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On December 5, 2024, a leading publication 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 assailant who then calmly departed the scene”. The daytime killing was indeed both chilling and disturbing. But many Americans reacted differently: for those who had been denied health insurance or faced exorbitant healthcare costs, the news felt like a release. Online platforms erupted. One comment stated: “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 increase earnings 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 fast-food restaurant in Altoona, Pennsylvania. He awaits trial on criminal counts of murder, with the district attorney seeking the death penalty. So what is his background? And what might have motivated the accused offense? These are the questions John H Richardson seeks to resolve in an inquiry that delves into wider topics, too.

Understanding the Person

A writer for a major publication, Richardson spent years researching 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 arrested, Luigi had a list of nearly three hundred titles on a reading platform”. Their subject matter ranged from climate change to masculinity, along with a “emphasis on his own self-improvement, both body and mind”. Furthermore, Richardson sifts through his correspondence with online personalities and authors as well as his many posts on social media. These original materials, intended to depict a picture of Mangione, instead present him as an unclear character. Richardson attempts to explain this by proposing that “Luigi’s mystery, in fact, is what gives him a little of that old trickster magic”. Throughout the book, Richardson tries to frame his subject in symbolic roles.

Mangione is profoundly worried about the world around him, one where ‘change is rapid 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”, “deny” and “remove”, etched on the ammunition left behind at the crime scene. These are the terms sometimes used by medical insurers to deny coverage. He examines the evidence Mangione had a long-term spinal issue, which could have been a reason for an attack, but finds no proof; instead, what meaning there is seems to lie 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 ultimately either dominate, or eliminate humanity, or both.

Missing Pieces

Notably missing from the book are interviews with the key individuals. Richardson asked, of course, but did not anticipate access to Mangione himself. And his relatives made it clear that they had chosen not to talk to the media in prior to the trial. Another flashing-yellow omission is any detailed data about the victim, Thompson, though we learn that under his leadership, from the early 2020s, UHC profits increased by 33%.

Ambiguous Findings

By the conclusion, the audience has no clear understanding of Mangione’s character or what might have motivated his accused actions. Worse still, Richardson’s obvious sympathy for him creates the uncomfortable impression of having been privy to a subtle approval of an targeted killing. In the book’s closing remarks, Richardson delivers his fairytale assessment: “We’ve entered a era of stories, the insane ruler, the beast in the labyrinth and the naked leader.” In that fable “outlaw heroes come with a beautiful promise … They arrive in periods of unrest, when the population is in pain and everything is confusing anymore.”

One thing is certain: as Mangione’s legal representatives works to have charges that could lead to the ultimate sentence thrown out, any reference of myths, folk heroes, champions or monsters 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.