurant in Altoona, Pennsylvania. He faces court proceedings on criminal counts of murder, with prosecutors seeking the death penalty. So what is his background? And what might have motivated the alleged crime? These are the issues John H Richardson seeks to resolve in an investigation that delves into wider topics, too.

Understanding the Person

A journalist for Esquire magazine, Richardson spent years researching the groups that lurk in the dark corners of the internet, writing stories about people “cursed with realistic fears about an end-times scenario”. To reveal “the making” of his subject, Richardson first examines Mangione’s extensive reading. We learn that “[when] he was arrested, Luigi had a list of nearly three hundred titles on a reading platform”. Their subject matter covered climate change to masculinity, along with a “focus on his own personal growth, both body and mind”. Furthermore, Richardson analyzes his correspondence with influencers and authors as well as his many posts on digital networks. These original materials, intended to depict a picture of Mangione, instead present him as an unclear character. Richardson attempts to explain this by suggesting that “Luigi’s elusiveness, in fact, is what gives him a little of that old deceiver’s charm”. Throughout the book, Richardson tries to frame his subject in archetypal terms.

Mangione is deeply anxious about the world around him, one where ‘everything is accelerating whether we like it or not’

Interpreting the Incident

As for “the meaning” of the title, Richardson uses as a clue three words – “postpone”, “deny” and “remove”, engraved on the ammunition left behind at the crime scene. These are the terms occasionally employed by health insurance companies to deny coverage. He looks at the evidence Mangione suffered from a long-term spinal issue, which could have been a reason for an attack, but finds no proof; instead, what significance there is seems to lie in Mangione’s philosophical dread about the world around him, one where “everything is accelerating whether we like it or not, sliding faster and faster to the edge”; a world where the general belief seems to be that AI is going to eventually either take control, or eliminate humanity, or both.

Missing Pieces

Conspicuous by their absence from the book are interviews with the principal actors. Richardson made requests, but never expected time with Mangione himself. And his relatives made it clear that they had decided against speaking to the media in prior to the trial. Another glaring gap is any detailed data about the victim, Thompson, though we learn that under his leadership, from 2021 to 2023, UHC profits increased by 33%.

Unclear Conclusions

By the conclusion, the reader has little insight of Mangione’s personality or what could have driven his alleged crimes. Worse still, Richardson’s apparent empathy for him gives the reader the disturbing feeling of having been exposed to a veiled endorsement of an assassination. In the book’s closing remarks, Richardson presents his fairytale assessment: “We’ve entered a era of stories, the insane ruler, the beast in the labyrinth and the emperor without clothes.” In that tale “outlaw heroes come with a appealing vow … They arrive in periods of unrest, when the people are suffering and nothing makes sense anymore.”

One thing is certain: as Mangione’s defence team continues in its attempts have charges that could lead to the death penalty thrown out, any mention of fables, Robin Hoods, champions or monsters will not be admissible as evidence in support for this handsome young man with a “jawline … and lips … out of a Caravaggio painting” soon to be on trial for murder.