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On December 5, 2024, a leading publication published the front-page story “Insurance CEO Gunned Down In Manhattan”. The article went on to state that Brian Thompson was “shot in the back in Midtown Manhattan by a killer who then calmly departed the scene”. The daytime killing was indeed both cold and shocking. But numerous US citizens reacted differently: for those who faced insurance rejections or faced exorbitant healthcare costs, the news felt cathartic. Social media blew up. One post read: “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.”

Five days later, Luigi Mangione, a good-looking, 26-year-old University of Pennsylvania alumnus with a master’s in computer science, was apprehended at a McDonald’s in Altoona, Pennsylvania. He awaits trial on criminal counts of murder, with prosecutors seeking the death penalty. So who is Mangione? And what might have motivated the accused offense? These are the issues John H Richardson attempts to answer in an investigation that explores broader themes, too.

Understanding the Person

A writer for a major publication, Richardson spent years researching the communities that exist in the hidden parts of the internet, producing articles about people “cursed with realistic fears about an apocalyptic future”. 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 “emphasis on his own personal growth, both body and mind”. Additionally, Richardson analyzes his communications with influencers and authors as well as his many posts on social media. These original materials, meant to paint a portrait 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 trickster magic”. Throughout the book, Richardson attempts to cast his subject in archetypal terms.

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

The Meaning Behind the Crime

As for “the meaning” of the title, Richardson takes as his lead three words – “postpone”, “refuse” and “remove”, etched 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 indication Mangione had a chronic back condition, which could have been a reason for an attack, but discovers no confirmation; instead, what significance there is seems to lie in Mangione’s philosophical dread about the world around him, one where “the pace is quickening 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 ultimately either take control, or destroy us, or both.

Missing Pieces

Notably missing from the book are conversations with the principal actors. Richardson asked, of course, but did not anticipate time with Mangione himself. And his family made it clear that they had chosen not to talk to the press in advance of the trial. Another glaring gap is any detailed data about the deceased, Thompson, though we learn that under his leadership, from 2021 to 2023, UHC profits rose significantly.

Ambiguous Findings

By the conclusion, the audience has no clear understanding of Mangione’s personality or what might have motivated his alleged crimes. More troubling, Richardson’s obvious sympathy for him gives the reader the disturbing feeling of having been privy to a veiled endorsement of an assassination. In the book’s final lines, Richardson presents his fairytale assessment: “We’ve entered a time of fables, the mad king, the monster in the maze and the naked leader.” In that tale “Robin Hoods come with a appealing vow … They arrive in periods of unrest, when the population is in pain 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 ultimate sentence thrown out, any reference of fables, folk heroes, champions or villains will not be allowed in court in defence of this attractive individual with a “jawline … and lips … out of a Caravaggio painting” facing judgment for murder.