What Luigi Mangione Has Revealed About Himself on Notes

Credit...Rachel Wisniewski for The New York Times

 

By James Barron

The New York Times

Good morning. It’s Wednesday. Today we’ll look at what’s known about Luigi Mangione, the suspect in the murder of a health care executive outside a Manhattan hotel. We’ll also get details on the city’s plan to close a shelter to head off concerns that it could be targeted by the Trump administration.

ImageSeveral officers, one in a jacket with the word “sheriff” on the back, walk Luigi Mangione, in an orange jumpsuit with his back turned, into a courthouse.

Despite a torrent of information that surfaced about the suspect in the murder of an insurance executive on a street in Midtown Manhattan, questions about the motives remained largely unanswered. But some hints came in the 262-word manifesto that the suspect, Luigi Mangione, was carrying when he was taken into custody in Pennsylvania — and in an internal report from the New York Police Department.

Mangione is fighting extradition to New York from Pennsylvania, which could leave him in custody there for weeks. He struggled against officers leading him to the courthouse in Hollidaysburg, Pa., near Altoona, for a hearing on Tuesday. He shouted at reporters before he went into the building. On his way out after the hearing, he was silent. 

“He views himself as a hero of sorts,” the police said. According to my colleague Chelsia Rose Marcius, the police “intelligence analysis report” said that the suspect considered himself a hero fighting a “parasitic” health insurance industry. Mangione did not explain why he had allegedly singled out Thompson, the chief executive of UnitedHealthcare.

But the police analysis said that the suspect had “appeared to view the targeted killing of the company’s highest-ranking representative as a symbolic takedown.”

The police report also referred to Mangione’s other complaints in the manifesto. Mangione wrote that health care in the United States was expensive and that corporate profits had risen, while “our life expectancy” had not.

He posted about continuing health issues. On Reddit, Mangione described back problems. Some of his posts appeared in a Reddit community about spondylolisthesis, a sometimes painful condition that occurs when a vertebra in the spine slips out of alignment.

He wrote that back pain, once a minor issue in his life, became more extreme in 2022 — the year he turned 24 — after he went surfing. The pain worsened still more a few weeks later, when he slipped on a piece of paper. He said that sitting down hurt and that his leg muscles had become twitchy. An X-ray that he posted on another social media account showed a spinal fusion. 

An operation for that problem in July 2023 seemed to make a difference. “The surgery wasn’t nearly as scary as I made it out to be in my head,” he wrote in one Reddit post, “and I knew it was the right decision within a week.” He said that he was comfortable sitting down, standing up and moving about — so comfortable that he had stopped taking pain medication.

Back pain was not his only struggle. At times he wrote about “brain fog,” which he said became so troubling during his college years that studying was difficult. He said that doctors could not figure out what was causing it.

 

He made only one mention of insurance coverage. He said on Reddit that Blue Cross Blue Shield had covered a test for irritable bowel syndrome in 2018. That would have been when he was a student at the University of Pennsylvania. The school said he graduated in 2020 with bachelor’s and master’s degrees in engineering.

He had worked for a nursing home network. The company, Lorien Health Services, said that he worked as an IT technician for a month in 2015 and performed community service work as a volunteer before that. My colleague Amy Qin writes that Lorien has a dozen facilities in Maryland and is owned by Mangione’s relatives.

He echoed the Unabomber. The police analysis noted that Mangione’s manifesto cited Ted Kaczynski, who killed three people and wounded 22 with pipe bombs mailed to scientists and executives, as sharing “the need for unilateral action to bring attention to abusive corporate actions.” 

Mangione wrote about Kaczynski and discussed him with a writer in England this past spring. The writer, Gurwinder Bhogal, said that Mangione had mentioned health care only briefly, complaining that it was too expensive in the United States. According to my colleague Jacey Fortin, Mangione said he admired the national health care system in Britain.

The investigation appears to be continuing. Even after Mangione was apprehended, the authorities continued trying to retrace his steps. People who work at the Greyhound bus terminal in Pittsburgh said that an investigator had asked for surveillance footage that might show Mangione passing through.