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On December 5, 2024, a major newspaper ran the headline “Insurance CEO Gunned Down In Manhattan”. The report 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 truly cold and shocking. But many Americans reacted differently: for those who had been denied health insurance or faced exorbitant healthcare costs, the news felt like a release. Social media blew up. One comment read: “All jokes aside … no one here is the judge of who should live or perish. That’s the job of the AI algorithm the insurance company designed to maximize profits on your health.”

Less than a week after, 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 faces court proceedings on federal and state charges of murder, with prosecutors seeking the capital punishment. So who is Mangione? And what drove the accused offense? These are the issues John H Richardson attempts to answer in an investigation that delves into wider topics, too.

The Making of a Subject

A journalist for Esquire magazine, Richardson devoted considerable time to studying the groups that exist in the hidden parts of the internet, producing articles about people “cursed with realistic fears about an end-times scenario”. To reveal “the making” of his subject, Richardson first reviews Mangione’s extensive reading. We learn that “[when] he was taken into custody, Luigi had a list of 295 books on Goodreads”. Their content covered climate change to masculinity, along with a “focus on his own self-improvement, both body and mind”. Furthermore, Richardson analyzes his communications with online personalities 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”. Here, as elsewhere, 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 uses as a clue three words – “delay”, “refuse” and “remove”, etched on the bullets 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 long-term spinal issue, which might have provided motive for an attack, but discovers no confirmation; instead, what significance there is seems to rest in Mangione’s existential anxiety 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 dominate, or eliminate humanity, or both.

Missing Pieces

Notably missing from the book are conversations with the principal actors. Richardson asked, of course, but never expected access to Mangione himself. And his family made it clear that they had chosen not to talk 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 guidance, from 2021 to 2023, UHC profits rose significantly.

Ambiguous Findings

By book’s end, the audience has little insight of Mangione’s character or what could have driven his alleged crimes. Worse still, Richardson’s apparent empathy for him creates the uncomfortable impression of having been exposed to a subtle approval of an targeted killing. In the book’s closing remarks, Richardson presents his mythical interpretation: “We’ve entered a time of fables, the mad king, the monster in the maze and the emperor without clothes.” In that fable “outlaw heroes come with a beautiful promise … They arrive in times of social turmoil, when the people are suffering and everything is confusing anymore.”

One thing is certain: as Mangione’s legal representatives works to have accusations that could lead to the death penalty thrown out, any reference of fables, folk heroes, heroes or villains will not be admissible as evidence in defence of this handsome young man with a “jawline … and lips … out of a Caravaggio painting” facing judgment for murder.