Back problems, brain fog bothered suspect in UnitedHealthcare CEO's killing, his posts show

After Luigi Mangione After making the difficult decision to undergo spinal surgery last year for chronic back pain, he became an advocate for the procedure that changed his life for the better.

He posted repeatedly on Reddit about his recovery and offered words of encouragement to people suffering from similar conditions, telling them to push away doctors who suggested they had to live with pain.

But notably absent from the messages are explicit concerns about corporate greed in the health insurance industry. That information appears to have surfaced only later: in a handwritten note found after Mangione was arrested as a suspect in the murder of UnitedHealthcare CEO Brian Thompson.

This short document refers to “parasites” in the health care system and deplores the power and profits of health insurers, according to law enforcement officials. In his first public words since his arrest in Pennsylvania, Mangione got out of a patrol car shouting “an insult to the intelligence of the American people” as sheriff’s deputies pushed him into a courthouse.

There is no indication that Mangione was ever insured by UnitedHealthcare, a senior NYPD official said in a statement. interview Thursday with NBC New York.

The murder nevertheless prompted widespread speculation to know if he had a bad personal experience with the healthcare system. But after his surgery in 2023, Mangione’s posts on Reddit suggest he was extremely happy with the result and finally relieved of his chronic pain. He encouraged others not to be scared by horror stories about surgeries gone wrong. He also referenced a backpacking trip to Asia earlier this year.

THE Ivy League graduate, 26 years old appears to have stopped posting on social media about six months ago, around the time he lost contact with his loved ones.

Family and friends have expressed shock at news of Mangione’s arrest, but little information has been released about his recent mental and physical health.

Mangione’s Reddit posts refer to a spinal condition called spondylolisthesis, which occurs when a fracture causes a vertebra to become misaligned. This can cause severe pain if the bone puts pressure on the spinal nerves.

The condition, which can stem from childhood or injury, began to negatively impact Mangione’s life in recent years, according to his social media posts.

After earning his bachelor’s and master’s degrees at the University of Pennsylvania, he worked until 2023 at the Santa Monica-based car shopping site TrueCar and lived for a time in Hawaii starting in January 2022. During a six-month stay at Surfbreak, a co-living space in Honolulu, Mangione’s back pain worsened in part due to a surfing incident.

Josiah Ryan, a spokesman for Surfbreak owner and founder RJ Martin, said Mangione expressed growing concerns about the pain. In addition to lacking recreational activities and exercise, he worried about how it might affect romantic relationships.

“That was definitely a theme during his time there,” Ryan said. “He wasn’t a big complainer. So it wasn’t like he was constantly talking about it. But those who knew him knew it was an important part of his life.

In July 2023, Mangione wrote in a Reddit post that he had decided to have surgery.

“I was stuck in this loop for a year, putting my life on hold in my 20s and damaging my nerves while I vacillated over the decision. I have surgery scheduled in two weeks and I still wonder why I was so afraid of it,” he wrote.

According to his publications, the operation was a success.

An image posted to an X account linked to Mangione showed what appeared to be an X-ray of a metal rod and several screws inserted into his lower spine.

“The surgery was painful the first two days, but I was shocked to find that by the seventh day I was literally not taking any pain medication,” Mangione said on Reddit in August 2023. “Obviously it will take a while before I embarked on any rigorous activity, but it was much less serious than I expected.

Medical experts say treating back pain is almost always a challenge.

“In the vast majority of treatments, surgery comes when all else has failed to provide relief,” said Dr. Jason Pittman, co-director of the Spine Center at Beth Israel Deaconess Medical Center in Boston. He said doctors usually try conservative treatments like physiotherapy, injections or medications before surgery.

Even people with health insurance can face thousands of dollars in bills following surgery depending on their deductible and other factors, although it is unclear whether Mangione has met any of these problems.

Chronic back pain can also have a significant impact on mental health, said Dr. Padma Gulur, a pain specialist at Duke Health.

“If you have underlying mental health issues — anxiety, depression — your pain may be worse because you’re in a lot more pain,” Gulur said. “But the second aspect is that pain can push you into anxiety and depression.”

Fingerprints and shell casings from the scene of a CEO’s murder in New York have now been directly linked to suspect Luigi Mangione. (CNN, WJAC, WABC, MORE)

Little is known about Mangione’s mental state in recent months, but it appears that he was withdrawing from intimate relationships. Since-deleted messages on X show a friend reaching out repeatedly and getting no response.

Her family reported her missing to San Francisco authorities in November, police said.

Earlier, while in college, Mangione posted on Reddit about severe brain fog and restless sleep.

In a July 2018 post, he said his grades were falling and he considered dropping out of school. But ultimately, “staying in college at least allowed me to maintain some semblance of normalcy,” he writes.

His last Reddit post was dated May 17, but other statements around that time suggest he was not suffering from unexpected complications or new back pain. He appears to be advocating for the type of surgery he underwent months earlier.

He posted in early April about the gear he took on a two-month backpacking trip through Asia that included motocross, saying he found “the perfect balance between minimalism and practicality.

In late April, he advised another Reddit user suffering from back problems to “keep trying different surgeons” and, if necessary, to communicate their inability to continue working.

“We live in a capitalist society,” he writes. “I have found that the medical industry reacts to these keywords much more urgently than you describing unbearable pain and its impact on your quality of life.”

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Kelleher reported from Honolulu. Skene reported from Baltimore. Associated Press writers Tom Murphy in Indianapolis and Devi Shastri in Milwaukee contributed to this report.